Increased awareness of STIs alone does not guarantee safer sexual behavior, study shows

More and more people are aware of modes of transmission of Sexually Transmitted Infections (STIs) and ways to be protected from them with increased media proliferation in recent years. However, the increased awareness alone does not guarantee safer sexual behavior, a study in Sri Lanka has shown.

The study which was carried out to assess knowledge, attitude and behavior related to STIs and HIV/AIDS among factory workers in the Seethawaka Export Processing Zone in Sri Lanka has found that the majority of the respondents had a satisfactory level of knowledge on HIV and STIs but a very low proportion exhibited safe sexual behavior.

For example, while 85% of the 480 respondents involved in the research were aware of HIV testing, fewer than 10% of respondents actually did the testing. Likewise, over one-third of the study population participated in sex with a non-regular partner and a large proportion did so without using a condom.

"The more alarming finding of the study was the prevalence of male-to-male sexual activity (15%) with very low condom use," says the lead author of the article, Dr Manjula Rajapakshe. "This is worrying as anal sex carries the highest risk of HIV transmission."

She says that this issue needs to be addressed in future interventions for factory workers and condoms should be promoted, stressing the high risk of HIV transmission through anal sex.

Likewise, the study, published in The Sri Lanka Journal of Sexual Health and HIV Medicine and made available online free of cost via the SLJOL platform, has shown that a big proportion of people in the area studied had a negative attitude towards people living with HIV. More than half the respondents expressed negative attitudes towards people living with HIV. Ironically, although a large chunk of the respondents resorted to unsafe sexual behavior, a high level of stigma against people living with HIV was present. The respondents said that people with HIV should not be given a job, should not be given the right to marry and have children, should not be given equal rights. Likewise, over half the respondents said they would not work together, live in the same house or eat together with a person that has HIV.

"As the study shows that the attitude towards people living with HIV/AIDs (PLHIV) was significantly associated with HIV-related knowledge of the factory workers, it is important to further increase the HIV-related knowledge among this group to reduce their negative attitudes towards PLHIV," says Dr Rajapakshe.

"Furthermore, the traditional methods of awareness programmes that target only on increasing knowledge [should change] to more focused methods of behavior change communication (BCC) strategies, both to reduce stigma against people living with HIV/AIDs and to promote safer sexual behavior. Training of peer leaders and update their knowledge and skills with retraining would be a sustainable intervention in this regard," she says.