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Background
HIV/AIDS is worldwide pandemic and has drawn
multinational efforts to control it. Tanzania on its part has declared
HIV/AIDS as a national disaster and has called upon stakeholders to
participate in one way or another in the fight against the pandemic. The
Simanjiro District in collaboration with stakeholders in the District
intents to develop interventions to combat the epidemic. However, prior to
the development of the interventions, the district therefore conducted a
study to assess Knowledge, Attitude, Practice and Behavior (KAPB) towards
HIV/AIDS and other Sexual Transmitted Diseases (STD) to guide development of
evidence-based interventions.
Objectives
The overall objective of the study was to assess the KAPB
towards HIV/AIDS in order to develop practical and cost effective
interventions against the epidemic. Specifically the study aimed at:
·
Identifying KAPB of different communities
in the Simanjiro District
·
Determining perceptions and cultural
factors that prevent behavior change or accelerate HIV transmission
·
Listening other risk factors that could
fuel HIV transmission
·
Using results of the study to develop
sustainable community-based HIV/AIDS/STD interventions
Results
Both qualitative and quantitative data collection
techniques were employed in the course of data collection to fulfill the
study’s data needs. A total of 609 individuals participated in the study
including 523 who participated the questionnaire interviews, nine heads of
departments and NGOs.
Status of Sexually Transmitted Diseases (STDs) in the
District
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STDs was one of the important subjects of
the study and was addressed to varied participants of the study
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From DMO’s (District
Medical Officer) records, in 2003 alone, the
district’s health facilities saw 820 STDs cases (508 males and 312 females)
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Eighteen separate cases of Syphilis (13
females, 5 males) were also reported during the same reference period
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10% thought there was no such a disease in
their area and 15% were unaware
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The problem is rampant in Simanjiro
District but how much do people know about STDs?
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This question was addressed through a
number of questions to the participants of the structured interviews
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Participants were asked to name any STDs
they knew. They named gonorrhoea (75%), Syphilis (57%), HIV/AIDS (46%),
chancroid (7%) and clamydia (0,8%). The rest could not mention a clearly
known STD (17%).
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Some could name STDs but not symptoms and
vice versa. Nevertheless, 39 % mentioned one symptom, 27% mentioned two
while 10% and 5% mentioned three and four respectively.
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Up to 76% said STDs could be treated
against 15% who thought they could not be treated. About 9% could not
comment.
Status of HIV/AIDS in the District
HIV prevalence in Simanjiro is 0,3% and in
2003 alone there were 411 new cases of HIV infections. In addition seven
reported AIDS cases and 4 deaths associated with HIV/AIDS were also reported
during the year.
Factors fuelling HIV transmission in the
district were mentioned. The factors have been categorized into three groups
i.e.
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Traditional
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Occupational/economic
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Bahavioural
Key informants also mentioned the following
factors
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Poor knowledge and understanding of
HIV/AIDS
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Poor communication in the district
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Through the constructed questionnaire,
numbers were attached to these factors
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The most important traditional factors were
“esoto” (51%) (Maasai word for informal meetings of boys and girls during
the night, singing and gathering together)
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Sharing of unsterilised blades during
circumcision (28%)
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Polygamy (17%) and sharing
women among peers (13%)
Impact of HIV/AIDS epidemic
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HIV/AIDS is already having a devastating
effect in Simanjiro area
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Increased mortality (66%)
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Increased orphan hood (30%)
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Loss of professional
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Too many resources spent on care and
support of AIDS patients (6%) and increased widowhood (3%)
Recommendations
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Immediate preventive, care and support
actions should be launched in Simanjiro District
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Sexually tailored Maasai traditions should
be one of the focuses of the program in the district. This should be done
through existing structure within the Maasai traditions (age sets)
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Involvements of community members in
drawing up intervention activities is crucial for ownership and
sustainability reasons
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Limited resources available in the district
should be spent cautiously/effectively to realize maximum output
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The district need to be given a capacity
building to be able to develop participatory and multisectoral HIV/AIDS
Action Plan Map
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Consideration should be made to form a
district NGOs Forum to bring together all HIV/AIDS activists
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In order to have realistic and reliable
HIV/AIDS records, the district needs to develop a clear and credible HIV
monitoring system
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STDs management services should be
strengthen across the district and proper counseling should be extended to
the patients
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