Hostname: page-component-7479d7b7d-c9gpj Total loading time: 0 Render date: 2024-07-11T19:36:31.712Z Has data issue: false hasContentIssue false

PERCEPTION OF VULNERABILITY TO HIV INFECTION AMONG OLDER PEOPLE IN NAIROBI, KENYA: A NEED FOR INTERVENTION

Published online by Cambridge University Press:  13 July 2012

GLORIA CHEPNGENO-LANGAT*
Affiliation:
Centre for Research on Ageing, School of Social Sciences, University of Southampton, UK

Summary

It is evident that sexual activity tends to decrease with age. Nonetheless, it is still prevalent enough to be considered a risk factor for the spread of HIV among older people. This paper uses quantitative data for 2053 individuals to examine HIV risk perception and correlates of perceived risk among older people aged 50 years and older living in Nairobi slums. It emerged that a majority of older people did not consider themselves at risk of infection. Of those who felt at risk, a greater proportion sensed only a small chance of contracting HIV. Women cited ‘no sexual activity’ while men mentioned ‘having only one and/or a faithful sexual partner’ as the primary reasons for perceiving minimal risk of HIV infection. There were no differences by sex in the basis for perceiving moderate-to-great risk of infection. Religion is a key factor in risk perception with Muslims perceiving higher levels of risk and, conversely, devotees irrespective of faith perceiving lower levels of risk. Older people willing to be tested for HIV had a decreased likelihood of perceived risk compared with those unwilling to be tested. This paper recommends evaluation of older people's perception of risk in order to better inform interventions aimed at minimizing their vulnerability to HIV infection.

