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ABC messages for HIV prevention in Kenya: Not as simple as they sound

Julie Pulerwitz, ScD1, Tiffany Lillie2, Lou Apicella3, Ann McCauley4, Tobey Nelson5, Simon Ochieng2, Peter Mwarogo2, and Edward Kunyanga6. (1) Horizons/Population Council (seconded from PATH), 4301 Connecticut Avenue, NW Suite 280, Washington, DC 20008, 202-237-9400, jpulerwitz@pcdc.org, (2) Family Health International, 2101 Wilson Boulevard, Suite 700, Arlington, VA 22201, (3) Horizons/Population Council, 4301 Connecticut Ave NW, Suite 280, Washington, DC 20008, (4) (formerly), Horizons/Population Council, 4301 Connecticut Ave NW, Suite 280, Washington, DC 20008, (5) Horizons/ICRW, 4301 Connecticut Ave NW, Suite 280, Washington, DC 20008, (6) (formerly), Family Health International, P.O. Box 38835-00623, Nairobi, Kenya

Background Although the “ABC” behaviors—being abstinent or delaying sex, being faithful to one sexual partner, and consistently using condoms—are widely accepted as key to reducing the sexual transmission of HIV, considerable debate surrounds how best to deliver messages about them. To better understand how ABC terms and behaviors are interpreted and perceived, we conducted a study in Kenya in 2004. Methods As part of a larger study, questionnaires were administered to over 500 working adults at flower farms in two communities in Kenya. Multiple focus group discussions were also held with these adults. Results Although almost all of the farm workers had heard of the ABC terms for HIV prevention, many were unable to define them correctly. Abstinence was best understood, with 39 percent of respondents supplying a correct definition. Less than a fourth could correctly define being faithful, which was commonly confused with other concepts, such as loyalty or being honest. Only 17 percent correctly defined consistent condom use, and a large proportion chose not to answer the question at all. Focus group discussions highlighted barriers to the ABC behaviors, including conflicting messages on condom effectiveness, the idea that sexuality can not be controlled, and gender-based violence and forced sex. Conclusion HIV prevention programs incorporating ABC messages must clarify the behaviors in locally appropriate language. ABC messages should be combined with other interventions that address barriers to the ABCs, such as gender-based violence reduction.

Learning Objectives: At the conclusion of the session, the participants in this session will be able to

Keywords: HIV/AIDS, Prevention

Presenting author's disclosure statement:

Not Answered

Policy Perspectives on Human Rights and Attention to HIV/AIDS Issues

The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA