http://hdl.handle.net/11671/680 2021-05-04T22:13:20Z http://hdl.handle.net/11671/687 HIV Sero-behavioural Study in Six Universities in Uganda Lake Victoria Basin Commission 2010-01-01T00:00:00Z http://hdl.handle.net/11671/686 HIV Sero-behavioural Study in the Fishing Communities along Lake Victoria in Uganda Lake Victoria Basin Commission The survey fieldwork was conducted in forty six fishing communities of the Lake Victoria Basin of Uganda in August 2010. The main aim was to establish HIV prevalence among fishing communities, the associated drivers of risk and vulnerability; and the effectiveness of HIV and AIDS response. The survey methods consisted of individual interviews, focus group discussions and key informants interviews. A desk-review was conducted to document HIV service availability and utilization, as well as institutional policies and structures for the coordination and delivery of HIV services. Laboratory testing for HIV was conducted both in the field and at central level. A total of 911 women and men aged 15-59 years were randomly selected and interviewed by four fieldwork teams. Of the 911 respondents, 559 (61 percent) are men and 352 (39 percent) are women. Each fieldwork survey team consisted of 4 interviewers, 1 counselor, 1 laboratory technician and 1 supervisor. Before the main survey, a pretest was carried out. All respondents provided written consent before the interviews and blood draw. The survey protocol was approved by the Science and Ethics Committee of the Uganda Virus Research Institute; and cleared by the Uganda National Council for Science and Technology. Data was captured using EPIINFO following a double data entry strategy. Main findings HIV prevalence and risk factors for HIV infection: Twenty two percent of the surveyed fishing community members are infected with HIV; HIV prevalence among women is higher (25.1 percent) than among men (20.5 percent).HIV prevalence is highest among widows/widowers (40 percent) followed by that among divorced people (32 percent). Furthermore, HIV prevalence is highest among respondents who had their first sex before the age of 15 years; where it is 36 percent in women, 21 percent in men and 30 percent in both women and men. HIV prevalence is higher among those respondents who engaged in higher risk sex compared to those who did not do so. Additionally HIV prevalence is higher among respondents who reported three or more lifetime sexual partners, compared to those who reported one or two lifetime sexual partners. Overall, HIV prevalence is higher among uncircumcised men and respondents with STI than in circumcised men and respondents without STI, respectively. HIV prevalence is 11 percent in circumcised men and 27 percent in uncircumcised men. Furthermore, among men with STI, HIV prevalence is 10 percent in circumcised men and 34 percent in uncircumcised men. Among men without STI, HIV prevalence is 12 percent in circumcised men and 25 percent in uncircumcised men. Source of HIV information: Radio is the commonest source of HIV/AIDS information and education. Of all information acquired on HIV prevention methods, limiting sex to one partner is perceived as the most important information acquired from the radios. 2010-01-01T00:00:00Z http://hdl.handle.net/11671/685 HIV Sero-behavioural study in Agricultural Plantations in Lake Victoria Basin, Uganda Lake Victoria Basin Commission Background, aim and survey methods The survey was conducted in four agricultural plantations of the Lake Victoria Basin of Uganda between April and May 2010. The main aim was to establish HIV prevalence among plantation workers, the associated drivers of risk and vulnerability; and the effectiveness of HIV and AIDS response. The survey methods consisted of individual interviews, focus group discussions and key informants interviews. A desk-review was also conducted to document HIV service availability and utilization, as well as institutional policies and structures for the coordination and delivery of HIV services. Laboratory testing for HIV was also conducted both in the field and at central level. A total 1432 women and men aged 15-59 years were interviewed by four fieldwork teams; of these, 1,072 (75%) are men. About two thirds of the respondents are aged 20-39 years.. Each team consisted of 4 interviewers, 1 counselor, 1 laboratory technician and 1 supervisor. Before the main survey, a pretest was carried out. All respondents provided written consent before the interviews. The survey protocol was approved by the Sicience and Ethics Committee of the Uganda Virus Research Institute; and cleared by the Uganda National Council for Science and Technology. Data was captured using EPIINFO following a double data entry strategy. Main findings About seven percent of the plantation workers are infected with HIV; HIV prevalence among women is higher (13.4%) than among men (4.5%). Of the 4 plantations, Kaweri has the highest HIV prevalence (8.3%) while Tilda has the lowest (5.1%). Across all the 4 plantations, HIV prevalence is highest among widows/widowers (28.6 percent) followed by that among divorced people (14.2 percent). HIV prevalence is highest among respondents with higher number of living children. Knowledge of single HIV prevention methods is widespread among plantation workers and is similar among women and men. Over three quarters of women (79.2 percent) and more than two thirds of men (68.4 percent) know that HIV can be transmitted from a mother to her child by breastfeeding. About two thirds of the respondents know that there are special drugs (antiretroviral drugs) that a doctor or nurse can give to a pregnant woman infected with the AIDS virus to reduce the risk of transmitting the virus to the baby. Knowledge of at least one source of a condom is widespread; ranging from 77 percent in Tilda to 91 percent in Kaweri. Misconception about HIV/AIDS is low. About 90% of both women and men know that a healthy-looking person can have the virus that causes AIDS. Much fewer respondents understand that the AIDS virus cannot be transmitted by mosquito bites: 56 percent of women and 60 percent of men know that AIDS cannot be transmitted by mosquito bites. The proportions of women and men who know that people cannot get the AIDS virus by sharing food with a person who has AIDS are 68.6 and 65.2 percent, respectively. The vast majority of plantation workers say that witchcraft is not a means of transmission of HIV, with 81.1 percent of women and 84.4 percent of men saying so. The majority of respondents have a caring attitude. Over ninety percent of women and men say they would be willing to care for a relative who is sick with AIDS in their own household. About 77% of respondents agree that a female teacher who has the AIDS virus but is not sick should be allowed to continue teaching in the school. Equally, about 77% of women and men say they would buy sugar or fresh vegetables from a vendor if they knew that he/she is HIV positive. Furthermore, about 48% of women and 63% of men say that if a member of their family got infected with the AIDS virus, they would not necessarily want it to remain a secret. The proportion of women and men who express positive attitudes on all four indicators are 31.5 and 40.4 percent, respectively Over 96 percent of the respondents said that they have ever had sex. The median ages at first sex for women and men were 16 and 18 years, respectively. Overall, 37 percent of women and 24.5 percent of men initiated sex before the age of 15 years. Primary abstinence was more common among men (12.9%) than in women (3%). There is a widespread acceptance of the ability of women to negotiate safer sex with their husbands. About 96 percent of women and 92 percent of men agree that a wife is justified in refusing to have sex with her husband if she knows he has a sexually transmitted disease and/or believe that a wife is justified in asking that he uses a condom if she knows that her husband has a sexually transmitted infection. Additionally, some of the respondents who were sexually active in the 12 months preceding the survey engaged in multiple sexual relationships (27.1% of men and 9.1% of women). The mean number of lifetime sexual partners was 6.3 in men compared to 3.2 in women. Higher risk sex is more common in men than in women. Similarly, condom use during the last higher risk sexual encounter is higher in men than in women. Women are more likely than men to undergo HIV counseling and testing; about 71 of women and 58 percent of men reported that they have ever had HIV tests. Fifty seven percent of pregnant women who gave birth in the last two years were counseled during antenatal care. Among those women who were offered and accepted HIV test during antenatal care, 27.2 percent received their results. The key factors cited by the key informants to be influencing the spread of HIV infection included: poverty; low female-to-male ratio, inadequate information on HIV/AIDS among plantation workers, low risk perceptions, the practice of commercial sex work as a means of supplementing income, seeking for favours, widow inheritance, negative beliefs on condoms and negative cultures/values. On policy, only two plantations (Kakira and Kaweri) have written workplace policies; although the one for Kaweri is still in draft form. The other two have unwritten policies. Never-the-less, all the surveyed plantations are implementing workplace policies and programmes. Among others, emphasis is being put on ensuring non-discrimination of HIV infected workers, gender sensitivity, safer work environment and confidentiality in handling HIV information. HIV related services that are being offered include awareness creation, health education, HCT, general HIV care and ART services. Conclusion Some action is required to address the key issues emerging from the survey. For instance, Tilda, Kaweri and Wilmar plantations should develop their HIV/AIDS work place policies; and the coordination structures for HIV prevention and control should be strengthened in the plantation sector. The range of HIV services in Ti lda, Kaweri and Tilda should be expanded to make them comprehensive. To increase the levels of HIV-related knowledge, there is need to strengthen the programmes for information-education-communication (IEC) in the plantations and surrounding areas. Programmes for behavior change communication also need to be strengthened. HIV counseling and testing should be promoted among the general population. Pregnant women should be particularly targeted with HCT. Finally, strategies consider the key emerging issues should be designed to address the high level of HIV infection among the plantation workers. 