Sexual behaviours, perception of risk of HIV infection, and factors associated with attending HIV post-test counselling in Ethiopia

Objectives: To describe sexual behaviours, perception of risk of HIV infection, and factors associated with attending HIV post-test counselling (PTC) among:Ethiopian adults. Methods: Data on socio-demographic characteristics, knowledge of HIV infection, sexual history, medical examination, and HIV and syphilis serological status were compared, through uni- and multivariate analysis, in relation to attending PTC within 60 days of HIV testing. Results: Between February 1997 and June 1998, 751 factory workers were enrolled in a cohort study of HIV infection progression. Despite reporting-high-risk sexual behaviours, mainly for males (64% of males and 6% of females had more than five sexual partners in their lifetime, 16% of males and 2% of females reported having had recent casual partners), and knowing that HIV is commonly-transmitted heterosexually in Ethiopia (97% of answers being correct, both genders combined), only 17% of males and 2% of females acknowledged having had activities which had put them at risk of HIV infection. HIV prevalence was 12%, and; did not differ by gender. Of all study participants, 327 (43.5%) returned for PTC within,60 days of HIV testing. PTC attendance did not differ by age, gender, or HIV serological status. Factors independently associated with PTC attendance in males were: good knowledge of HIV infection, [odds ratio (OR) = 1.66], belief that medical follow-up improves the course of HIV infection (OR = 2.02), history of:genital-symptoms (OR = 2.83), positive syphilis serology (OR = 2.62), recent weightless (OR = 1.89), and, with a negative association, being a manual worker (OR = 0.40), and history of recent casual sexual relationships (OR = 0.35). In women, belief that HIV/AIDS can be cured (OR = 3.16), never having been married (OR = 5.02), having five or less children (OR = 2.16), having been raped (OR = 3.42), and having used health facilities in the past year (OR = 1.73) were all positively and independently associated with PTC attendance. Conclusion: Study participants reported high-risk sexual behaviours, yet had a low perception of individual risk. Men attended for PTC because of their knowledge of HIV infection, their past sexual history or their current health status. Women attended for PTC because of their plans for the future, marriage and/or children, rather than their past sexual exposure. Only in cases of rape were they willing to learn of their HIV status.