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Biomedical subjects

D Nyamwaya

Publications and source records attributed to D Nyamwaya.

7 recordsLinked to original sources
PubMed2000

Preventing HIV infection through peer education and condom promotion among truck drivers and their sexual partners in Tanzania, 1990-1993.

HIV prevention through peer education and condom promotion among truck drivers and their sexual partners is described. Trends during an initial 18-month intensive phase, followed by a 24-month maintenance phase, were monitored with surveys. Trends for self-reported condom use were: increase among men (56 to 74%) during the first phase with a decrease (72%) during the maintenance phase. Respective figures for women were 51%, 91% and 70%. Multivariate analyses revealed that men most likely to report using condoms were unmarried, had children, were more educated, had previously reported a genital ulcer, and perceived themselves at risk for HIV infection (OR = 1.95-3.47). Women tending to use condoms were unmarried, aware of the limitations of condoms, not in denial as to the existence of HIV, harboured inaccurate information about HIV transmission and were afraid (OR = 1.35-2.52). Both sets of results suggest that the most sexually experienced men and women who did not have a permanent stable relationship and who perceived themselves at risk, were most likely to use a condom. Peer education was an effective tool for increasing knowledge and encouraging appropriate behaviour change. It was most effective as an intensive high-input intervention and sustainable with the relatively stable population of truck drivers.

Adolescent↗
PubMed1997

Adolescent sexual behavior along the Trans-Africa Highway in Kenya.

OBJECTIVE: To describe the demographic characteristics and HIV-related risk behaviors of adolescents frequenting truck stops along the Trans-Africa Highway in Kenya. METHODS: A cross-sectional study of 200 adolescents (52% female) aged 15-19 years was conducted at the Malaba, Sachangwan and Mashinari truck stops in Kenya. A standardized questionnaire assessing the adolescents' demographic characteristics and sexual behavior was administered. RESULTS: Most (89%) of the adolescents interviewed were out of school. Their median monthly family income was Ksh1000 (US$25). Most felt that their families provided inadequate access to food (72%), clothing (70%) and pocket money (87%). Ninety-three per cent of girls and 87% of boys had ever had sexual intercourse and of these 54% of girls and 38% of boys had ever used a condom. Fifty-two per cent of the girls and 30% of the boys reported ever having had a sexually transmitted disease. Forty-six percent of girls reported usually having sex with truck drivers, 78% of girls reported usually exchanging sex for gifts or money and 59% of boys reported usually giving gifts or money for sex. Subjects engaging in these three risk behaviors were generally less likely to be in school, less likely to live with relatives and less likely to report getting along well with their parents. CONCLUSION: Adolescents at truck stops along the Trans-African Highway in Kenya appear to be at significant risk for HIV infection. In the absence of an immediate and wide-ranging intervention, these conditions are likely to facilitate the spread of HIV from truck drivers and sex workers to adolescents.

Acquired Immunodeficiency Syndrome↗
PubMed1987

A case study of the interaction between indigenous and Western medicine among the Pokot of Kenya.

The article discusses the complex interrelationship between Pokot indigenous medicine and Western medicine. Pokot concepts of the causation of illness are examined as a prelude to the main argument, which states that though these concepts of causation influence the use made of both indigenous and Western forms of therapy, a number of other factors also affect this use. The relationship between the two types of medicine is shown to be dynamic and that it can be competitive, supplementary or complementary. It is also shown that there is differential perception of both forms of therapy by different categories of Pokot. The interrelationship between the two forms of medicine is discussed by using specific illustrations divided into three categories, i.e. the cognitive, behavioural and organizational. It is further shown that Pokot perceive both forms of medicine as elements of a single medical system.

Attitude to Health↗
PubMedDate not supplied

Socio-cultural information in support of local health planning: conclusions from a survey in rural Kenya.

Existing health information systems in developing countries are managed and used mainly by biomedically trained personnel and by general healthcare administrators. They focus on epidemiology, service utilization and finance; they generate little of the socio-cultural data needed for developing and adjusting health services and disease control programmes to local health-related perceptions, values and resources. This paper reviews some of the published literature on socio-cultural factors related to health and summarizes the findings of a health household interview study in rural Kenya. It concludes that local views on specific disease categories and their causes are crucial for the planning of local disease control and that health information systems need to be expanded to incorporate such data. It discusses methods of generating community-based socio-cultural health information likely to be useful, particularly at district level. Options include observation, household interviews, focus group discussions and key informant interviews. Four improvements are suggested: (1) health information systems should be reoriented to focus less on individual patients and clients and more on population-based information including socio-cultural data; (2) post-basic health manpower training is needed in applied health-related social sciences; (3) staff positions for social scientists at central, provincial and district levels of the health sector; and (4) expansion of research on national and local socio-cultural issues of relevance to health and care-seeking behaviour.

Community Health Planning↗