Sexual Practices and Reproductive Aspirations of People Living with Hiv and Aids, Receiving Treatment in Central Sakwa, Bondo Sub-County, Kenya

Abstract

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.