div class="t m0 xc he y1c9 ff1 fsb fc0 sc0 ls1 ws0">Rural-rural - - 1.18 (1.01 - 1.37)* 1.11 (.89 - 1.39)
Had multiple sex partners in last 12 months
No .04 (.01 - .30)** .49 (.33 - .75)*** .48 (.26 - .90)* .40 (.28 - .56)***
Yes 1.00 1.00 1.00 1.00
Age
15 - 19 .46 (.36 - .60)*** .88 (.53 - 1.45) .54 (.45 - .65)*** .65 (.47 - .90)**
20 - 29 .75 (.61 - .91)** 1.24 (.88 - 1.76) .89 (.77 - 1.02)+ 1.20 (.93 - 1.55)
30+ 1.00 1.00 1.00 1.00
Marital status
Not currently married .72 (.60 - .87)*** 1.00 (.69 - 1.43) .59 (.50 - .69)*** 1.03 (.79 - 1.35)
Currently married 1.00 1.00 1.00 1.00
Education
Less than High School .69 (.57 - .83)*** .57 (.43 - .74)*** .86 (.74 - 1.00)+ .79 (.64 - .97)*
High School or higher 1.00 1.00 1.00 1.00
Ethnicity
Other ethnic groups 1.49 (1.22 - 1.81)*** .95 (.69 - 1.32) 1.29 (1.11 - 1.50)*** .38 (.30 - .49)***
Kikuyu 1.00 1.00 1.00 1.00
Religion
Other religious affiliation 2.42 (1.86 - 3.14)*** 3.09 (2.09 - 4.56)*** 3.06 (2.5 - 3.8)*** 3.49 (2.45 - 4.96)***
Muslim 1.00 1.00 1.00 1.00
Age at first sexual intercourse
At age 15 or later .67 (.51 - .89)** .63 (.45 - .88)** .76 (.64 - .90)*** 1.00 (.81 - 1.24)
Before age 15 1.00 1.00 1.00 1.00
Knows someone who has or died of AIDS
No .83 (.67 - 1.01)+ .73 (.52 - 1.02)+ .82 (.71 - .95)** .75 (.61 - .91)**
Yes 1.00 1.00 1.00 1.00
Model X2 219.09*** 117.86*** 438.45*** 261.54***
Number of cases 2467 1110 4879 2345
***p < .001; **p < .01; *p < .05; +p < .10.
women in other ethnic groups were more likely to perceive
themselves at risk of HIV/AIDS infection (OR = 1.49 and 1.29
in urban and rural areas, respectively). In contrast, being a Ki-
kuyu was associated with lower perception of risk of
HIV/AIDS for men; but the effect was only statistically sig-
nificant in rural areas (OR for non-Kikuyu men as compared to
Kikuyu men was .38 at p .001).
Religion had a similar effect on the perceived risk of
HIV/AIDS for both men and women, regardless of their place
of residence. Compared to Muslim, men and women of other
religious faiths and non-believers were about three times more
likely to perceive themselves at risk of HIV/AIDS infection (at
p .001).
The timing of first intercourse is significant factor of per-
ceived risk of HIV/AIDS, especially among women. Compared
to their counterparts who had their first sexual intercourse be-
fore age 15, Kenyan women who had their sexual debut at age
15 or later were significantly less likely to perceive themselves
at risk of HIV/AIDS infection (OR = .67 at p .01 and OR
= .76 at p .001, respectively in urban and rural areas). Among
men, only those in urban areas had significant odds of perceiv-
ing themselves at low risk of HIV/AIDS, if they had first sexual
experience at age 15 or later (OR = .63 at p .01).
For both men and women, not knowing someone who has
HIV or died of AIDS was associated with lower perception of
HIV/AIDS risk. However, such risk was lower for men than for
women both in urban areas (OR = .73 and .83 respectively for
men and women both at p .10) and rural setting (OR = 75
and .82 respectively for men and women both at p .01).
Correlates of Condom Use at Last Non-marital
Sexual Intercourse
Results presented in Table 5 focused on condom use at last
Copyright © 2012 SciRes. 173
S. R. KIMUNA, Y. K. DJAMBA
Table 5.
Adjusted odds ratios of using condom at last non-marital sexual intercourse by place of residence and by sex, KDHS 2003.
