Abstract:
Improvements in health and life expectancy of HIV-infected patients on antiretroviral
therapy (ART) and the use of ART in prevention of mother-to-child transmission and
post exposure prophylaxis may lead to a belief that HIV is no longer a serious and deadly
disease. With the scale up of ART in developing countries, little is known on the
association of large-scale ART use and sexual behavior. The objective of this thesis is to
determine the association between ART related Knowledge and beliefs and sexual
behavior. Herpes simplex virus type 2 (HSV-2) infection has been used as a surrogate
marker for sexual behavior. Secondary data analysis was performed on cross-sectional
data collected in Kisumu municipality among 1655 people aged 15-49 years randomly
selected from the general population. It evaluated sociodemographic risk factors for
HSV-2 infection, determined the prevalence of HSV-2 and assessed ART related
knowledge and beliefs and evaluated their association with HSV-2 infection. The overall
prevalence of HSV-2 was 53% with females (65%) having a higher prevalence than
males (38%, P < 0.01). Prevalence rates gradually increased with increasing age. Males
and females without secondary education (P=0.01 and P<0.001), with history of abusing
drugs (P=0.01 and P=0.04) and ever being married (P<0.001 and P<0.001) were
associated with increased likelihood of having HSV-2 infection. Over 80% gave correct
answers to 9 out of the 15 knowledge questions on HIV and ART. However, 17% of the
participants thought that ART cured HIV/AIDS and were more likely to have HSV-2
infection (AOR: 2.02, 95% CI: 1.19-3.43) and (AOR: 2.14, 95% CI: 1.34-3.40) for males
and females respectively. Targeted informative messages to those at risk may aid in
reducing the incidence of HSV-2. In this era of increased availability of HIV care and
ART treatment, programs should consider educating the general population about true
nature of ART treatment. This will effectively reduce ART related misperceptions and
thus reduce the associated risk of HSV-2 infection and other STIs including HIV