Type
Articles
Copyright
Copyright © Cambridge University Press 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Akers, A., Bernstein, L., Henderson, S., Doyle, J. & Corbie-Smith, G. (2007) Factors associated with lack of interest in HIV testing in older at-risk women. Journal of Women's Health 16, 842858.CrossRefGoogle ScholarPubMed
Akwara, P. A., Madise, N. J. & Hinde, A. (2003) Perception of risk of HIV/AIDS and sexual behaviour in Kenya. Journal of Biosocial Science 35, 385411.CrossRefGoogle ScholarPubMed
APHRC (2010) The Nairobi Urban Health and Demographic Surveillance System. APHRC, Nairobi, Kenya.Google Scholar
Bauer, M., McAuliffe, L. & Nay, R. (2007) Sexuality, health care and the older person: an overview of the literature. International Journal of Older People Nursing 2, 6368.CrossRefGoogle ScholarPubMed
Beguy, D., Bocquier, P. & Zulu, E. M. (2010) Circular migration patterns and determinants in Nairobi slum settlements. Demographic Research 23, 549586.CrossRefGoogle Scholar
Bignami-Van Assche, S., Chao, L. W., Anglewicz, P., Chilongozi, D. & Bula, A. (2007) The validity of self-reported likelihood of HIV infection among the general population in rural Malawi. Sexually Transmitted Infections 83, 3540.CrossRefGoogle ScholarPubMed
Bongaarts, J. (2007) Late marriage and the HIV epidemic in sub-Saharan Africa. Population Studies 61, 7383.CrossRefGoogle Scholar
Branstrom, R., Kristjansson, S. & Ullen, H. (2006) Risk perception, optimistic bias, and readiness to change sun related behaviour. European Journal of Public Health 16, 492497.CrossRefGoogle ScholarPubMed
Browning, C. R. & Olinger-Wilbon, M. (2003) Neighborhood structure, social organization, and number of short-term sexual partnerships. Journal of Marriage and Family 65, 730745.CrossRefGoogle Scholar
Campbell, C., Skovdal, M. & Gibbs, A. (2011) Creating social spaces to tackle AIDS-related stigma: reviewing the role of church groups in sub-Saharan Africa. AIDS and Behavior 15(6), 12041219.CrossRefGoogle ScholarPubMed
Centers for Disease Control (2008) HIV/AIDS among Persons Aged 50 and Older. CDC HIV/AIDS Facts, Centers for Disease Control.Google Scholar
Central Statistical Office (CSO) & Measure DHS (2007) 2006–07 Swaziland Demographic and Health Survey (SDHS): HIV Prevalence. CSO & Measure DHS.Google Scholar
Clausen, T., Charlton, K. E. & Holmboe-Ottesen, G. (2006) Nutritional status, tobacco use and alcohol consumption of older persons in Botswana. Journal of Nutrition, Health & Aging 10, 7.Google ScholarPubMed
Cockcroft, A., Kunda, J. L., Kgakole, L., Masisi, M., Laetsang, D., Ho-Foster, A., Marokoane, N. & Andersson, N. (2010) Community views of inter-generational sex: findings from focus groups in Botswana, Namibia and Swaziland. Psychology, Health & Medicine 15, 507514.CrossRefGoogle ScholarPubMed
de Cock, K. M., Marum, E. & Mbori-Ngacha, D. (2003) A serostatus-based approach to HIV/AIDS prevention and care in Africa. Lancet 362, 18471849.CrossRefGoogle ScholarPubMed
Deeks, S. G. & Phillips, A. N. (2009) HIV infection, antiretroviral treatment, ageing, and non-AIDS related morbidity. British Medical Journal 338, a 3172.CrossRefGoogle ScholarPubMed
Dieffenbach, C. W. (2012) Preventing HIV transmission through antiretroviral treatment-mediated virologic suppression: aspects of an emerging scientific agenda. Current Opinion in HIV and AIDS 7, 106110.CrossRefGoogle ScholarPubMed
Douglas, M. (1992) Risk and Blame: Essays in Cultural Theory. Routledge, London.CrossRefGoogle Scholar
Gold, R. S. (2006) Unrealistic optimism about becoming infected with HIV: different causes in different populations. International Journal of STD & AIDS 17, 196199.CrossRefGoogle ScholarPubMed
Gott, C. M. (2001) Sexual activity and risk-taking in later life. Health & Social Care in the Community 9, 7278.CrossRefGoogle ScholarPubMed
Gustafson, P. E. (1998) Gender differences in risk perception: theoretical and methodological perspectives. Risk Analysis 18, 805811.CrossRefGoogle ScholarPubMed
Gyimah, S. O., Tenkorang, E. Y., Takyi, B. K., Adjei, J. & Fosu, G. (2010) Religion, HIV/AIDS and sexual risk-taking among men in Ghana. Journal of Biosocial Science 42, 531547.CrossRefGoogle ScholarPubMed
Janz, N. K. & Becker, M. H. (1984) The health belief model: a decade later. Health Education & Behavior 11, 147.Google ScholarPubMed
Joffe, H. & Bettega, N. (2003) Social representation of AIDS among Zambian adolescents. Journal of Health Psychology 8, 616631.CrossRefGoogle ScholarPubMed
Justice, A. (2010) HIV and aging: time for a new paradigm. Current HIV/AIDS Reports 7, 6976.CrossRefGoogle ScholarPubMed
Kalichman, S., Simbayi, L., Kaufman, M., Cain, D. & Jooste, S. (2007) Alcohol use and sexual risks for HIV/AIDS in sub-Saharan Africa: systematic review of empirical findings. Prevention Science 8, 141151.CrossRefGoogle ScholarPubMed
Kane, E. W. & Macaulay, L. J. (1993) Interviewer gender and gender attitudes. Public Opinion Quarterly 57, 128.CrossRefGoogle Scholar
Knodel, J. & Im-em, W. (2004) The economic consequences for parents of losing an adult child to AIDS: evidence from Thailand. Social Science & Medicine 59, 9871001.CrossRefGoogle ScholarPubMed
Kouabenan, D. R. (1998) Beliefs and the perception of risks and accidents. Risk Analysis 18, 243252.CrossRefGoogle Scholar
Longfield, K., Glick, A., Waithaka, M. & Berman, J. (2004) Relationships between older men and younger women: implications for STIs/HIV in Kenya. Studies in Family Planning 35, 125134.CrossRefGoogle ScholarPubMed
