Abstract #257  -  Behavioral Risk and Association with HIV Status in Rural Zimbabwe
Authors:   Presenting Author:   Dr. Daniel Montano - Batelle
Additional Authors:  Dr. Danuta Kasprzyk, Dr. April Greek, Mr. Pesanai Chatikobo, Dr. Mufuta Tshimanga,
Aim: Most research on behavioral risk in Africa has been done in urban areas, so less is known about patterns of behavior that put people at risk for acquiring STD and HIV in rural areas. The objective of this study was to determine: 1) frequency of behaviors that may put people at risk for STD and HIV acquisition in rural Zimbabwe, and 2) which risk factors are associated with HIV prevalence.
Method / Issue: As part of a large behavioral prevention intervention, baseline data were collected from a cohort of 5543 people age 18-30 in 30 rural growth points in Zimbabwe, recruited from social venues (bottle stores, general dealers, markets). Approximately equal numbers of males and females were recruited. Personal interviews assessed demographics and behavioral risks including STI symptoms, alcohol use, and sexual behavior. Data were collected on sex with 5 recent partners, including frequency, relationship type, and condom use. Participants also had a health assessment, including an HIV test.
Results / Comments: Results are reported for 4,441 participants who reported they had ever had sex (52% male, 48% female). 55% were married and 32% never married. 21% reported > 1 partner in the past 6 months (males 32%; females 10%), with 49% having sex with a steady partner, 6% with a casual partner (8% males; 4% females) and 9% exchanged money/goods for sex (12% males; 6% females). HIV prevalence was 25%. Higher HIV prevalence was associated with being married, traditional razor marks, exchanging money/goods for sex, STI symptoms, greater likelihood of drinking/getting drunk, having > 1 sex partner, and having a casual or commercial partner in past 6 months. Additionally, HIV positive people were younger at first sex, more likely to use condoms with spouse (9% vs. 5%), more likely to drink before sex, and less likely to use condoms with steady partners (46% vs. 54%). Sex differences were found for risk behavior prevalence and associations with HIV prevalence.
Discussion: This comprehensive survey of rural Zimbabwe clearly shows prevalence of risk behaviors associated with HIV status. Unlike some other African countries, people in rural Zimbabwe are not protected by location. HIV/AIDS prevention strategies must be implemented in rural areas. Differences by sex and recommendations for prevention will be discussed.
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