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Vulnérabilité et risques liés au VIH et sida chez les groupes sociaux historiquement marginalisés « Batwa » des districts de Rusizi, Nyamasheke et Nyamagabe au Rwanda

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par Muhire Kanyamasoro
Université nationale du Rwanda/ école de santé publique - Master degree at public health 2010

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1. Context

Most of the people who belong to the vulnerable groups and especially the historically marginalized groups live into conditions likely to favor the risk of HIV and Aids. The situation of discrimination by the other social groups leads to behaviors or attitudes favorable to the prevention against HIV and Aids.

For historically marginalized groups, the situation still remained unknown because since till then no specific studies had been conducted in order to apprehend their situation. Thus, this study has been conducted to this purpose.

2. Objectives

To determine the particularities of vulnerability and risk to HIV and Aids by the Batwa, as social vulnerable and historically marginalized group so as to propose operational strategies in order to prevent and/or to reduce HIV and Aids prevalence in this group.

3. Methodology

Data collecting has effectively reached 130 individuals, say 10.4%, a largely acceptable and representative percentage for the reliability of the survey results in social sciences.

The sample has been established at two degrees of survey: (i) at the district level district, and (ii) to the household level. The study has covered the former Province Cyangugu in the today's districts of Rusizi and Nyamasheke and the one of Nyamagabe in the former province of Gikongoro, while taking into account the balancing weight of locations habitually estimated as populated by a significant number of individuals who the historically marginalized Batwa group. The choice of the respondents has been focused on heads of households, who have been randomly selected per site, a man and a woman if possible. The analysis has been carried out through " SPSS» and» Epi info" computer programme. Chi2 test has been applied with a 5% statistical significance level.

4. Results

The results obtained from the descriptive analysis of the respondents show that 60,7% of the respondents get married before the legal age of 21 years old (the median age being 19 ; medium age : 20, the mode : 16 with 95% C I [19,5416-21,4346]).

In the same vein, regarding age at the first sexual intercourse, more than the half of the respondents (57,7% ) have confirmed having had sex before 21 years old and even before age sixteen (26,9%).

Still as regards sexual behavior, 43,8% of the respondents had non-desired pregnancies before marriage; and a no-negligible group do not perceive any risk of HIV infection (6,9%).

The majority of the respondents acknowledges that HIV does exist (96,9%). So do they for the modes of its transmission and prevention. But they don't know anything at all about Mothers to Child HIV Transmission (PMTCT).

Only 5,4% of the respondents know about HIV prevention and transmission methods, with reference to the three chief means of prevention; notably sexual abstinence, fidelity to an unique non-infected partner and the correct use of the preservative.

As concern prejudices formed around HIV, results demonstrate that the respondents confuse HIV with the poisoning (79,2%). Women are more inclined to believe this than men (60,2% versus 39,8% ).

The surveyed population accuses acute poverty as the main reason which urges the Twa wife to have extra conjugal sexual relations in order to satisfy her household primary needs. Among the given reasons, the quest for food comes first (66,2%), then money and presents (32%) and finally the valorization and/or prestige of having sex with rich person (2%).

As the marital status, married people are the most protected (33,3%) in relation to independent union (0,0%) with p = 0,030; 95% IC [0,562-0,791].

Regarding the use of the condom, results show that the existence of the condom is almost totally known (96,9%). However, only 10,7% of the respondents affirm having used the condom at least once in their life.

Given the fact that the Batwa live in isolation, they don't easily access to information because only 8% argue that they have a health animator within their group; the rest receive information from the radio (28,1%), from neighbors (9,5%), in community meetings with local authorities (19,8%) from the cell health animators (42,5%).

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