Risk perception of HIV infection and sexual behavior among young and adults from Kinshasa (D.R.Congo): a case-control study.
ESC Congress Library. Lopez-del Burgo C. May 4, 2016; 127038; A-213
Prof. Dr. Cristina Lopez-del Burgo
Prof. Dr. Cristina Lopez-del Burgo
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Background: Sub-saharan Africa has one of the highest prevalence of HIV in the world. Avoiding risky sexual behaviors is essential for the prevention of HIV and other STIs and it requires that people perceive their risk.

Objective: To evaluate the perception of risk of HIV in an outpatient center of Kinshasa (D.R. Congo) and to analyze predictors of perceiving risk of HIV infection.

Methods: A case-control study was carried out from December 2010 until June 2012. Patients aged 15-49 attending a primary outpatient center in Kinshasa were invited to participate in the study. They were HIV Voluntary Counselling and Testing attendees (VCT) and blood donors. Before HIV testing, an interview on HIV-related knowledge, attitudes and behaviors was conducted. Personal HIV risk perception was evaluated ('Do you think you have any risk of HIV?'No risk/low/high/don´t know). Cases and controls were respondents with newly identified HIV-positive or HIV-negative test, respectively. Logistic regression was used to analyze predictors of perceiving risk.

Results: 1,615 participants were recruited (274 cases and 1340 controls). Half of the cases reported, before having the HIV test result, that they did not have any risk or did not know their chance of infection. Thirty one percent of controls were also unaware of their risk of infection. Among those participants referring multiple sexual partners or inconsistent or no use of condoms, that is, with real risk of infection (n=1310), 32% were unaware of their risk, 31% perceived no risk at all and only 37% perceived any risk. This perception was independently associated to being female (OR=1.56; 95%CI 1.16-2.11), having high education (OR=1.77; 95%CI 1.10-2.85), requesting HIV VCT (OR=1.74; 95% CI 1.30-2.31), being informed about ABC ('abstinence, be faithful, condom use') preventive strategy (OR=2.15; 95%CI 1.66-2.78), having had serial (OR=1.59; 95%CI 1.20-2.10) or concurrent (OR=1.84; 95%CI 1.24-2.74) multiple sexual partners. Only 36% of participants with inconsistent or no condom use perceived risk of infection, but condom use was not statistically significant associated to perceiving risk in multivariate analysis (OR=1.20; 95%CI 0.85-1.81).

Conclusions: A high percentage of young and adults in Kinshasa are unaware of their personal risk of HIV infection despite referring risky sexual behaviors or even having the infection. More efforts are needed to improve correct and complete knowledge about risk factors of HIV infection, especially among males and less educated people, in order to effectively prevent HIV infection.


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