Knowledge of HIV status, sexual risk behaviors and contraceptive need among people living with HIV in Kenya and Malawi.
BACKGROUND
Several studies support the need for effective interventions to reduce HIV transmission risk behaviors among people living with HIV/AIDS (PLWHAs).


METHODS
Cross-sectional nationally representative demographic health survey of Kenya (2003) and Malawi (2004-2005) that included HIV testing for consenting adults.


METHODS
We analyzed demographic health survey data for awareness of HIV status and sexual behaviors of PLWHAs (Kenya: 412; Malawi: 664). The analysis was adjusted (weighted) for the design of the survey and the results are nationally representative.


RESULTS
Eighty-four percent of PLWHAs in Kenya and 86% in Malawi had sex in the past 12 months and in each country, 10% reported using condoms at last intercourse. Among sexually active PLWHAs, 86% in Kenya and 96% in Malawi reported their spouse or cohabiting partner as their most recent partner. In multivariate logistic regression models, married or cohabiting PLWHAs were significantly more likely to be sexually active and less likely to use condoms. Over 80% of PLWHAs were unaware of their HIV status. Of HIV-infected women, nearly three-quarters did not want more children either within the next 2 years or ever, but 32% in Kenya and 20% in Malawi were using contraception.


CONCLUSIONS
In 2003-2005, majority of PLWHAs in Kenya and Malawi were unaware of their HIV status and were sexually active, especially married or cohabiting PLWHAs. Of HIV-infected women not wanting more children, few used contraception. HIV testing should be expanded, prevention programs should target married or cohabiting couples and family planning services should be integrated with HIV services.
Anand
Abhijeet
A
Global Immunization Division, National Center for Immunization and Respiratory Diseases, National Center for HIV, Viral Hepatitis, STD and TB Prevention (NCHHSTP), Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. aanand@cdc.gov
Shiraishi
Ray W
RW
Bunnell
Rebecca E
RE
Jacobs
Krista
K
Solehdin
Nadia
N
Abdul-Quader
Abu S
AS
Marum
Lawrence H
LH
Muttunga
James N
JN
Kamoto
Kelita
K
Aberle-Grasse
John M
JM
Diaz
Theresa
T
D000293:Adolescent; D000328:Adult; D017280:Condoms / Q000706:statistics & numerical data; D003268:Contraception Behavior / Q000706:statistics & numerical data; D003270:Contraceptive Agents / Q000008:administration & dosage; D003273:Contraceptive Devices / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000517:prevention & control* / Q000523:psychology / Q000635:transmission; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D007630:Kenya; D008295:Malawi; D008297:Male; D020380:Needs Assessment; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000523:psychology; D012309:Risk-Taking; D012725:Sexual Behavior; D012959:Socioeconomic Factors; D055815:Young Adult
D003270:Contraceptive Agents