W. Qidwai ( Family Medicine Division, Department of Community Health Sciences, The Aga Khan University, Karachi. )
Prevalence of Human Immuno-deficiency Virus (HIV) infection is still believed to be low in Pakistan. However, because of its location in South Asia and the presence of high risk group for the disease, it is likely that Pakistan would experience diffusion of HIV1. We therefore decided to cany out this study to access the understanding of young Pakistani men about sexually transmitted infections (STI s).
Material, Methods and Results
A questionnaire was administered to 188 men between the age of 18 to 30 years, visiting the Family Physicians, at the outpatient clinic of the Aga Khan University Hospital, Karachi, Pakistan. The demographic profile of the patients was recorded. One hundred fifty (80%) were married, majority of the respondents were professionals, belonging to the middle socio-economic group, and had high school or higher level education. Men were selected by convenience sampling. Informed written consent was obtained.
About 66 (35%) of the respondents thought that condom use can prevent STI’s, 38 (20%) thought avoiding intercourse with a prostitute can avoid STI’s, 38 (20%) thought restricting sexual intercourse to one partner can help. Avoidance of homosexuality, sex education and religious teachings were listed as modalities for prevention of STI’s. Interestingly 21(11%) of the respondents were not aware of a condom, 77 (4 1%) of the respondents did not know that condom use could prevent STI’s. Fifty six (30%) of the respondents were not aware that an apparently healthy person could transmit STI’s, 1.6% thought that sexual intercourse with a child could cure STI’s, 36% were not sure about this. A significant 36% were not sure of the answer.
One hundred fifty six (83%) of the respondents stated friends as the source for information about sexual matters, 20 (10.6%) consulted their parents and 12 (6.4%) consulted their siblings in this regard.
We are fortunate that HIV prevalence is still very low in Pakistan. A high proportion of infected cases have come to Pakistan from the Middle East and were sent back after they were found positive for the HIV infection1. Our study shows that young men in our sample are not fully aware about prevention of STI’s. Condom use in Asians has been shown to be less frequent in practice in comparison to non-Asians, even when settled in the West2. Bangladesh fears an epidemic of HIV because of its proximity with India and Myanmar, countries with high HIV prevalence3. Similar fears of HIV epidemic in Pakistan also exist.
In India, ongoing counseling and testing for HIV was associated with risk reduction behavior including condom use4. We can expect such change in behavior in our society if we make an effort in this direction. Sexually active adolescent boys in Gujrat, India are reported to be inadequately prepared to protect them against STI’s and therefore it is advocated that education about safe sex be provided to them5. A survey conducted among the lower class urban population of Delhi, India, revealed that 4.4% respondents had sex outside wedlock and only half of them used condoms6. In a cross sectional survey done in Karachi, 30 sexually active females between the ages 15-45 years from urban community were interviewed. Almost 75% of the respondents had inadequate knowledge about STI’s7. I-IIV in Pakistan is reported to be a disease of those Pakistanis (and their sexual partners) who have traveled abroad, overseas contract workers and those who were transfused abroad or received imported blood products8. The current study demonstrates that a young, sexually active, male of our country has inadequate knowledge about STI’s and their prevention. There is a need to educate them about safe sex in order to decrease the incidence of STI’s including HIV.
I thank Dr. Rukhsana W. Zuberi, Associate Professor, Community Health Sciences, The Aga Khan University, Karachi, for her guidance.
1.Shah SA, Khan OA, Kristensa S, et al. HIV-infected workers deported from the Gulf States: Impact on Southern Pakistan, Int. J. STD. AIDS., 1999;10: 8 12-1 4.
2.Bradby H, Williams R. Behaviors and expectations in relation to sexual intercourse among 18-20 year old Asians and Non-Asians. Sex Transm. Infect., 1999 ;75:162-7.
3.Gibley L, Choudhry P. Khwaja Z, et al. Behavior risk factors for HI V/AIDS in a low HIV prevalence Muslim nation: Bangladesh. Int. J. STD. AIDS., 1999;10: 186-94.
4.Bentley ME, SpratI K, Shepherd ME, et al. HIV testing and counseling among men attending Sexually Transmitted Disease clinics in Pune. India: changes in condom use and sexual behavior over time. AIDS., 1998; 12: 1869-77.
5.Sharma V. Shanna A. Adolescent boys in Gujrat, India: their sexual behavior and knowledge of acquired immunodeficiency syndrome and other sexually transmitted diseases. J. Dcv. Behav. Pediatr., 1997; 18: 399-404.
6.Kumar A, Mehra M, Badhan SK, Gulati N. Heterosexual behavior and condom usage in an urban population of Delhi, India. AIDS. Care, 1997;9: 3 11-18.
7.Hashwani S, Hiranl, Fatima M. Awareness of sexually transmitted diseases in a selected sample in Karachi. J. Pak. Med. Asso., 1999; 49: 161-4.
8.Baqi S, Kayani N, Khan JA. Epidemiology and clinical profile of HIV/AIDS in Pakistan. Trop. Doct., 1999; 29:144-48.