Rugigana, Etienne, Francine Birungi, and Manassé Nzayirambaho. 2014. HIV Knowledge and Risky Sexual Behavior among Men in Rwanda. DHS Working Papers No. 105. Rockville, Maryland, USA: ICF International.
Introduction: In many countries different interventions have been implemented to prevent new infections of the Human Immunodeficiency Virus (HIV). Rwanda has developed and implemented many strategies at the national level to reduce the incidence of HIV in the general population. One of the main objectives of such interventions is to improve the general
level of knowledge of HIV, with the hypothesis that increasing HIV knowledge will reduce risky sexual behavior. However, there has been a concern that HIV knowledge may not necessarily reduce risky sexual behavior. Only a limited number of population-based studies describe the
results of these interventions in terms of how HIV knowledge affects risky sexual behavior. Therefore, the aim of this paper is to fill in this gap, by exploring HIV knowledge and its effect on risky sexual behavior among men in Rwanda.
Methods: The study used data from the 2005 and 2010 Rwanda Demographic and Health Surveys to analyze the association between HIV risk factors and two types of risky sexual behavior—having two or more partners in the past 12 months; and among those with two or more partners, not using a condom at last sex)—and the association between HIV knowledge and those risky behaviors. In addition to descriptive and bivariate analyses, multivariate logistic regression on pooled data from 2005 and 2010 was used to determine predictors of risky sexual behavior.
Results: Among men in the study sample, 5% in 2005 and 7% in 2010 reported having two or more sexual partners in the last 12 months preceding the survey. Among these men, 93% in 2005 and 74% in 2010 did not use a condom at the last sex. Knowledge of the protective effect of having just one uninfected faithful partner decreased from 90% to 82% between 2005 and
2010, and basic knowledge of HIV decreased from 71% in 2005 to 68% in 2010. Knowledge of the protective effect of using condoms increased from 90% in 2005 to 94% in 2010. In adjusted multivariate analysis, HIV knowledge was not associated with either type of risky sexual behavior.
Conclusion: The findings suggest that, while knowledge of the protective effect of using condoms has increased, knowledge of the protective effect of one uninfected faithful partner has been decreasing in Rwanda. This should draw attention to the need to take corrective measures. The study did not find strong evidence of a significant association between HIV knowledge and risky sexual behavior among men in Rwanda. In setting up policies and strategies related to HIV prevention, policymakers should consider that focusing on HIV knowledge is not sufficient in itself.