Models
Urban Rural
Variables Women Men Women Men
Non-migrant 1.00 1.00 1.00 1.00
Migrant
Urban-urban 1.15 (0.63 - 2.07) 0.58 (0.29 - 1.17)
Rural-urban 0.70 (0.38 - 1.27) 0.58 (0.29 - 1.19)
Urban-rural - - 1.34 (0.70 - 2.59) 1.02 (0.58 - 1.81)
Rural-rural - - 1.30 (0.71 - 2.35) 0.97 (0.61 - 1.53)
Perceived risk of getting HIV
No 1.03 (0.60 - 1.77) 2.09 (1.06 - 4.12)* .54 (.32 - .92)* .56 (.35 - .91)*
Yes 1.00 1.00 1.00 1.00
Age
15 - 19 .77 (.38 - 1.56) .63 (.24 - 1.66) 1.73 (.85 - 3.56) 2.50 (1.22 - 5.12)**
20 - 29 1.09 (.64 - 1.84) .70 (.30 - 1.62) 1.91 (.96 - 3.82)+ 3.55 (1.85 - 6.83)***
30+ 1.00 1.00 1.00 1.00
Marital status
Not currently married .68 (.14 - 3.24) 1.38 (.43 - 4.38) 4.75 (.60 - 37.47) 1.29 (.49 - 3.40)
Currently married 1.00 1.00 1.00 1.00
Education
Less than High School .59 (.36 - .96)* .46 (.27 - .77)** .51 (.30 - .86)* .72 (.47 - 1.10)
High School or higher 1.00 1.00 1.00 1.00
Ethnicity
Other ethnic groups .92 (.56 - 1.51) 1.15 (.62 - 2.14) 1.11 (.63 - 1.94) 1.73 (1.07 - 2.82)*
Kikuyu 1.00 1.00 1.00 1.00
Religion
Other religious affiliation 1.20 (.49 - 2.98) .85 (.35 - 2.07) 2.28 (.27 - 19.17) 4.98 (1.05 - 23.57)*
Muslim 1.00 1.00 1.00 1.00
Age at first sexual intercourse
At age 15 or later 1.10 (.58 - 2.11) 2.05 (1.16 - 3.62)** .68 (.38 - 1.22) 1.10 (.73 - 1.65)
Before age 15 1.00 1.00 1.00 1.00
Knows someone who has or died of AIDS
No .54 (.30 - .97)+ .92 (.43 - 1.95) .42 (.20 - .87)* .63 (.39 - 1.02)+
Yes 1.00 1.00 1.00 1.00
Model X2 21.627*** 26.493** 31.104*** 39.190***
Number of cases 390 280 468 477
***p < .001; **p < .01; *p < .05; +p < .10.
sexual intercourse for those whose last intercourse was with a
non-marital sex partner. These data show that there was no
significant difference per migration status. Similarly, we found
no significant effect of current marital status on condom use at
last non-marital sexual intercourse. In contrast, the remaining
variables have some significant association with the dependent
variable.
One surprising finding was that, for both men and women in
urban areas, those who perceived themselves at risk of HIV
infection were less likely to use a condom at their last
non-marital sexual intercourse than those who did not consider
themselves at such risk. However, the association was statisti-
cally significant only for men (OR = 2.09 at p .05). On the
other hand, perceived risk of getting HIV was positively and
significantly associated with the use of condoms at last
non-marital sexual encounter for both men and women in rural
areas. Compared to rural residents who perceived themselves at
risk of HIV/AIDS, those who did not consider themselves at
risk were significantly less likely to have used a condom at the
last non-marital sexual intercourse (OR = .56 and .54 respec-
tively men and women both at p .05).
Overall, education was associated with condom use. Those
who had at least a high school education were more likely to
have used a condom at their last non-marital sexual intercourse
than respondents with less than high school education. Among
women, the magnitude of impact was similar in both urban and
rural areas (OR = 59 and .51 respectively, and both at p .05).
For men, the association was statistically significant only in
urban areas (OR = .46 at p .01). In addition, respondent’s age
was significant only for rural residents. However, the relationship
was that of an inverted U-shape with those aged 20 - 29 more
likely to have used a condom at their last non-marital sexual in-
tercourse than younger and older respondents. However, the im-
pact of age on condom use was only statistically significant
among rural residents; among women those aged 20 - 29 were
about two times (OR = 1.91 at p .10) more likely to have used a
condom at their last non-marital sexual intercourse as compared
to women aged 30 and older. Among men in rural areas, all
Copyright © 2012 SciRes.
174
S. R. KIMUNA, Y. K. DJAMBA
those below age 30 were significantly more likely to have used
a condom at their last non-marital sexual experience as com-
pared to the older men (OR = 2.50 at p .01 and OR = 3.55 at
p .001 for age-groups 15 - 19 and 20 - 29 respectively).
