The burden of water, sanitation and hygiene on people living with HIV/AIDS in Kibera sum

Abstract

HIV transmission is often perceived as a consequence of human behaviors: unprotected sex, injection drug use, sharing needles. While transmission risk behaviors are, in fact, necessary for HIV-infection, it is important to note that these behaviors occur in context, that they are “conditioned by their environment.” In the context of poverty, malnutrition, high prevalence of co- infections with other infectious diseases, and overburdened health systems, individuals may be more susceptible to acquiring HIV and less able to cope with HIV-related illnesses, both physically and economically. The study presented is to determine the burden of water, sanitation and hygiene on people living with HIV/AIDS in Kibera slum. The research design utilized was cross sectional study design and 369 respondents were interviewed and 10 water samples were collected for bacteriological analysis. The study showed that 95% (n = 350) of the respondents had access to municipal water supply. The bacteriological analysis of the water samples from water sources showed that all the drinking water were contaminated and samples had as high as over 180 most probable number of coliforms. Secondary contamination was noted since all households water samples had over 180 most probable number of coliforms. The households were spending 33% of their total monthly income on drinking water with some households spending as high as 62% of their total income. There was high prevalence (62%) of diseases caused by taking contaminated water and living in poor environmental conditions. There was poor sanitary conditions in place as showed by 84% (n = 308) of the respondents who did not have hand washing facilities that allows running water, 20% (n = 74) had their food displayed in the open and uncovered, 87% (n = 322) did not have standard sanitary bins present in the latrines / toilets and 61% (n = 225) did not have waste storage bins at their household. The study reported that 84% of the respondents practiced taboos, beliefs and cultures that affected the water quality and sanitation measures. Logistic regression analysis was employed to predict the probability that a respondent living with HIV/AIDS in Kibera slum would be infected with diseases related to taking contaminated water and living in poor environmental sanitary conditions. The predictor variables showed a significant partial effect: Employing a 0.05 criterion of statistical significance; respondent’s household drinking water treatment behavior (X2

=4.589, df = 1, p<0.001), taboos, beliefs and cultures that affects water quality and environmental sanitation measures (X2 = 11.232, df = 1, p = 0.032), availability of standard sanitary bin in the respondent's latrine (X2 = 14.838, df = 1, p<0.001) and presence of waste storage bin at household level (X2 = 23.942, df = 1, p<0.001). A test of the full model versus a model with intercept only was statistically significant, x2 (5, N = 369) = 73.912, p < .001. The study concluded that due there was low levels of environmental sanitary measures coupled with taboos, beliefs and cultures that affected sanitation measures in place. Safe drinking water was therefore inaccessible to a majority of participants indicating a high risk of opportunistic diseases and high economic burden. The study concluded that there is need for the integration of environmental sanitation measures and water quality management issues in HIV/AIDS management and treatment coupled with proper treatment of drinking water supplied by the county governments and health education at the household level