• Food poverty, to be precise, is the single most important risk factor.
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According to the Homa Bay multi-sectoral Aids strategic plan 2014/15-2018-19, there are a number of socio-cultural and socio-economic factors that lead to the spread of HIV in the county.
The study was conducted in the eight subcounties between September 2014 and October 2015. It identified several factors as the main driver of the HIV epidemic.
In the survey, poverty was found to be the most important factor increasing the risk and vulnerability to HIV infection. Under poverty, food poverty was the single most important risk factor. This was followed by poor nutrition, lack of school fees and inadequate access to healthcare, clothing and shelter.
Cultural practices were also highlighted. The survey found that the most significant cultural practices included widow inheritance, taboos and community celebrations involving sex (planting and harvesting rites, constructions, among others), polygamy, low number of circumcised males, post-funeral rites and celebrations and husband inheritance.
Sexual attitude and behaviour was another factor. This includes low deception of risk and multiple (concurrent) partnership; womanhood (weak or inability to negotiate safe sex); casual heterosexual transactional sex; mascuilinity and conquest ideology prevalent in men and adolescents (men generally considered/strong powerful).
Other factors are pleasure-loving lifestyle (risky sexual behaviour during celebrations); intergenerational sex; and permissiveness in young male boy sexuality (boys encouraged to have girlfriends). Fisherfolk and fishing industry networks within the fisherfolk and fishing networks were four significant sources of vulnerability.
They include middlemen and women (Jaboya), fishing lifestyle and related activities (jorimba) engagement with female sex workers residing in the islands of Lake Victoria, inadequate health facilities and poor parental attitude towards schooling.
General lifestyle-related factors under this category include misuse of alcohol and bhang, love of music and other entertainment (disco matanga, ohangla, video shows, parties and faithful-based fellowships, camping), joblessness/being idle, orphanhood (inadequate social and economic protection, sexual abuse).
Others are early marriages (age 15 years and below), a disconnect between knowledge and practice, gender-based violence (spouse battering), single parenting, sexual violence(rape), dropout from learning institutions, behaviour of political leaders and the youth emulating them.
The important part of vulnerability included attitudes of individuals, health service providers and distance to the health facilities. It also included confidentiality issues by health care providers, availability of drugs and skilled health providers and the affordability of user fees and other charged profession-related skills. This was the least significant risk factor among the seven drivers of the HIV epidemic.