Patterns of utilization of hiv preventive services by boda-boda operators in homabay town, kenya
Omolo, Winnie Akinyi
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The mobility of the transport sector makes it difficult to access health information and treatment and/or maintain a drug regimen. There is high HIV prevalence rate in Homa-Bay County with a prevalence of 25.7% compared to 5.6% nationally. The purpose of the study was to determine patterns of utilization of HIV preventive services which specifically sought to find out awareness of HIV status, to determine the HIV prevention strategies employed by the boda-boda, to investigate the driversaffecting the uptake of HIV preventive services and finally to explore the health seeking behavior patterns among boda-boda operators in Homa-Bay town. The study adopted three theories key among them was cognitive theory. This was a mixed methods study. The study population was 1120 and it targeted male boda-boda operators who were aged between 20-40 years. The sample size for the study was 119. The main respondents were boda-boda operators while key respondents were their group leaders. Logistic regression analysis was used to determine the drivers affecting the uptake of HIV preventive services among the study population. Results from this study show that a majority of the operators (89.3%) reported having been tested for HIV. Relatively low HIV prevention service uptake with condom being the most used service at 68.9%. In the multivariate analysis, occupation of the respondent, marital status and highest level of education attained were significantly associated with HIV prevention services uptake. Participants who reported owning a business, either (Duka, Kiosk or Juakali) were about 38% less likely to utilize any of the services compared to those who reported farming as their other source of income occupation (PR=0.62, 95% CI 0.62-0.96); whereas in terms of marital status, divorced/separated were two-fold likely to use any of the two services compared to the married in a monogamous family (PR=2.13, 95% CI 1.36-3.33). Those respondents reporting having attained primary level of education as the highest were 1.3 more likely to utilize any of the services compared to those reporting secondary as the highest level of education (PR=1.33, 95% CI 1.00-1.78). Finally, medical pluralism was noted among boda-boda operators who sought health services. The study concludes that, HIV testing services in Homa-Bay are effective since many respondents reported having had an HIV test. However, utilization of HIV preventive services are relatively low as compared to the high awareness of HIV preventive services. Occupation, marital status and level of education were found to be the drivers affecting uptake of HIV preventive services. Finally, medical pluralism was noted among the operators who sought health services. The study recommends to the ministry through NACC to create flexible HIV testing hours in order to reach all the operators with testing services, put emphasis to increase the utilization of HIV prevention methods through education, there is also a need to target operators with higher educational levels, those that own business and married monogamous to increase their ability to effectively utilize HIV preventive methods. Finally, education on the importance of seeking medical services from health facilities should be stressed.