Exploring the perceptions of young women living with HIV towards HIV risky sexual behaviours: the case of Mbinga Town Council

Although young women living with HIV are reported to have more HIV knowledge and awareness compared to those who are HIV negative, the previous literature shows that their engagement in risky sexual behaviours is high and young women living with HIV face challenges in negotiating for safer sex due to power differences, they engage in multiple sexual relationships and face the problems of poor abstinence capability and alcohol consumption. The risky sexual behaviors position them into the risk of new HIV transmission and being re-infected, thus increasing viral load and drug resistance to new HIV strains. Few studies treat YWLHIV as homogenous group and demonstrate their belief and perception towards their behaviours regarding that practices involves thought, beliefs, and feeling evolution. Therefore, this study aims to explore YWLHIV perceptions towards HIV risk sexual behaviours and the way their current behaviour can be explained or understood. A purposive sample of twenty-one young women living with HIV participated in this study. The inclusion criteria were disclosure of HIV and AIDS status, attending CTC and RCH, age 15-24 years old, being in a sexual relationship and living in Mbinga. In-depth interview guide was used to collect data. The Health Belief Model was used as the theoretical framework. The data was collected from Mbinga Town hospital and 5 health centres. The results showed that YWLHIV have positive perceptions towards the avoidance of risk sexual behaviours, however low efficacy on safer sex negotiation and use of condoms was influenced by power difference, trust for their couples, economic dependence to their partner, fear of losing their partners and long-time relationships. This implies that despite being HIV positive YWLHIV still face the risk of being re-infected and infecting others. The study recommends that efforts which aims on preventing HIV infection among key populations should also include YWLHIV, emphasizing the use of other protective methods like virginal microbicides, build self-efficacy among this age group and economic empowerment.