UNDERSTANDING OF THE COMMUNITY TOWARDS SAFER SEX STRATEGIES THE CASE OF KIAMBU MUNICIPALITY


UNDERSTANDING OF THE COMMUNITY TOWARDS SAFER SEX STRATEGIES THE CASE OF KIAMBU MUNICIPALITY

 

 

 

 

 

 

 

 

 

 

 

 

 

A research proposal submitted to Premese Africa Development Institute in partial fulfilment for the award of Diploma in Community Health and Development.

 

 

 

 

 

 

 

By

ANN NYAWIRA MAINA

DCHD/SEM-1/FT/004/085/2007

 

 

 

 

 

 


TABLE OF CONTENTS

 

Context                                                                                                Page                   

 

Table of contents   ……………………………………………………   i

Glossary …..…………………………………………………………….…   ii

Abstract …..…………………………………………………………….…   iii

Introduction ………………………………………………………………   1

Problem Statement ……………………………………………………  5

Significance of Study ……………..………………………………….   5

Objective of the Study ………………………………………………..  6

Study Location ……………………………….….…………………….…..   7

Methodology            ……….…………………………………………………   9

Literature Review …….……………………………………………..    9

Bibliography ………………………………………………………….. 13

Appendices ………………………………………………………….   14

Appendix: 1  References …………………………………………….. 14

Appendix: 2  Interview Questions …….…………………………..  15

Appendix: 3  Map of Kiambu Municipality………………………. 16

Appendix: 4  Map of Kiambu District …………………………….. 17

Appendix: 4  Map of Kenya ………………………………………..  18

 

 


GLOSSARY

 

AIDS               Acquired Immune Deficiency Syndrome

HIV                 Human Immune-Deficiency Virus

STIs                 Sexually Transmitted Infections

PADI               Premese Africa Development Institute


Abstract

Safer sex is any sex where you choose behaviours that make it less likely you will get an infection. Although safer sex may mean protecting yourself and your partner(s) from the exchange of body fluids, it really means any changes you make in your sexual activities to protect each other.

 

Given the rapid spread of the disease (HIV/AIDS), there is need to continually reassess transmission mechanisms and the behavioural factors which increases the likelihood of a rapid spread of HIV infection and its prevention.

 

Evidence suggests that there is greater potential to alter the behaviour and attitudes of younger people with regard to sexuality and HIV/AIDS, because their opinions and behaviour patterns are less well established, so that preventive activities aimed at young people are not only highly necessary but may also be particularly effective.

 

This study seeks to focus on the assessment of the level of understanding of the community and religion towards safer sex strategies at Kiambu Municipality. The aim of the study is to assess or determine the level of understanding and perception of the community and religion towards safer sex strategies. Interview questions will be used to collect the information.


  1. 1.       Preamble

1.1.     Background information

 

Safer sex is any sex where you choose behaviours that make it less likely you will get an infection. Although safer sex may mean protecting yourself and your partner(s) from the exchange of body fluids, it really means any changes you make in your sexual activities to protect each other.

 

Given the rapid spread of the disease (HIV/AIDS), there is need to continually reassess transmission mechanisms and the behavioural factors which increases the likelihood of a rapid spread of HIV infection and its prevention.

 

Evidence suggests that there is greater potential to alter the behaviour and attitudes of younger people with regard to sexuality and HIV/AIDS, because their opinions and behaviour patterns are less well established, so that preventive activities aimed at young people are not only highly necessary but may also be particularly effective.

 

This study seeks to focus on the assessment of the level of understanding of the community and religion towards safer sex strategies at Kiambu Municipality. The aim of the study is to assess or determine the level of understanding and perception of the community and religion towards safer sex strategies. Interview questions will be used to collect the information.

 


 

1.2.    Problem Statement

 

Sexuality and sexual behaviour encompass immense area of human nature and behaviour. However, in most societies, these issues are usually not a matter of open discussions.

