Marseille 2007
| Abstract #420 - Barriers to Safer Sex Practices among HIV-Positive Soldiers and Civilians in Clinical Care in Mozambique | ||||
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Session: 26.45: Posters B (Poster) on Tuesday in Chaired by Authors: Presenting Author: Dr Deborah Cornman - University of Connecticut, United States |
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| Additional Authors: Ms Caroline Redding, Dr Jason Seacat, Dr Susan Kiene, Ms Wynne Norton, Mr Antonio Langa, Dr Aboobacar Sultane Ramadan , Dr Cassamo Chagane Hachimo , Dr Anne Thomas, Dr Jeffrey Fisher, | ||||
| Aim: An estimated 16% of the population in Mozambique is HIV+ with approximately 500 new infections occurring daily (U.S. State Department, 2005). As ARVs become more widely available and people living with HIV/AIDS (PLWHA) in Mozambique live longer, it becomes increasingly important to develop targeted interventions that help PLWHA to practice safer behaviors so they do not transmit HIV to others, or infect themselves or their partners with other pathogens. But effective interventions cannot be developed without first understanding the extent of risky sexual behavior among the target population and the specific factors that contribute to that risky behavior. Thus, the aim of this study was to understand the sexual practices of HIV+ PLWHA in Mozambique by conducting formative qualitative research with HIV+ patients and clinic staff at Maputo Military Day Hospital in Maputo, Mozambique | ||||
| Method / Issue: This study was informed by the Information-Motivation-Behavioral Skills (IMB) model of HIV preventive behavior (Fisher & Fisher, 1992, 2000, 2002). A total of 6 focus groups were conducted to identify the types of sexual behaviors engaged in by HIV+ soldiers and HIV+ civilians; the prevalence of risky sexual behavior among these patients; and the specific informational, motivational, and behavioral skills-related factors that contribute to their risky behavior. In addition, we explored whether there were specific IMB and other factors that were unique to HIV+ soldiers. A total of 6 focus groups (N=45) were conducted over a 5-day period with HIV+ male soldiers, HIV+ male civilians, HIV+ female women (soldiers and civilians), HIV+ peer educators (2 groups), and clinic staff. Focus groups were audio recorded, transcribed, and analyzed with traditional qualitative techniques. | ||||
| Results / Comments: Various informational, motivational, behavioral skills and other barriers to consistent safer sexual behavior were identified during these focus groups. Examples of informational barriers included the belief that Europeans are trying to kill Africans by contaminating condoms with HIV and that HIV can be cured by the African potato and traditional doctors/healers. Motivational barriers included negative attitudes towards condoms (e.g., disliking condoms because they reduce the number of times a man can ejaculate in one night), fears of being abused or abandoned if one insists on condom use, and concerns that introducing condoms into a relationship will raise trust issues. Behavioral skills barriers included difficulty using a condom correctly, womens limited ability to negotiate safer sex due to gender inequality, and difficulty with HIV disclosure. Other barriers included use of alcohol and marijuana during sex. Barriers unique to HIV+ soldiers included the barracks running out of condoms, separation from their spouse for extended periods, and fears of discrimination if they disclose their serostatus. | ||||
| Discussion: In order for HIV risk reduction interventions to be effective with Mozambican PLWHA, they must address the specific HIV-related informational, motivational, and behavioral skills factors that are contributing to their risky sexual behavior. With increasing numbers of PLWHA being prescribed ARVs and going to clinics on a regular basis, integrating a risk reduction intervention into clinical care may be a time- and cost-effective way to support PLWHAs safer sexual practices. | ||||
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