Study finds high use of HIV pill (Truvada) among co-wives in Kenya

By Gatonye Gathura

More women in polygamous unions, than in monogamous relationships are taking up the daily HIV prevention pill.

A study presented last month in Boston, US, by Dr John Kinuthia of Kenyatta National Hospital (KNH), showed a high acceptance of the pill among women in polygamous unions.

This, implied women in polygamous marriages are aware they are at a higher risk of HIV infection by virtue of the multiplicity of partners involved and need protection.

This week Kenyans have been riveted by a call from Kiambu politician, Gathoni wa Muchoba for local men to marry several wives.

But the study by Dr Kinuthia, also head of research at KNH, shows women in polygamous unions do not necessarily find them a bed of roses.

Last year the Ministry of Health launched a once-a-day pill to protect HIV negative people against infection.

The pill Truvada is recommended for people, both men and women, who think they are at a substantial risk of HIV infection.

Top on this list, ministry guidelines show are prostitutes, drug injectors, young girls and people with multiple sex partners.

So far data shows about 13,000 Kenyans including truck drivers are taking the pill.

In his study Dr Kinuthia, also affiliated to the University of Washington, US, had assessed the acceptance of the pill by women attending antenatal clinics in western Kenya.

“Women in western Kenya, a region with high HIV prevalence rates, are at a high risk of infection,” Dr Kinuthia had told the conference.

The study had screened 1,008 pregnant women last year for willingness to take up the HIV prevention pill also called Pre-exposure Prophylaxis or PrEP.

Of the total number of women, 252 accepted and were prescribed for PrEP the same day.

“More women in polygamous marriages were initiated for PrEP than women in monogamous marriages,” said Dr Kinuthia.

In this and an earlier study by Dr Kinuthia which also confirmed possible higher risk of HIV in polygamous unions he recommended better protection for the involved women.

His message targeted the estimated 2.5 million spouses in polygamous unions in Kenya. These are about 1.8 million wives and about 700,000 husbands in the unions.

The Kenya Demographic Health Survey estimates that 60 per cent of women in Kenya are married and 13 per cent of these are in polygamous unions.

The same document says about 50 per cent of men in the country are married with seven per cent of them in polygamous unions.

North Eastern has the highest proportion of women, more than a third or 36 per cent in polygamous unions.

In Nairobi only two per cent of women are in a polygamous unions but this does not take into account those secretly living in similar relationships.

Western, Nyanza, Rift Valley, and Coast provinces all have proportions ranging between 15 and 23 per cent of women in polygamous relationships.

Among men, Nyanza has the highest number living in polygamous unions while the least number of males in such unions are to be found in Central Province, according to the 2009 KDHS.

“The proportion of married women reporting one or more co-wives has declined from 16 per cent in 2003 to 13 per cent in 2008, and the proportion of married men who report having more than one wife has declined from 10 per cent to seven per cent,” says the KDHS.

Population experts say women with little or no education and also the poorest are most likely to be in such unions. These unions are also more prevalent in rural than urban areas of the country.

The study had also warned that due to the nature of more than one sexual partner, polygamy presents an elevated risk of HIV infection.

In an earlier study on cervical cancer prevention in Kenya by Eleanor Atieno Ochodo then with Royal Tropical Institute of the University of Amsterdam, The Netherlands the researcher had had linked polygamy to a higher risk of cervical cancer.

The study had recommended women in polygamous unions for regular cervical cancer screening.

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