HIV Knowledge is Associated with Risky Sexual Behavior: An Evaluation Study in Uganda

Background: The HIV prevalence in Uganda has stagnated calling for improvement of prevention, care and treatment efforts. Understanding risky sexual behavior is a key component of HIV prevention. However, the association between HIV-knowledge and risky sexual behavior is unknown in Uganda.  

Methods: Cross-sectional descriptive study using secondary data previously collected in a nationally representative HIV sero-behavioral survey of 18,525 adults, 15-59 years old, for HIV and sexually transmitted diseases. Risky sexual behavior’s definition was unprotected sex at last encounter with any non-marital or non-cohabiting partner. Comprehensive HIV Knowledge variable was constructed as a composite variable from six knowledge questions.

Using bivariate and multivariate analyses, HIV-knowledge and selected socio-demographic factors were assessed to understand their relationship with risky sexual behavior.

Results: Of 14,044 respondents who responded to the sexual behavior questions and were included, 55% were female. Overall, mean age was 33 and 27 among non-risky and risky group respectively. 21% had secondary education or more; 94% were HIV negative; 26% of the men were circumcised and 26% reported one sexual partner in the last 12-months; 17% of participants with Comprehensive HIV-Knowledge were engaged in risky sexual behavior; 10% not knowledgeable engaged in risky sexual behavior.  The odds that Moslems would report engagement in risky sexual behavior were 1.22 times more than Catholics (p-value 0.001, OR: 1.04-1.43); a multivariate analysis, adjusting for sex, age, education and occupation, Comprehensive HIV-Knowledge was associated with risky sexual behavior (AOR 1.79 [CI] 1.62 to 1.99, p<0.001).

Conclusions: Comprehensive HIV-Knowledge does not translate into non-risky sexual behavior.  Therefore development of better messaging and interventions should target both those who are knowledgeable and not for HIV prevention.