Factors Associated with HIV- Related Risky Sexual Behaviour Among Ugandan Military Personnel.

Abstract

Introduction and background: The Human Immunodeficiency Virus (HIV) epidemic has been fueled by poverty, multiple concurrent sexual partners, lack of adequate HIV knowledge, and unsafe sexual practices among others. Military personnel are among those considered at greatest risk for contracting and transmitting HIV. Preventing risky sexual behaviors such as sexual intercourse without a condom and multiple sexual relationships has been the focus of HIV interventions in sub-Saharan Africa. It has been noted that soldiers are generally young and sexually active and that they are often deployed far from their homes and families. These soldiers fall prey to peer-pressure, sex workers, stress, and other frustrations that may increase their sexual encounters.

Main Objective: The general objective of this study was to assess the factors influencing HIV-related risky sexual behavior among the Ugandan military population.

Methodology: This was a descriptive cross-sectional study employing both quantitative and qualitative methods of data collection. The main source of data was from the interview questionnaire that were filled by 304 military personnel in First Division namely Mbuya, Kakiri, and Bombo barracks. Data was entered into a computer SPSS system for analysis. Pearson Chi-squared were used to determine relationship between sexual behavior and predetermined factors.

Results: 80.6% of the participants were male and 46.5% were aged 20-29years. 95.4% had good knowledge of HIV transmission and 86.5% perceived soldiers to be at risk for HIV. For condom use, statistically significant associated factors were marital status (p-value <0.001), and knowledge of HIV prevention (p-value = 0.018). For sex with multiple sex partners, the statistically significant factors were male gender (p-value = 0.005), young age of less than 30years (p-value = 0.008), lower education (p-value = 0.006) and knowledge of HIV transmission and prevention. The factors that significantly influenced sex with commercial sex workers were age (p-value = 0.020), male gender (p-value <0.001), lower education level attained (p-value <0.001), deployment within Uganda (p-value = 0.002), and HIV prevention services in the barracks (p-value = 0.029). The factors that significantly influenced alcohol consumption before sex included younger age (p-value = 0.020), education (p-value = 0.033), deployment within Uganda (p-value = 0.035), and HIV prevention inclusion in the training curriculum (p-value = 0.002). At multivariate analysis male gender, younger age, lower education level, marital status, knowledge of HIV prevention methods, deployment, and HIV prevention education in the training curriculum were still found to be significantly associated with risky sexual behavior.

Conclusions and Recommendations: Unmarried military personnel used condoms more, hence less at risk of engaging in risky sexual behaviors. Male gender, older age, and lower education, engaged in sex with multiple sex partners and sex with commercial sex workers. Soldiers of older age and lower education consumed alcohol before sex. Soldiers with good knowledge of HIV prevention did not consistently use condoms. Those with good knowledge of HIV transmission and prevention engaged in sex with multiple sex partners. Perception of soldiers being at more risk for HIV did not influence their engagement in risky behavior. Military personnel who were deployed within Uganda engaged less in sex with commercial sex workers. Alcohol consumption before sex was less in those who were deployed within Uganda and those who reported HIV prevention inclusion in their training curriculum. The UPDF should take a multidimensional approach to continuously provide information and communication on condom use and reduction in risky sexual behavior among all military personnel.