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Abstract:
Introduction: In many countries different
interventions have been implemented to
prevent new infections of the Human
Immunodeficiency Virus (HIV). Rwanda has
developed and implemented many strategies at
the national level to reduce the incidence of
HIV in the general population. One of the
main objectives of such interventions is to
improve the general
level of knowledge of HIV, with the
hypothesis that increasing HIV knowledge will
reduce risky sexual behavior. However, there
has been a concern that HIV knowledge may not
necessarily reduce risky sexual behavior.
Only a limited number of population-based
studies describe the
results of these interventions in terms of
how HIV knowledge affects risky sexual
behavior. Therefore, the aim of this paper is
to fill in this gap, by exploring HIV
knowledge and its effect on risky sexual
behavior among men in Rwanda.
Methods: The study used data from the 2005
and 2010 Rwanda Demographic and Health
Surveys to analyze the association between
HIV risk factors and two types of risky
sexual behavior—having two or more partners
in the past 12 months; and among those with
two or more partners, not using a condom at
last sex)—and the association between HIV
knowledge and those risky behaviors. In
addition to descriptive and bivariate
analyses, multivariate logistic regression on
pooled data from 2005 and 2010 was used to
determine predictors of risky sexual
behavior.
Results: Among men in the study sample, 5% in
2005 and 7% in 2010 reported having two or
more sexual partners in the last 12 months
preceding the survey. Among these men, 93% in
2005 and 74% in 2010 did not use a condom at
the last sex. Knowledge of the protective
effect of having just one uninfected faithful
partner decreased from 90% to 82% between
2005 and
2010, and basic knowledge of HIV decreased
from 71% in 2005 to 68% in 2010. Knowledge of
the protective effect of using condoms
increased from 90% in 2005 to 94% in 2010. In
adjusted multivariate analysis, HIV knowledge
was not associated with either type of risky
sexual behavior.
Conclusion: The findings suggest that, while
knowledge of the protective effect of using
condoms has increased, knowledge of the
protective effect of one uninfected faithful
partner has been decreasing in Rwanda. This
should draw attention to the need to take
corrective measures. The study did not find
strong evidence of a significant association
between HIV knowledge and risky sexual
behavior among men in Rwanda. In setting up
policies and strategies related to HIV
prevention, policymakers should consider that
focusing on HIV knowledge is not sufficient
in itself.
HIV Knowledge and Risky Sexual Behavior among Men in Rwanda (PDF, 487K)