THE ROLE OF POLYGAMY IN THE TRANSMISSION OF HIV/AIDS IN NIGERIA: A SECONDARY DATA ANALYSIS OF NARHS 2012 PLUS

Abstract

Sub-Saharan Africa is one of the regions with the largest burden of HIV/AIDS and has resulted in health losses over the years. This accounts for over 23.5 million people living with HIV/ AlDS representing 69% of the global burden. Concurrent relationships such as a polygamous union are common in SSA and have been documented to be associated with HIV transmission. Studies have shown that having multiple partners overlapping, i.e. having several partners at the same time increases the risk of contracting HIV. Studies on the association of polygamy and HIV/AIDS have been inconclusive and few studies have explored this association in Nigeria. This study seeks to investigate the association of polygamy with HIV/AIDS, as well as to determine knowledge and behaviour concerning HIV and AIDS among practicing polygamists in Nigeria. A secondary analysis of 31138 respondents from the 2012 National HIV/AIDS Reproductive Health Survey (NARHS plus II 2012) was studied. Along with sociodemographic characteristics, polygamy measured by the variable "number of wives" was used to distinguish the status of monogamy and polygamy. Risky sexual behaviour was measured using type of partners and condom use with partner. Mean knowledge score < 4 was categorized as having poor while a score of ≥ 4 was categorized as having good knowledge of HIV. Descriptive statistics, Chi-square test and logistic regression were used to analyze associations at P= 0.05. Majority of the respondents were currently married (63.9%), half were self-employed (44.6%) and of an average wealth index (42.4%). Less than half of the respondents were aged between 20 - 29 years with a mean age of 31.6±11.9 years. Majority (62.4%) had sexual intercourse with regular partners, while about 800/1000 and 200/ 1000 had sex with casual and commercial partners respectively. Majority did not use condom with regular partner (88.4%), about 300/1000 did not use condoms with casual partners and 100/1000 used condoms with commercial partners. Risley sexual behaviour was prevalent among those who were in polygamous unions . HIV was more prevalent among those who were divorced/separated/widowed (5.2%) compared to those who y,·ere currently married and single. The prevalence of polygamy in this study was 21 % and was not associated with HIV/ AIDS in this study (OR=- 1.16, 95% Cl=0.89 - 1.51. p-value = 0.275). The factors which were associated with HIV/AIDS infection were education and knowledge of HIV/AIDS. Those who have no formal education (OR=0.68, 95% CI=0.49 - 0.88, P = 0.006) are less likely to be HIV positive. Those who have good knowledge of HIV were more likely to test positive to HIV (OR=1.23, 95% CI = 1.00 - 1.50, P=0.042). In this study, despite the low prevalence of polygamy, those in polygamous union were engaged more in risky sexual behaviours. These are risk factors for transmission of HIV. Therefore more efforts should be put into educating and promoting HIV prevention strategies especially those aimed at women to reduce the prevalence of HIV infection. Cultural and traditional practices like widow inheritance known to increase the risk of HIV/AIDS should be discouraged.