 

Hundreds of thousands of women and children have contracted the HIV virus despite living lives of moral fidelity. For example, in many cultures a woman’s highest risk factor is to be faithfully and submissively married to a husband.

In many places it is unacceptable for a woman to negotiate safe sex; to ask her husband to be sexually faithful; to insist he uses a condom if he isn’t faithful; to refuse sex if she suspects he is infected; or to leave him if she feels her life is at risk. Rape and sexual abuse are always more common in such cultures (and subcultures).

Jesus endorsed sexual union and faithfulness within committed, monogamous heterosexual relationship as “good”, as being part of God’s intention for humanity. But the Church in general has handled the subject of sex with embarrassment and discomfort. This lack of frank discussion fuels the AIDS crisis by failing to offer forum for discussion, clear guidelines, role models or accountability for those exploring their sexuality, instead attributing it.

 

1.3.    Significance of Study

 

  • In the view of the above, there is need to assess the level of understanding of the community in Kiambu Municipality towards safer sex strategies.

 

  • The study will initiate a dialogue to create awareness and educate people on various aspects of sexual health, HIV/AIDS and to promote safe sex practices, including use of condom.

 

  • This study seeks to encourage the church to be leading the way in discussing and celebrating, rather than attributing it to ethical cause or blame.

 

1.4.    Objectives of the Study

1.4.1          General Objectives

 

  • To assess or determine the level of understanding of the community towards safer sex strategies (abstinence, being faithful and use of condoms)

 

1.4.2         Specific Objectives

 

  • To asses the community and religion perception and behaviour towards the use of safer sex strategies.
  • To identify information needs of the community and religion in the context of sexuality, sexual health and safe sex.
  • To use this information needs through dialogue by creating an enabling environment and to empower the community to adopt safe sex practices.
  • To determine whether the health workers at community level disseminate proper and accurate information to the community members on the safer sex strategies (sex education).

 

1.5.    Research Question

 

The researcher seeks to find the level of understanding of safer sex strategies among the Kiambu town community, and if they do practice it.

 

1.6.    Study Location

1.6.1          Background Information

 

Kiambu District covers an area of approximately 1,324 km2. Bordering in the South is the Nairobi and Kajiado Districts, to the East and West by Nyandarua and Nakuru Districts respectively. The district has seven administrative divisions which are subdivided into locations as shown in Fig.xx. Kiambu Municipality is the district administrative headquarters where the District Commissioner resides. The local government has a bottom up administrative structure starting from the Sub – Location to the district level, namely: i.e. chiefs, divisional administrators, commissioner.

 

The district is divided into four broad topographical regions i.e. the Upper and Lower highlands and Upper and Lower midland respectively. The upper highland is found in Lari location and is an extension of Aberdare ranges. It lies at an attitude of 1,800M above the sea level. The lower highlands are mostly found in Limuru, part of Kikuyu and Githunguri divisions. It’s characterised by hills, plateaus and high level structural plains which make it fairly easy for construction of road network.

 

The upper midland which is below 1,500M above the sea level covers parts of all the divisions in the district except Lari. The landscape comprises of dry plains. Attitude is the single most important factor influencing climate in Kiambu. The rainfall regime bimodal and reliable rains occur between April and May while the short rains fall from October to November. The mean temperature in the district is 26oC; average temperature ranges from 20.4oC in the upper highlands to 34oC in the lower midlands of Karai in Kikuyu divisions.

 

Surface and subsurface water are the main water sources in the district. The surface waters comprise of many permanent rivers and springs i.e. Kamiti, Riara, Kiu, Ruiru, Gatamaiyu, Kamothai, Bathi, kiruini which are fairly well distributed all over the district except in Karai and Ndeiya. The swampy areas are found in Ondiri in Kikuyu and Ruiru in uplands.

 

Although the district hosts different ethnic groups, the majority of the people here are Kikuyu who are engaged in agriculture. The agriculture and rural development sector have earned the district a lot of income both at the household and industrial levels.