Ethnicity and religion were significantly associated with
condom use only for men in rural areas. Compared to men from
the Kikuyu ethnic group, men from other ethnic groups were
nearly two times (OR = 1.73 at p .05) more likely to have
used a condom at their last non-marital sexual intercourse. As
for religion, non-Muslims were about five times (OR = 4.98 at
p .05) more likely to have used a condom at their last
non-marital sexual intercourse as compared to Muslim men.
On the other hand, age at first sex had significant impact on
condom use only for men in urban areas. Urban men who de-
layed the onset of sexual activity were significantly more likely
to use a condom at their last non-marital sexual intercourse than
those who had sex before age 15 (OR = 2.05 at p .01).
Finally, knowing someone who had HIV or died of AIDS
affected condom use. Results in Table 5 show that regardless
of place of residence and sex, respondents who were acquainted
with people infected with HIV were more likely to use con-
doms at their last non-marital sexual intercourse than those who
had no knowledge of people with HIV. In urban areas, such
impact is only significant for women. Compared to those who
don’t know anybody who has HIV or died of AIDS, those who
do, had a significantly low odds (OR = .54 at p .10) of having
used a condom at their last non-marital sexual relation. In rural
areas, the effect was significant for both sexes, although the
magnitude of the impact was stronger for women (OR = .42 at
p .05) than men (OR = .63 at p .10).
Table 6.
Adjusted odds ratios of having had sexual intercourse with more than one partner in the last 12 months by place of residence and by sex,
KDHS 2003.
Models
Urban Rural
Variables Women Men Women Men
Non-migrant 1.00 1.00 1.00 1.00
Migrant
Urban-urban 1.73 (.72 - 4.14) 1.31 (.80 - 2.13) - -
Rural-urban 1.33 (.66 - 2.71) 1.08 (.64 - 1.84) - -
Urban-rural - - .76 (.40 - 1.46) 1.39 (.95 - 2.03)+
Rural-rural - - 1.51 (.80 - 2.85) 1.13 (.81 - 1.58)
Perceived risk of getting HIV
No 25.69 (3.50 - 188.46)*** 2.04 (1.34 - 3.10)* 2.12 (1.13 - 3.98)* 2.48 (1.76 - 3.49)***
Yes 1.00 1.00 1.00 1.00
Age
15 - 19 .95 (.37 - 2.43) .45 (.22 - .94)* .75 (.35 - 1.61) .55 (.33 - .91)*
20 - 29 1.13 (.55 - 2.29) 1.13 (.73 - 1.75) 1.01 (.59 - 1.75) 1.10 (.76 - 1.58)
30+ 1.00 1.00 1.00 1.00
Marital status
Not currently married 2.51 (1.28 - 4.93)** 1.40 (.90 - 2.17) 1.53 (.84 - 2.78) 1.35 (.93 - 1.97)
Currently married 1.00 1.00 1.00 1.00
Education
Less than High School 1.82 (.92 - 3.58)+ 1.54 (1.07 - 2.20)* 4.54 (1.61 - 12.79)** 1.60 (1.14 - 2.23)**
High School or higher 1.00 1.00 1.00 1.00
Ethnicity
Other ethnic groups 1.34 (.63 - 2.87) 1.44 (.93 - 2.23) 1.87 (.87 - 4.02) 3.20 (2.05 - 4.98)***
Kikuyu 1.00 1.00 1.00 1.00
Religion
Other religious affiliation 3.50 (.79 - 15.44)+ .86 (.50 - 1.49) 2.23 (.68 - 7.33) 1.09 (.60 - 1.98)
Muslim 1.00 1.00 1.00 1.00
Age at first sexual intercourse
At age 15 or later .65 (.29 - 1.43) .85 (.57 - 1.27) .42 (.43 - .70)*** .57 (.43 - .77)***
Before age 15 1.00 1.00 1.00 1.00
Knows someone who has or died of AIDS
No .67 (.29 - 1.56) .48 (.27 - .83)** .67 (.36 - 1.25) .89 (.64 - 1.23)
Yes 1.00 1.00 1.00 1.00
Model X2 48.877*** 44.738** 48.887*** 99.983***
Number of cases 2467 1110 4879 2345
***p < .001; **p < .01; *p < .05; +p < .10.
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S. R. KIMUNA, Y. K. DJAMBA
Sexual Experience with Multiple Partners
The results in Table 6 show the likelihood that a respondent
would have had sex with multiple partners in the 12 months
before the survey. The independent variables included in these
analyses are the perceived risk of being infected with HIV,
socio-demographic characteristics, age at first sexual inter-
course, and knowledge of someone living with HIV or who
died of AIDS.
