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APHA Scientific Session and Event Listing

Kathleen S. Crittenden, PhD¹, Sitingawawo I. Kachingwe, MSN², Chrissie P.N. Kaponda, PhD, RN², Diana N. Jere, MS, RNM², Kathleen F. Norr, PhD³, and James L. Norr, PhD¹. (1) Department of Sociology, University of Illinois at Chicago, M/C 312, 1007 W Harrison St., Chicago, IL 60607, 312-996-3009, kcritt@uic.edu, (2) Kamuzu College of Nursing, University of Malawi, Private Bag 1, Lilongwe, Malawi, (3) College of Nursing, University of Illinois at Chicago, (MC 802), 845 S Damen, Chicago, IL 60612

Background: HIV prevention is urgently needed in rural Malawi where over 80% of the population resides, and information about sexual risk factors is essential to designing a community-collaborative intervention program. Methods: We interviewed random samples of 1152 adults and 601 adolescents in communities in two rural Malawi districts, as well as all 186 health workers in those districts, and conducted focus groups with each subgroup. We used multiple regression to assess patterns of 5 risky sexual behaviors – unprotected sex, multiple partners, bar sex, sex for money, and forced sex – and overall risky behavior among these subgroups. Predictors were age, gender, urban background, level of education (for the adult subgroups), and current school attendance (for adolescents). Results: Unprotected sex was by far the most reported risky behavior reported by each subgroup. Among community adults, we found that the number of risky behaviors decreased with age, was higher for men than women, and increased with level of education. For health workers, only gender was significant; the number of risky behaviors was higher among men. For youth, increasing age increased both sexual activity and risky behaviors, and current school attendance reduced both of these. Focus groups suggested the social desirability of over-reporting unprotected sex and under-reporting other risky sexual behaviors. Conclusions: Different population subgroups have different patterns of HIV risk that must be addressed in interventions targeted to these subgroups.

Learning Objectives:

• 1. Understand patterns of risky sexual activity among health workers and community adults and adolescents in rural Malawi.
• 2. Learn the cultural context within which these behaviors occur and are reported.
• 3. Learn the implications of these results for intervention content.

Keywords: HIV Risk Behavior, International Public Health

Presenting author's disclosure statement:

Not Answered