Women, economic hardship and the path of survival: HIV/AIDS risk behavior among women receiving HIV/AIDS treatment in Uganda

Abstract

The results are presented from a 2005 survey of 377 women in four HIV/AIDS treatment programs in Uganda. The aim of the study was to explore women's economic hardships and the association with four sexual risk behaviors: whether a woman was sexually active in the last 12 months, whether a condom was used during the last sex act, whether she reported having had a sexual partner in the last six months who she suspected had multiple partners and report of forced, coercive or survival sex in the last six months. Few women were sexually active (34%), likely due to the high proportion of widows (49%). Married women were likely to report forced, coercive or survival sex (35%). Eighty-four percent of women reported condom used at last sex act. Forced, coercive or survival sex was associated with number of meals missed per week (AOR=1.125, 95% CI 1.11, 1.587, p<0.05). Sex with a partner in the last six months who a woman suspected had multiple partners was also associated with number of missed meals per week (AOR=2.080, 95% CI 1.084, 3.992). Currently women in Ugandan antiretroviral therapy programs are not likely to be sexually active, except for married women. Many women need to find food and other support, which may put them at risk of forced, coercive or survival sex due to dependency on men.

Keywords:

• HIV/AIDS treatment
• HIV/AIDS prevention
• developing countries
• sexual risk behaviors
• gender inequality
• poverty
• secondary transmission of HIV

Acknowledgements

The authors would like to acknowledge the Makerere Institute of Social Research (MISR) at Makerere University and the Kampala and Masaka HIV/AIDS treatment centers that made this research possible: Reach Out Mbuya Parish HIV/AIDS Initiative, JCRC – Joint Clinical Research Centre, The Mildmay Centre and Uganda Cares of Masaka.