Table 6 results show that migration was a significant corre-
late of multiple sexual partners only among men living in rural
areas. Among rural resident men, only urban-rural migrants
were significantly more likely to have had sex with multiple
partners than non-migrants (OR = 1.39 at p .10). In contrast,
we found that respondents who did not consider themselves to
be at risk of being infected with HIV were significantly more
likely to have had sexual intercourse with multiple partners.
This pattern was consistent for men and women in both rural
and urban areas; but the most outstanding case was found
among urban resident women with an odds ratio value of 22.69
(p .001).
The age category showed teenagers to be somewhat different
from the rest of the respondents in terms of their risk of having
sex with multiple partners. Still, the effect was significant only
for men for whom the likelihood of having had sex with multi-
ple partners was significantly lower among teenagers compared
to men aged 30 years and older (OR = .45 and .55, both at p
.10, respectively in urban and rural areas) . Also, we found
that marriage had only some protective effect among women in
urban areas. For urban women, those who were married had
lower risk of having had sex with multiple partners (OR = 2.51
at p .01).
Interestingly, for both men and women in rural and urban
areas, education was significantly associated with lower risk of
having had sex with more than one partner in the last 12
months. However, the magnitude of the effect was not the same
across models. The strongest impact was found among rural
women with less than high school education. For such women,
the likelihood of having had sex with multiple partners in the
12 months before the survey was nearly five times higher (OR
= 4.54 at p .01) compared to rural women with high school
education or higher. The lowest, yet significant effect was ob-
served among urban resident men with less than high school
education (OR = 1.54 at p .05), in comparison to those with
high school education or higher.
The odds ratios for ethnicity show that the Kikuyu were less
likely to have had sex with multiple partners, compared to other
ethnic groups. Nonetheless, this ethnic effect was statistically
significant only among men in rural areas (OR = 3.20 at p
.001). Religion had only a marginally significant effect on the
number of sexual partners among urban. For these women,
being of Muslim religion greatly reduced the risk of sexual
activity with multiple partners women (OR = 3.50 at p .10).
As one would expect, having had first sexual intercourse at a
younger age was associated with having had sexual experience
with multiple partners even in this case where the timeframe
was one year. However, this association was only significant in
rural areas where both men (OR = .57 at p .001) and women
(OR = .42 at p .001).who initiated sex at younger ages were
more likely to have had more sexual partners in the last 12
months than those who delayed their debut of sexual inter-
course. Ironically, for men in urban areas, knowing at least one
person living with HIV or who died of AIDS significantly in-
creased the likelihood of having had sex with multiple partners.
This study set out to examine internal migration in Kenya
and its effect on risky sexual behaviour as measured by the
perceived risk of getting HIV, use of condom at last non-mari-
tal sexual intercourse, and sexual intercourse with multiple
partners. We argued that because migration exposes people to
different cultural norms and values, migrants would be more
likely than non-migrants to engage in risky sexual behaviour.
However, our findings show only a marginal impact of urban-
rural migration among rural residents. Overall, more respon-
dents considered themselves to be at risk of being infected with
HIV (little more than 60% of men and women in the sample).
Such risk was consistently and statistically significantly higher
among migrants than non-migrants, regardless of sex and place
of residence.
However, once socio-demographic characteristics and other
correlates of sexual behaviour were introduced in the regression
models, migration effect became statistically significant only
for migrant women in rural areas. Even for such women, only
those who moved from urban to rural areas were significantly
more likely to perceive themselves at risk of HIV infection,
compared to non-migrants.
This may suggest that migrant women in rural areas are rela-
tively more attractive in the local sexual network market hence
their heightened perceived risk of HIV infection. As noted in
Brokerhoff and Biddlecom (1999) study, there could be a
number of explanations for these findings. First, rural migrant
women may be moving away from kin, which may remove the
behavioural constraints imposed by family and second, they
may be moving to rural road sites and trading centres, where
the forces of migration may further aggravate gender related
inequalities by increasing women’s economic and physical
exposure to casual or transactional sex as a survival strategy
(Anarfi, 1993).
As it has been noted elsewhere (Kimuna & Djamba, 2005;
Hattori & Dodoo, 2007), we also found that marriage does not
reduce the risk of having HIV in Kenya. This is probably be-
cause married people have more resources and other qualities
that are attractive in mate selection process. Likewise, our
findings showed that education does not reduce the risk of be-
ing infected with HIV in this sample.
