Factors predictive of HIV sero-status among married couples in Kenya using a national data set: Implications for health interventions

The purpose of this study was to assess factors predictive of HIV sero-status among married Kenyan couples using a national data set. The study also assessed the health needs related to HIV prevention among married couples with an aim of making suggestions for health interventions for this population. Numerous studies have been conducted on the vulnerability to HIV infection of the high risk groups, which excludes married couples, instead of high risk behavior, which is inclusive of the married couples in Sub-Saharan Africa. Consequently, virtually no studies exist that focus on married couples as at-risk of infection to the disease. Recent epidemiological studies have found married couples as the single largest group with the highest rate of new infections of HIV in Africa with women being disproportionately affected contrary to the assumption that marriage is a safe haven. Recognizing the central role that culture plays in behavioral and health decisions, this dissertation sought to assess factors predictive of HIV sero-status among married Kenya couples within a cultural framework. Secondary data from the 2003 Kenya Demographic Health Survey was used in this study with a sample size of 1430 married couples.

T-tests, ANOVAs, and logistic regression analyses were the main statistical methods for data analysis in this study. Hypotheses were tested at .05 level of significance. Consistent with the theoretical framework that guided this study and supported by existing literature, the findings from this study show that factors predictive of HIV sero-status among married Kenyan couples are multi-dimensional and include demographic, socio-cultural, behavioral, economic, psycho-social and biological categories. Empirical findings from this research provides health professionals with helpful information for designing culturally appropriate health interventions and policies that may contribute to effective HIV prevention for this population. Integrating selected constructs from the PEN-3 Model; AIDS Risk Reduction Model; and the Empowerment Theory, a new model for predicting HIV sero-status among married couples is proposed. Interdisciplinary studies are needed to uncover some of the confounding factors of the epidemic in the face of mixed and inconclusive results that currently exist. Well-developed causal models are important in understanding human behavior and social change.