Magnitude and determinants of risky sexual behaviours among youths attending HIV care and treatment clinics in Dar es Salaam region, Tanzania

Abstract

Introduction Risky sexual behaviors are mainly the focal point of programmes on HIV prevention. Little interest has been given to sexual behaviors among HIV positive youths. Sexual behaviors of HIV infected youth have not been described. The intention of this study was to determine the magnitude and determinants of risky sexual behaviors among HIV infected youths. Methods A cross-sectional study was conducted in June 2010 in selected Care and Treatment Clinics (CTCs) in the three municipalities of Dar-es-Salaam. A total of 282 eligible HIV infected youths aged 15-24 years were interviewed using a structured questionnaire to obtain data from study participants. Data was analyzed using the SPSS version 15.0. Results Prevalence of unprotected sex was found to be 40.0% among males and 37.5% among females (p<0.001) with 38.7% of males and 29.1% of females reporting to not use condom consistently. More than 50% of the participants didn't know HIV status of their sexual partners. A large proportion (46.7% males versus 60.4% females) of youth had low knowledge on STI prevention and STI transmission (65.3% for males and 73.4% for females). Multiple sexual partnership was reported by 10.6% of males and 15.9% of females (p<0.005). Independent predictors of condom use in this population was poor attitude towards condom (Adjusted Odds Ratio 0.23, 95% Confidence Interval (Cl): (0.06-0.81) and not being on ARV (AOR, 0.38, 95% Cl: 0.17-0.85). While those in young age group (15-19 years) were almost 3 times more likely to report multiple sexual partnerships and those not using alcohol was associated with 62% less likely to report to do so. Conclusions Practice of unprotected sex and multiple sexual partnerships was prevalent among youth living with HIV / AIDS in Dar-es-Salaam. Low STI knowledge and low HIV disclosure status increased the vulnerability and risk for transmission of HIV infection among youth. Specific intervention measures including integrating reproductive health counseling in routine CTC should be a priority. Intervention measures should take into account age, location, ARV use status and other individual related behaviors such as alcohol consumption and condom use.