Despite the fact that most respondents reported fear of being
infected with HIV, the majority still did not use condoms at
their last non-marital sexual activity (53% for men and 75% for
women). Moreover, the results from multivariate analyses in-
dicate that there is no significant difference in condom use at
last non-marital sexual activity by migration status. This may
indicate either the presence of strong cultural norms against
condom use, or that there is no significant difference in the
knowledge and availability of condoms between urban and
rural areas.
The lack of migration effect on condom use in this analysis
may also suggest that contraceptive knowledge and practices
are well diffused across Kenya. It may also indicate a more
circular nature of migration in which those involved don’t stay
longer in place of destination. Another important finding is that
marital status does not affect the chance of using condoms in
non-marital relations and this was regardless of sex and place of
residence.
These results suggest that high risk sexual behaviour such as
non-condom use with multiple sexual partners is very complex
Copyright © 2012 SciRes.
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S. R. KIMUNA, Y. K. DJAMBA
and it needs to be approached from a socio-cultural standpoint.
Moore and Oppong’s (2007) study noted the futility of advo-
cating for people to use condoms, especially those in marriages.
Their research found that people in steady relationships such as
marriage did not believe in using condoms with their spouses,
even when they knew of their sero-positive HIV status. The fact
that condom use is not related to marital status even when mar-
ried people engage in extramarital sex is alarming. Prevention
programs should be multifaceted and take the environment in
which people live and local realities into consideration.
The migration effect was also non-significant in the models
of the likelihood of having multiple sexual partners, except
among men in rural areas. For the latter, we found that net of
other control variables urban-rural male migrants were signifi-
cantly more likely to have had sex with multiple partners than
non-migrants. With the exception of unmarried women in urban
areas who were significantly more likely to have had sex with
multiple partners, we did not find a significant effect of mar-
riage among men or women in rural areas. Again, this weak and
generally lack of strong effect of marriage on risky sexual be-
haviour shows that marriage per se is not a protective factor in
the combat against HIV/AIDS.
One encouraging finding is that those who consider them-
selves to be at risk of being infected with HIV tend to limit the
number of sexual partners. This result supports the popular
view that knowledge is power. Yet, this was not translated into
condom use at last non-marital sexual intercourse for urban
residents.
Education emerged as an important factor associated with
low sexual risk. Although more educated respondents tended to
see themselves at higher risk of being infected with HIV, they
were significantly more likely to use condoms at last non-
marital sexual activity and to report lower risk of having had
sexual intercourse with multiple partners. This finding supports
the idea that formal education is a strong empowerment vari-
able that leads to more responsible sexual behaviour. Likewise,
knowing someone who had HIV or died of AIDS seems to raise
awareness about HIV risk and to lead to better likelihood of
condom use in an extra-marital relationship.
We also found that delaying the onset of sexual intercourse
helps to lower risky sexual behaviour. Respondents who had
their first sexual intercourse at age 15 or later were significantly
less likely to see themselves as being at risk of HIV infection.
Such respondents were also more likely to use condoms at their
last non-marital sexual activity and were less likely to have had
sex with multiple sexual partners in the 12 months before the
survey. This result suggests that delayed sexual activity may
result in more knowledge and safer sexual practices. Other
cultural factors, such as religion and ethnicity also played some
role in risky sexual behaviour, although their effects were not
all consistent across sex and place of residence.
Overall, this study suggests that there is little or no signifi-
cant difference in sexual behaviours between migrants and
non-migrants. This is probably because migration in Kenya is
ongoing and quite complex. First, Kenya is a country of inter-
nal migration as compared to other nations in the region (Choi,
2003). As shown in this study, more than half of the respon-
dents in the sample were migrants. Second, Kenya is character-
ised by unique ethnic groups that have distinctive cultural
norms that have specific effects on sexual behaviours. As a
result, the findings from this study must be used with caution
when comparing to other regions of the world.
Nonetheless, the lack of strong effects of migration on the
sexual risk and sexual behaviour variables examined here sug-
gests that efforts to reduce risky sexual behaviour should target
all segments of the population, regardless of their migration
status and place of residence.
Acknowledgements
This paper was presented at the International Organization of
Social Sciences and Behavioural Research, the spring 2012
conference. Thanks also to Tawanda Blackmon and Erin Brown,
respectively research assistant and program assistant at the
Center for Demographic Research at Auburn University at
Montgomery, for helping with the preparation of the statistical
tables. The authors are grateful to the anonymous reviewers for
their comments and suggestions.
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