"Half plate of rice to a male casual sexual partner, full plate belongs to the husband":Findings from a qualitative study on sexual behaviour in relation to HIV and AIDS in northern Tanzania

Joseph R Mwanga,Godfrey Kaatano,Gerry Mshana,John Changalucha

doi:10.1186/1471-2458-11-957

Joseph R Mwanga, Godfrey Kaatano + Show 2 more

Open Access

https://doi.org/10.1186/1471-2458-11-957

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Abstract

BackgroundA thorough understanding of the contexts of sexual behaviour of the people who are vulnerable to HIV infection is an important component in the battle against AIDS epidemic. We conducted a qualitative study to investigate perceptions, attitudes and practices of sexually active people in three districts of northern Tanzania with the view of collecting data to inform the formulation of appropriate complementary interventions against HIV and AIDS in the study communities.MethodsWe conducted 96 semi-structured interviews and 48 focus group discussions with sexually active participants (18-60 years of age) who were selected purposively in two fishing and one non-fishing communities.ResultsThe study revealed a number of socio-economic and cultural factors which act as structural drivers of HIV epidemic. Mobility and migration were mentioned to be associated with the risk of HIV acquisition and transmission. Sexual promiscuous behaviour was common in all study communities. Chomolea, (a quick transactional sex) was reported to exist in fishing communities, whereas extramarital sex in the bush was reported in non-fishing community which was predominantly Christian and polygamous. Traditional practices such as Kusomboka (death cleansing through unprotected sex) was reported to exist. Other risky sexual behaviour and traditional practices together with their socio-economic and cultural contexts are presented in details and discussed. Knowledge of condom was low as some people mistook them for balloons to play with and as decorations for their living rooms. Acute scarcity of condoms in some remote areas such as vizingani (fishing islands) push some people to make their own condoms locally known as kondomu za pepsi using polythene bags.ConclusionsHIV prevention efforts can succeed by addressing sexual behaviour and its socio-economic and cultural contexts. More innovative, interdisciplinary and productive structural approaches to HIV prevention need to be developed in close collaboration with affected communities and be closely related to policy-making and implementation; to go beyond the limited success of traditional behavioural and biomedical interventions to particularly address the underlying social and structural drivers of HIV risk and vulnerability in the study communities.

Highlights

A thorough understanding of the contexts of sexual behaviour of the people who are vulnerable to HIV infection is an important component in the battle against AIDS epidemic
Sub-Saharan Africa still bears an inordinate share of the global HIV burden with 22.5 million people of the global total infected with HIV; with more women than men living with HIV
Tanzania is among the countries affected greatly by HIV and AIDS with 1.3 million people, including adults and children aged less that 18 years, in Tanzania mainland were living with HIV by early 2008 [3], and specific subpopulations in Tanzania among others, fishing communities have disproportionately high HIV burden [4]

Summary

Introduction

A thorough understanding of the contexts of sexual behaviour of the people who are vulnerable to HIV infection is an important component in the battle against AIDS epidemic. Sub-Saharan Africa still bears an inordinate share of the global HIV burden with 22.5 million people (more than two-thirds) of the global total infected with HIV; with more women than men living with HIV. As HIV continues to spread and affect the lives of millions of people, discovering ways to prevent the transmission of HIV is of primary concern to health care authorities worldwide and a growing sense of urgency has developed about the imperative need to stop the epidemic. Sexual behaviour is one of the most significant factors in the spread of HIV as the vast majority of people newly infected with HIV in sub-Saharan Africa are infected during unprotected heterosexual intercourse [1,5,6]. Negative messages about sexuality can undermine, rather than promote, safer sexual behaviour [10]

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