 

1.6.2         Population

 

The District has a total population of 802,625 people, and 189,706 households with a density of 1,375. Kiambu Municipality division by itself, where the study is conducted has a population of 188,055 persons, and 50,965 households with a density of 987. The population data was obtained from the District Commissioner’s Office of Kiambu based on census done in 1999, January 2001 publication. The estimate population distribution of the district is shown in the table below.

 

1.6.3         Literacy

 

With 137,635 pupils enrolled in Primary School, there is an indication that the district has a participation rate of 89%. However, there are many school dropouts after the Primary level of education due to the high cost of education and the limited number of place in secondary school. About 50% of the children in this age end up in the labour market, youth polytechnic and the informal sector.

 

1.6.4         Health Services

 

The district has accessible and fairly well distributed health facilities; it has 203 clinics, 37 dispensaries, 22 health centres and 11 hospitals. The health providers are either the government or non-government organization.

 

The most common diseases in the district are Respiratory Tract Infections, Malaria, Skin diseases and Intestinal worms. Diseases of Respiratory system are caused by exposure to coldness and if not treated can cause Pneumonia and Bronchitis. HIV/AIDS is also very significant here and is believed to have a very high prevalence.

 

 


2.0              Literature Review

The researcher will critically find out if any study of the kind was carried out to collate and aggregate data. The validation of results will involve comparison with some documented research in the topic and interviews, where possible to draw some validation.

 

3.0              Methodology

This will explain the study design, how the sampling will be carried out and the sample size. It will also elaborate on tools used, data analysis and the limitations of the study.

 

3.1               Study design

 

This will be a descriptive cross-sectional study, which will be carried out to determine the level of understanding on safer sex strategies among the sexually active, commercial sex workers, employed and unemployed in Kiambu Municipality.

 

The criteria for choosing these place was based on their regional representation, service delivery, security, accessibility, expected level of coverage and presence of diverse activities. The criteria to determine the sample size was derived from a number of factors: The population coverage, prevalence of HIV/AIDS, which forms the target population for questioning on safer sex strategies.

 

The sample size is therefore determined by using the Andrew Fisher’s method of 1990:   n =    Z2pq___

d2

Where n = desired sample size of the total population, < 10, 000 and where,

Z = Standard normal deviate set at 95% which corresponds to 1.96 in the statistical tables.

 

P = proportional of population under study (0.70) – known characteristics in the target population.

q = 1 – p (0.70);           d = level of accuracy desired set at 0.07.

n = (1.96)2 x (0.70) x (0.30) = 164.6327 units

(0.07)2

 

n = 165_

1+165

2256

 

Since the n = desired sample size was less than 10, 000; the N = estimate study population is 2, 256 Hence, n = n__   therefore;                                      = 154

1+n_

N

The probability proportional to size (PPS) technique was used to arrive at the number of respondents for the study location.

 

3.2              Sampling Frame/Procedure

 

Random sampling method will be used to determine the number of respondents required in each village by using probability proportion to size technique.

 

3.8              Data collection instruments

 

  • The main instrument for the exercise will be in-depth interviews (face to face). Data will be collected using structured and semi-structured interviews, to gather information on social demographic, knowledge, attitude and practice and on the understanding of safer sex strategies.

 

  • The interviews questions are prepared knowing that, the majority of the questions are subjected to quantitative and qualitative analysis. Questions are clear and unambiguous, direct with simple language so that the respondents can comprehend question.

 

  • The researcher will ensure good respond rate, by establishing trust by assuring the respondent of the confidentiality of the research and encouraging the him/her by leaving a free hold the respondent to express his/her own opinion in some questions and emphasising to the fact that their cooperation would benefit the community as research is concern the health of the community.
  • The balance between quantitative and qualitative (more opinion) data and open ended questions to be asked to the respondents will achieve the quality of measurement.

 

3.4              The questionnaire design

 

The designs of the questions are grouped into four phases: the general information of the respondent, knowledge, attitude and practice on the safer sex strategies.

