SEXUAL-BEHAVIOR AND RISK ASSESSMENT OF HIV SEROCONVERTORS AMONG URBANMALE FACTORY-WORKERS IN ZIMBABWE

Despite extensive HIV prevention programmes and knowledge of people dy ing of AIDS, people in Zimbabwe continue to be infected with HIV and o ther sexually transmitted infections (STIs). This paper presents selec ted case histories from interviews with 57 men who became HIV positive during follow up of 1678 seronegative male factory workers in Harare, and describes the circumstances in which they were exposed to infecti on. Youth was a major risk factor, with 47% of those who seroconverted aged between 18 and 24 yr. STIs were reported by 23% of the group in the seroconversion period, a marker of unprotected sex. Individuals di d not: recognise themselves or their partners as candidates for infect ion because of categorisation of high risk groups as ''promiscuous'' o r clients of sex workers. Many were optimistic that they had changed s ufficiently by using condoms more often or by avoiding sex workers. Th ey made inaccurate assessments of who was safe for unprotected sex, ba sed on judgements about their character, background and age. Over 40% of the seroconvertors had previously been counselled on staying HIV ne gative. Community approaches which nurture development of supportive g roup norms, respect for human rights and responsibilities, and safe en vironments for disclosure of HIV status, are vital for overcoming deni al of risk at individual and societal levels. Special efforts targeted at youth are crucial since they have the highest risk of new infectio ns and include use of media, drama, role models, advisory centres, pee r education programmes. Health professionals need training and skills to enable people at risk of HIV infection to devise strategies based o n more realistic personal risk assessment. (C) 1998 Elsevier Science L td. All rights reserved.