2010-01-01T00:00:00Z http://hdl.handle.net/11671/684 HIV sero-behavioural study in six universities in Kenya Lake Victoria Basin Commission Universities and institutions of higher learning in general consist mainly of young people in the 17-24 year old category, most of whom are sexually active, and therefore most vulnerable to HIV infection. And though studies such as KAIS (2007) and KDHS (2003, 2008) have been conducted on the general Kenyan population, studies specific to institutions of higher learning are scanty, in particular, sero-prevalence data on this target group is lacking. This prompted the EALP/IUCEA to commission a study to understand the extent, nature and impact as well as response to HIV and AIDS within universities. The purpose of this assignment therefore was to generate an understanding of the way that HIV/AIDS is affecting universities and host communities and to identity responses and gaps in the management of the pandemic that could be used to strengthen and expand interventions at national and regional levels. The study had a total representative sample of 3942 students drawn from six universities in Kenya, four of which were from the Lake Victoria Basin region. Thus, this study is aimed at providing evidence to guide the responses and policy formulation to the challenge of HIV in institutions of higher learning Findings of the EALP/IUCEA HIV and AIDS baseline study in institutions of higher learning carried from 1st March to 12th March and from 25th May to 5th June 2009, revealed that 20 (0.51%) of the 3942 respondents were diagnosed as infected with HIV at the time of the survey. Significantly greater prevalence was recorded among men (0.58%) than women (0.40%) Thus, HIV prevalence among students at Kenyan universities is way below the national average of 3.8% for the age group of 15-24 years (KAIS, 2007) where most belong. HIV prevalence among male students was within the national range of 0.4% to 2.6% for that age group. However, HIV prevalence among female students was well below the national range of 3% to 12% for the age group. HIV prevalence among total orphans was higher than other parenthood groups Sexual debut was at 18 years and was earlier in males than females. For those testing HIV positive, sexual debut was one year earlier at 17 years. Primary abstinence was reported in a quarter of the respondents, was higher in females, and decreased with increase in year of study. The main reasons given for abstinence were religion (70%), followed by waiting for marriage (66.5%) and fear of contracting HIV (62.3%). The prevalence of the high risk anal sex was generally low at 2.5%. However, anal sex for HIV positives respondents was four times higher than the overall prevalence rate in the study. 2010-01-01T00:00:00Z http://hdl.handle.net/11671/683 HIV Sero-behavioural Study In Two Agricultural Plantations In Lake Victoria Basin, Kenya Lake Victoria Basin Commission The HIV and AIDS pandemic remains a global public health challenge. By the year 2009, an estimated 33.3 million people were living with HIV and there were 2.6 million new infections in the same period. Sub-Saharan Africa remains the most affected region, accounting for over two-thirds of the 33.3 million people living with HIV in 2009 and three-quarters of the HIVrelated deaths that occurred in the same year. In Kenya, there was a decline in HIV prevalence from 10% in mid 90s to below 7% in 2009 with an increase in the number of people receiving antiretroviral treatment. The National AIDS Control Council (NACC), housed within the Office of the President provides leadership of the national response to HIV&AIDS by coordinating the multiple sectors. The Ministries of Health (MoH), through the National AIDS and STI Control Programme (NASCOP) spearhead the interventions on the fight against HIV/AIDS by coordinating implementation of technical programs. The Kenya National AIDS Strategic Plan III (KNASP III), covering the period 2009/10 to 2012/13 that was developed by NACC guides the implementation of HIV and AIDS interventions in Kenya. 2010-01-01T00:00:00Z http://hdl.handle.net/11671/682 HIV sero-behavioural study among fishing communities in Lake Victoria, Kenya Lake Victoria Basin Commission 2010-01-01T00:00:00Z http://hdl.handle.net/11671/681 A toolkit for mainstreaming gender and rights based approaches in agricultural plantations in Lake Victoria Basin in the context of HIV/AIDS Lake Victoria Basin Commission 2011-01-01T00:00:00Z