Utilization of condoms among HIV positive women attending the comprehensive care centre of Thika level 5 hospital

Type Thesis or Dissertation - Master of Science in Epidemiology
Title Utilization of condoms among HIV positive women attending the comprehensive care centre of Thika level 5 hospital
Publication (Day/Month/Year) 2016
URL http://ir.jkuat.ac.ke:8080/bitstream/handle/123456789/2315/MACHARIA, ANNE GATHONI MSC. EPIDEMIOLOGY​2016.pdf?sequence=1&isAllowed=y
Condoms offer protection against HIV transmission when used correctly and
consistently. Many HIV infected people do not use condoms regularly, thus leading to
new HIV infections. Condom use is considered to be low in Kenya and HIV prevalence
is higher among women than men. Utilization of condoms among HIV positive women
has not been studied. This study was aimed at investigating the extent to which HIV
positive women presenting at the Comprehensive Care Centre (CCC) of Thika Level 5
Hospital, utilize condoms during sexual engagement. A descriptive cross-sectional study
design that utilized a combination of Qualitative & Quantitative approaches was
employed. A pre-tested structured questionnaire, Focus Group Discussion (FGDs) and
In-depth Interviews (IDIs) were used to collect data which was entered in MS- Excel
database. Data cleaning was done manually before descriptive analysis to ensure
completeness and quality. Statistical Package for Social Sciences (SPSS v.21) was used
for analyses. Pearson’s Chi-square test and odds ratio with corresponding 95%
confidence interval were computed to assess the association between condom use and
independent variables (p-value < 0.05). These include: type and number of partners,
sexual partner’s HIV status, disclosure of HIV status to partner, knowledge and
perceptions on condom use. Further, binary logistic regression analysis was performed
to identify variables independently associated with condom use. Consistent condom use
among sexually active HIV positive women was found to be 57.4% (95%CI: 52.7% -
62.1%). The stepwise logistic regression revealed that attending tertiary education
[AOR=2.54; 95%CI=1.30-4.95; P=0.006], disclosing HIV status [AOR=2.27;
95%CI=1.27-4.06; P=0.005], having a HIV negative partner [AOR=4.23; 95%CI=1.99-
8.98; P<0.001], not taking alcohol [AOR=1.72; 95%CI=1.10-2.69; P=0.017], never
encountered resistance to use condom by partners [AOR=1.87; 95%CI=1.15-3.03;
P=0.011] and perceived risk of contracting STIs [AOR=2.11; 95%CI=1.12-3.97;
P=0.021] as factors independently associated with consistent condom use. This study
shows that there is still low prevalence of consistent condom use among HIV positive
women. The factors identified to influence condom use were; advanced level of
education, disclosure of sero positive status to partner, sero discordant partnership and
perceived risk of contracting STIs. The main barriers to condom use identified were;
alcohol use, resistance of condom by partner, lack of negotiation skills, fear of mistrust
by partner, non- disclosure of sero positive status to partner, condom spoils pleasure and
religion. Programs should focus on interventions to increase condom use among HIV
positive women with emphasis on need for disclosure. In addition, more education and
sensitization of HIV positive women would reduce barriers associated with alcohol use;
misconceptions associated condom use and impart skill for women to negotiate condom
use with their male partners.

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