3.5              Data analysis

 

The data will be collected and analysed manually using scientific calculator. The results will be presented in figures, tables, percentages, bar and pie charts.

 

3.6              Ethical Consideration

 

Property rights for any investigations methodology developed will lie with the generator. Any information or specific data will be subjected to confidentiality agreement which will permit the dissemination of the generic findings on a non-attributable basis.

 

3.7              Time Frame of the Study

 

The lead researcher will be responsible for the overall supervision, organisation and co-ordination of research activities, meetings, computer work and final preparation of the research report (analysis).

 

Travel and subsistence are essential costs as the researcher will have to spend more time in literature review in big libraries and collect data, likewise in the field during the actual exercise.

 

Table: 4 Time Frame

 

Period’07 Task/Stage
Oct 15
  • Research proposal  to PADI
Oct. 17
  • Finalise commitment with questionnaire review and translation (refined)
  • Field preparation and data collection
Oct. 26
  • Literature/reference search
  • Data analysis and compiling the report.
Nov. 5
  • Communication of results and Binding
Nov. 12 – 21
  • Submission of the final draft (report)

 

 

3.8              Proposed Bibliography/Reference

 

The researcher will gain time to research on the topic in various books, research papers, and documentaries.

 

 


Appendix: 1 Reference

  1. Community Counselling & Training Centre, Handouts.
  2. William M. Muraah, William N. Kiarie, HIV/AIDS, Facts that could change your life, 2001.
  3. Daily Nation Newspaper, article –

 

 


Appendix: 2 Interview Questions:

  1. How old are you?
  2. Sex of the respondent: M=1, F=2
  3. Age of the respondent: 12-14=1, 15-28=2, 29-44=3, 45+=4
  4. Marital status of the respondent: Single=1, Married=2, Widow=3, Widower=4, Separated=5, Divorced=6
  5. How many children do you have? 1-5=1, 5-10=2, None=3
  6. Are all your children alive? Yes=1, No=2. If no, explain the cause of death? ____
  7. Education level: Primary=1, High School=2, University=3, None=4
  8. What do you do for a living? Employed=1, Unemployed=2, Farmer=3, Business=4, Other specify _______=5
  9. What is your religion? Christian=1, Muslim=2, None=3
  10. Have you ever heard of an illness called HIV/AIDS? Yes = 1, No = 2
  11. Where did you hear about HIV/AIDS? Church=1, Family=2, Health Workers=3, Don’t know=4
  12. What do you feel about HIV/AIDS?
  13. Do you discuss it? Yes=1, No=2
  14. How is HIV/AIDS transmitted? Sex = 1, Body fluids/blood = 3, Mosquitoes = 4, Sharp objects = 5, Don’t know = 6
 

  1. Is there anything a person can do to avoid getting HIV/AIDS? Yes = 1, No = 2, Abstinence = 3, Faithfulness = 4, Condoms = 5, Don’t know = 6, Other (specify) = 7
  2. Have you seen this? (show the condom) Yes=1, No=2
  3. Do you use them? Yes=1, No=2
  4. What do you feel about them? Bad = 1

Good = 2, Embarrassing = 3, Don’t know = 4

  1. Do the church talk about them? Yes = 1, No = 2. If no, why not? ________
  2. Have you ever been forced to sex? Yes=1, No=2; if yes, what did you do?
  3. Have you ever received money or goods in exchange for sexual services? Yes=1, No=2
  4. How many sexual partners do you have? 0=1, 1-4=2, 5-10=3, 11+=4
  5. What do you feel about the PWAs:
  6. Have you ever received any information on sexuality and safer sex? Yes=1, No=2
  7. If yes, where? School=1, Health providers=2, Parents=3,
  8. Do you usually have sexual dialogue at home? Yes=1, No=2

 


Appendix: 3 Map of Kiambu Municipality


Appendix: 4 Map of Kiambu District


Appendix: 5 Map of Kenya


Posted on March 2, 2012, in Categorized. Bookmark the permalink. Leave a comment.

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