Sexual Practices and Reproductive Aspirations of People Living with Hiv and Aids, Receiving Treatment in Central Sakwa, Bondo Sub-County, Kenya
Abstract/ Overview
In Kenya, although HIV and AIDS prevalence deeline ;~ S:e t8r~88~ as 5 49 years in
2012, the rates increased to 28.2% in Central Sakwa Location, Bondo Sub-County. Despite
knowledge of their HIV status, it is not known how ability of people living with HIV and AIDS
(PLWHAs) receiving treatment to embrace HIV preventive measures may be constrained by
structural forces (stigma and discrimination, cultural factors, and gender inequalities and
reproductive aspirations) and hence contribute to the emerging HIV statistics. This study
explored community perceptions about sexual and reproductive aspirations of PLWHAs
receiving treatment, influence of socio-cultural factors on sexual practices of PLWHAs receiving
treatment and influence of reproductive aspirations on sexual practices of PLWHAs receiving
treatment. The study was guided by structural violence theory (Farmer, 2004) and human agency
(Ortner, 2006). It was conducted in Central Sakwa Location. It adopted ethnographic design,
employing both qualitative and quantitative methods in two phases. Firstly, 50 PLWHAs and
nine sexual partners, selected using snowball technique were interviewed in depth over time.
Purposively sampled key informants included 12 community health workers (CHWs), five NGO
officials, two voluntary counseling and testing (VCr) personnel, two assistant chiefs, one chief,
two church officials and 10 elderly persons. Eight focus group discussions were conducted with
CHWs and community members. In phase two, Yamane's (1967) formula was used to obtain a
sample size of 358 community members from 34Q4 households, selected through systematic
random sampling and adm~nistered with semi-structured interviews. Qualitative data were
thematically analyzed while quantitative data were analyzed using descriptive statistics and
presented in tables of frequencies and percentages. Findings showed that although access to ART
is positively changing corrununity perception about HIV and AIDS, equating the virus to
malaria, 84.4% of community members perceived PLWHAs as promiscuous. They felt PLWHAs
should neither engage in sexual intercourse nor aspire to .bear children unless otherwise.
Conversely, 64.2% of community members would resist condom if a partner suggested for its
use without disclosing HIV status. They perceived disclosure of HIV status as a way of declining
their sexual advances. The PLWHAs engaged in HIV risk sexual practices such as multiple
sexual relationships and attributed it to stigmatizing environment and cultural factors. They also
had reproductive aspirations, though faced with challenges, predisposing them to HIV
transmission risk. Therefore, the study recommended that HIV and AIDS programmes need to
address structural factors making PLWHAs vulnerable to HIV transmission risks.