SEXUAL-BEHAVIOR AND PERCEIVED RISK OF AIDS AMONG MEN IN KENYA ATTENDING A CLINIC FOR SEXUALLY-TRANSMITTED DISEASES

The sexual transmission of human immunodeficiency virus type 1 (HIV-1) continues at an alarming rate in sub-Saharan Africa despite the fa;ct that awareness of AIDS is high. One explanation for this alarming rat e may be that individuals do not believe that they are personally at r isk for AIDS and are not sufficiently motivated to make changes in the ir behavior. We conducted a cross-sectional study of men with genital ulcer disease to assess their sexual behavior and their perceived risk of AIDS. We studied 787 men between the ages of 17 and 54 years who p resented to a referral clinic for sexually transmitted diseases (STDs) in Nairobi, Kenya. Of these 787 men, 188 (24%) were infected with HIV -1. Awareness of AIDS was essentially universal in this population; ho wever, only 64 men (8%) thought that they were personally at risk of d eveloping AIDS. A logistic regression analysis found that men who beli eved they were personally at risk knew someone with AIDS (odds ratio [ OR], 8.9; 95% confidence interval [CI], 4.0-19.7), received informatio n about AIDS from television or video (OR, 3.0; 95% CI, 1.7-5.5), or h ad previously had an STD (OR, 2.2; 95% CI, 1.2-4.1). Except for a mode st increase in condom use, there was no significant difference in sexu al behavior between the group who considered themselves to be at risk for AIDS and the group who did not consider themselves to be at risk. The results of this study challenge the current strategies on HIV/AIDS education and prevention for urban men in Kenya.