Abstract:
In order to deepen the understanding of risk factors associated with HIV infection in the
Kagera region of Tanzania and to investigate the potentials of communicating with the people in planning
for interventions, two studies were performed in the districts of Bukoba Urban, Bukoba Rural
and Muleba in 1989. The HIV prevalence of these areas ranged between 4.5% and 24.2% according to
the prevalence study performed earlier in 1987. The studies involved the community in ward meetings
on the one hand, and previously studied individuals on the other hand. The studies aimed both at conveying
to the people the results of a previously performed study and at collecting new data using a
combination of quantitative and qualitative methods in order to better understand the associated risk
factors, perceived or real, and what suggestions the community could offer for reducing HIV transmission
in the region. From the initial study, awareness about AIDS was found to be universal. Change
of sexual partners and infection with syphilis were found to be the major risk factors for HIV-I infection.
From the ward meetings people sugges~:ed a variety of solutions for interventions which we have
categorized as either "hard" or "soft". The "hard" solutions involved suggestions such as isolation,
imprisonment, castration and killing of AIDS victims, while the "soft" solutions involved sympathetic
handling of the sick and educating the people about the modes of transmission and how best to prevent
infection. There was a greater tendency for the low HIV prevalence rural communities to suggest the
"hard" solutions than the high HIV prevahmce urban ones which tended to suggest the "soft" solutions.
However, with the changing dynamics of HIV infection in the region towards higher HIV prevalence
in rural areas, it is likely that the "soft" solutions will gain acceptance and become adopted for
interventions throughout the region. The information obtained from these studies has provided lessons
that can be used for rational counselling as well as for guiding the implementation of IEC activities
geared at interventions. It is also suggested that there should be further research into new strategies or
their combinations which could be crucial in prevention such as those of community participation,
empowerment of women and solidarity in AIDS intervention work.