Lovejoy, T. I., Heckman, T. G., Sikkema, K. J., Hansen, N. B., Kochman, A., Suhr, J. A., Garske, J. P. & Johnson, C. J. (2008) Patterns and correlates of sexual activity and condom use behavior in persons 50-plus years of age living with HIV/AIDS. AIDS and Behavior 12, 943956.CrossRefGoogle ScholarPubMed
Matovu, J. K. B. & Makumbi, F. E. (2007) Expanding access to voluntary HIV counselling and testing in sub-Saharan Africa: alternative approaches for improving uptake, 2001–2007. Tropical Medicine & International Health 12, 13151322.CrossRefGoogle ScholarPubMed
Measure DHS (2011) Demographic and Health Surveys. Measure DHS & ICF Macro, Calverton, MD, USA.Google Scholar
Miller, L. & Gur, M. (2002) Religiousness and sexual responsibility in adolescent girls. Journal of Adolescent Health 31, 401406.CrossRefGoogle ScholarPubMed
Mills, E. J., Barnighausen, T. & Negin, J. (2012) HIV and aging – preparing for the challenges ahead. New England Journal of Medicine 366, 12701273.CrossRefGoogle ScholarPubMed
Minichiello, V., Hawkes, G. & Pitts, M. (2011) HIV, sexually transmitted infections, and sexuality in later life. Current Infectious Disease Reports 13, 182187.CrossRefGoogle ScholarPubMed
Ministry of Health & ORC Macro (2006) Uganda HIV/AIDS Sero-behavioural Survey 2004–2005. Ministry of Health and ORC Macro, Calverton, MD, USA.Google Scholar
Munier, B. (2004) The perception of risk. Journal of Socio-Economics 33(1), 127130.CrossRefGoogle Scholar
NASCOP & Ministry of Health (2008) Kenya AIDS Indicator Survey 2007: Preliminary Report. Government of Kenya, Nairobi.Google Scholar
National AIDS Control Council (2005) Kenya HIV/AIDS Data Booklet. Government of Kenya, Nairobi.Google Scholar
Nyambedha, E. O., Wandibba, S. & Aagaard-Hansen, J. (2003) “Retirement lost” – the new role of the elderly as caretakers for orphans in western Kenya. Journal of Cross-Cultural Gerontology 18, 3352.CrossRefGoogle ScholarPubMed
Obermeyer, C. M. & Osborn, M. (2007) The utilization of testing and counseling for HIV: a review of the social and behavioral evidence. American Journal of Public Health 97, 17621774.CrossRefGoogle ScholarPubMed
Olivi, M., Santana, R. G. & Mathias, T. A. D. (2008) Behavior, knowledge and perception of risks about sexually transmitted diseases in a group of people over 50 years old. Revista Latino-Americana de Enfermagem 16, 679685.CrossRefGoogle Scholar
Phakathi, Z., Van Rooyen, H., Fritz, K. & Richter, L. (2011) The influence of antiretroviral treatment on willingness to test: a qualitative study in rural KwaZulu-Natal, South Africa. African Journal of AIDS Research 10, 173180.CrossRefGoogle Scholar
Prentice-Dunn, S. & Rogers, R. W. (1986) Protection Motivation Theory and preventive health: beyond the Health Belief Model. Health Education Research 1, 153161.CrossRefGoogle Scholar
Schlesinger, B. (1996) The sexless years or sex rediscovered. Journal of Gerontological Social Work 26, 117131.CrossRefGoogle Scholar
Seeley, J., Wolff, B., Kabunga, E., Tumwekwase, G. & Grosskurth, H. (2009) ‘This is where we buried our sons’: people of advanced old age coping with the impact of the AIDS epidemic in a resource-poor setting in rural Uganda. Ageing and Society 29, 115134.CrossRefGoogle Scholar
Shisana, O., Zungu-Dirwayi, N., Toefy, Y., Simbayi, L. C., Malik, S. & Zuma, K. (2008) Marital status and risk of HIV infection in South Africa. South African Medical Journal 94, 537.Google Scholar
Smith, D. J. (2003) Imagining HIV/AIDS: morality and perceptions of personal risk in Nigeria. Medical Anthropology 22, 343372.CrossRefGoogle ScholarPubMed
South, S. J. & Lloyd, K. M. (1995) Spousal alternatives and marital dissolution. American Sociological Review 60, 2135.CrossRefGoogle Scholar
Takyi, B. K. (2003) Religion and women's health in Ghana: insights into HIV/AIDs preventive and protective behavior. Social Science & Medicine 56, 12211234.CrossRefGoogle ScholarPubMed
Theall, K. P., Elifson, K. W., Sterk, C. E. & Klein, H. (2003) Perceived susceptibility to HIV among women – differences according to age. Research on Aging 25, 405432.CrossRefGoogle Scholar
UN Department of Economic and Social Affairs (2012) World Urbanization Prospects. The 2011 Revision. World Urbanization Prospects.Google Scholar
UNAIDS (2011) Global Report: UNAIDS Report on the Global AIDS Epidemic 2010. Joint United Nations Programme on HIV/AIDS (UNAIDS), Geneva, Switzerland.Google Scholar
van der Geest, S. (2001) “No strength”: sex and old age in a rural town in Ghana. Social Science & Medicine 53, 13831396.CrossRefGoogle Scholar
Wallace, R. (1993) Social disintegration and the spread of AIDS-II: Meltdown of sociogeographic structure in urban minority neighborhoods. Social Science & Medicine 37, 887896.CrossRefGoogle ScholarPubMed
Ward, E. G., Disch, W. B., Levy, J. A. & Schensul, J. J. (2004) Perception of HIV/AIDS risk among urban, low-income senior-housing residents. AIDS Education and Prevention 16, 571588.CrossRefGoogle ScholarPubMed
Weinstein, N. D. (1984) Why it won't happen to me: perceptions of risk factors and susceptibility. Health Psychology 3, 431457.CrossRefGoogle ScholarPubMed
Williams, A. & Tumwekwase, G. (2001) Multiple impacts of the HIV/AIDS epidemic on the aged in rural Uganda. Journal of Cross-Cultural Gerontology 16, 221236.CrossRefGoogle Scholar
Wilson, S. R., Brown, N. L., Mejia, C. & Lavori, P. W. (2002) Effects of interviewer characteristics on reported sexual behavior of California Latino couples. Hispanic Journal of Behavioral Sciences 24, 3862.CrossRefGoogle Scholar
Zulu, E. M., Dodoo, F. A. & Ezeh, C. A. (2002) Sexual risk-taking in the slums of Nairobi, Kenya, 1993–98. Population Studies 56, 311323.CrossRefGoogle Scholar