Married indviduals' perceptions about the factors associated with HIV infection in marriage: A case study of Mbarara Municipality, South Western Uganda.

Abstract

Introduction: Married individuals’ perception about factors associated with HIV infection in marriage often determines whether they seek routine counselling and testing services, avoid risky behaviours that would not predispose them to HIV, adopt preventive measures and continuously practice them to avoid HIV infection. These perceptions are subjective but are vital in an effort to reduce HIV infection in marriage. Currently there is no documentation regarding married individuals’ perception about factors responsible for HIV infection in marriage in Mbarara Municipality. Objectives: The main objective of the study to identify married individuals’ perceptions on the factors associated with HIV infection among married individuals in Mbarara municipality by specifically addressing the demographic factors associated with high risk of infection with HIV, cultural and behavioural factors associated with HIV infection, Perceived personal risk of HIV transmission and the enabling factors for positive behavioural change among married individuals. Methods: A case control study was carried out. Both married individuals HIV positive and HIV negative were recruited. A sample of 57 HIV positive (cases) and 57 HIV Negative (controls) aged 15-49 years was selected. Data was collected using questionnaires. The investigator cross-checkeddata collected for completeness and accuracy and was analyzed using stata 11. Results: Of the 114 clients studied, 55(43.6%) were males, 59(56.1%) were females. The majority of the cases (54.9%) were <29 years compared to between 40-49 for controls (54.6%). The strongest predictor of having HIV among marrieds was knowledge of one's HIV status (p<0.018). Actually, the odds of having HIV among marrieds that participated in the study were 5 times higher among marrieds who knew their HIV status at the time of the interview as compared to those who didn't know. Being a businessman was associated with a 4.5 odds higher than those with professional jobs. Being a businessman or woman is an independent risk factor for HIV among marrieds (p<0.017). The odd of HIV among marrieds is 3.3 higher among peasants as compared to those with Professional jobs. Generally, 88% of the study participants believed marriage to be a risk factor for HIV infection. Married individuals perceived that, age of the married individual, the distance between spouses, education, religion, widow inheritance, and violence were major predisposing factors for HIV infection in marriage and high incomes from good pay, being faithful and education on condom use would lead to positive behaviour change and thus lead to a reduction in HIV in marriage. Conclusion and Recommendations: Marriage is perceived as a risk factor for HIV infection. Violence is the number one risk factor for HIV in marriage and educating marrieds on how to use condoms is vital in the fight against HIV in marriage. It is critical that married people are also targeted for prevention interventions focusing on several Socio demographic and behavioral determinants. HIV prevention campaign should put special focus on married people with a view to sensitizing them to the risk of HIV infection. Such messages have to be contextualized within the socio-cultural milieu to increase effectiveness of prevention strategies. Married persons should be encouraged to know their HIV status so that they can take appropriate precautions to prevent and control the spread of HIV infection. Keywords: Married individuals, Perceptions, perceived risk, Enabling factors, Behavioural Change.