Factors Associated with HIV Risk Sexual Behaviours among Female Domestic Workers in Nairobi City, Kenya

Abstract

Female domestic workers (FDW) are classified as a key population at HIV risk of HIV infection because they are exposed to physical violence, sexual harassment and exploitation in the private household settings where they work. They are also considered a bridge population in HIV transmission and may therefore contribute to new transmission in households. This study sought to identify factors associated with HIV risk sexual behaviour among Female Domestic Workers (FDW) living in employer’s households in Nairobi city, Kenya. The objectives included: determining the socio-demographic characteristics of female domestic workers in Nairobi, Kenya; determining the proportion of female domestic workers in Nairobi that engage in HIV risk sexual behaviour, 12 months prior to the interview; determining the level of awareness and risk perception of HIV and AIDS among female domestic workers in Nairobi, 12 months prior to the interview and assessing factors associated with HIV risk sexual behaviour among female domestic workers in Nairobi, 12 months prior to the interview. Across sectional study design was employed. Respondents were stratified along upper, middle and lower income socio-economic classes of their employers’ households. Respondents were randomly selected by applying a skipping pattern of the households to enrol the 187 FDW in the study. Data was collected by trained interviewers guided by a structured questionnaire. Findings indicated that majority of the FDW were young with a mean age of 25.7 (+7.5); about half of the FDW had attained a minimum of primary education and a quarter of the respondents were married. Majority of the FDW interviewed (>70%) were awareness of HIV and AIDS and correctly dispelled myths on transmission. FDWs with post primary education being in a higher awareness of HIV and AIDS category was 0.63 times more than FDWs with primary education. Age and marriage status were associated with HIV risk sexual behavior. If an FDW were to increase in age by one year, her ordered log-odds of being in a higher risk sexual behavior category would increase by 0.05. The ordered logit for FDWs that have never married being in a higher risk sexual behaviour category was -0.67 less than FDWs that had ever been married. FDWs working in a middle and high socio-economic location being in a higher risk category was 1 and 0.91 times more than FDWs working in a low socio-economic location The socio demographic characteristics of the female domestic workers in Nairobi as described in this study are similar to those found by other researchers. It is a workplace that attracts young and school drop outs who often have limited options in the job market; this is a factor that can make them vulnerable to HIV risk sexual behaviour as they desperately seek to keep the job at any cost. The high proportion of FDW engaging in HIV risk sexual behaviour (51%) can be due to the gender perceptions and power balance in the households. The HIV risk behaviour was higher among the younger FDW (18-30years) possibly due to low knowledge. Only one construct on risk perception was associated with HIV risk sexual behaviour. The study recommends that HIV prevention interventions should aim at raising age of entry to domestic work; target especially FDW in low and middle income employer households; sensitize FDW on HIV risk and consequences; and provide correct information on condom use to prevent risks of new HIV/ STI infections.