HIV/AIDS prevention knowledge and behaviors of rural women who are recipients of a community health worker program in Nampula Province, Mozambique

摘要

Background: Mozambique has an HIV/AIDS prevalence of 11%. A number of educational programs that promote condom use have been implemented to reduce transmission, but the impact of these programs has not been well documented. A better understanding of the relationship between these programs and the knowledge and behavior of program recipients is of great public health significance. udMethods: Data from a 2012 cross-sectional survey evaluating the coverage of Community Health Worker (CHW) programs in Mozambique was analyzed. Logistic regression analysis was used to determine the relationship between discussing prevention of HIV with a CHW and, a) recipient knowledge of a condom source; and, b) recipient use of condoms at last sexual intercourse. Sharing of HIV messages between the recipient and others in the community was also analyzed. udResults: Among women who discussed prevention of HIV with a CHW, 57% (n=377) reported knowing a condom source. Ninety-five percent (n=635) of the women reported sexual experience, but only 9% (n=55) of these women reported condom use at their last sexual encounter. Approximately 55% (n=148) of women shared HIV prevention information with someone else in their community. The odds of knowing a condom source are five times greater for women who spoke to a CHW about HIV compared to women who did not speak to a CHW about HIV (OR=5.12, 95% CI: 2.89-9.09). Women who spoke to a CHW about HIV were no more likely to use a condom at last sexual encounter than women who did not speak to a CHW about HIV (OR=1.20, 95% CI: 0.50-2.88). udConclusions: The HIV epidemic in Mozambique is extremely complex due to the social, cultural, and economic aspects of the environment. An astounding amount of money has gone towards prevention but the epidemic has not abated. CHW programs are one approach to mitigating the epidemic, but more research needs to be done to better understand the role of CHWs in changing behavior around sexual health. Finally, it is essential that we discover new and innovative ways of implementing HIV educational programs in Mozambique to have a positive impact on HIV prevention behaviors. ud