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

Abstract

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 con¬dom 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.