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“A cow dies with grass in it’s mouth” – Fishermen’s response to “zero grazing” in Kisumu, Kenya

“A cow dies with grass in it’s mouth” – Fishermen’s response to “zero grazing” in Kisumu, Kenya. Anjali Sharma, Elizabeth Bukusi, Zachary Kwena, Anne Buffardi, Billy Agot, Charles Muga, King Holmes. HIV/AIDS: Estimated Prevalence. Kenya: 7% Nyanza: 15% Kisumu: 23% Kenya DHS: 2003.

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“A cow dies with grass in it’s mouth” – Fishermen’s response to “zero grazing” in Kisumu, Kenya

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  1. “A cow dies with grass in it’s mouth” – Fishermen’s response to “zero grazing” in Kisumu, Kenya Anjali Sharma, Elizabeth Bukusi, Zachary Kwena, Anne Buffardi, Billy Agot, Charles Muga, King Holmes

  2. HIV/AIDS: Estimated Prevalence Kenya: 7% Nyanza: 15% Kisumu: 23% Kenya DHS: 2003

  3. Location: Lake Victoria, Kisumu District zachary: What doethis statement (last sentence in the notes) mean? It is not clear to me.

  4. Study Objectives Among fishermen who live and work along the shores of Lake Victoria: • Describe HIV/STI protective and risk behaviors – what, why, when, how • Determine baseline HIV/STI rates

  5. Study Methods Qualitative Research: 12 FGDs: of 8-12 men 17 Key Informant Interviews STI/HIV Prevalence Survey: Selected 250 men through cluster sampling proportionate to size (18 of 32 beaches; 3-4 boats/beach; 3-4 men/boat).

  6. Demographic Data

  7. Work Fishing Night/Day Selling fish Mending nets Mending boats Side jobs Farming Odd jobs Leisure Eating Sleeping Drinking Smoking marijuana Videos/music Socializing Looking for ladies Work and Leisure Activities

  8. Work and Leisure Activities Conducive to Risky Behavior ‘Looking for ladies’: Time, money,fish “Waiting for time to go to the lake.” “Leave home without [financial] plans.” “When I eat [fish], my desire rises.” Consuming alcohol & marijuana: “become [warm], brave, high/ strong to endure the hard work.” “Alcohol is sold cheap in small packs”

  9. Current Prevention Model Abstinence Be faithful (zero grazing) Correct & consistent condom use

  10. Abstinence Incompatible with Local Traditions “Traditionally, among us Luo people, most of our customs end with sex … Whether it is the planting season or when you want to harvest, everything ends with sex.”KII11 Other ritual: Sexual cleansing of widows

  11. Abstinence Impedes Earnings for Female Fishmongers “Continues [searching for fish to sell] until … she finds someone close to her [to provide the fish]. He will start by giving her small quantities [of fish] … but will tell her that “I want you to be my lover.” KII14

  12. Abstinence Impedes Earnings for Female Fishmongers

  13. Being Faithful: Possible for Some “Decided in their homes that they will not have other sexual partners and they remain like that [faithful to each other].” KII11

  14. Multiple Concurrent Partnerships Common for Men and Women in the Fishing Industry “When a fisherman sees other nice women, he forgets the children back home and the wife. Even the women … You could have 5 boats and I have 1 ... You get along with my wife and have sex because you are giving her money.” KII2

  15. Condom Non-Use • Due to • Compromised sexual pleasure for both partners • Contraceptive properties • No receptacle for disposal • Lack of time and privacy • Trust issues • Suspicious of lubricant • Not acceptable for ritual sex

  16. Perceptions of HIV Risk • “Had people been thinking [about protection], these diseases like AIDS could have been wiped out. People hear but do not care. Men go on admiring faces and big asses, without caring about the implications.”KII1

  17. Perceptions of HIV Risk • ‘Lake dwellers have an assumption that AIDS is like any other disease like malaria, or it is like the way one can be on a journey and involves himself in an accident.’ • KII1

  18. Perceptions of HIV Risk “Initially people took AIDS seriously because people were dying and getting infected. But nowadays, we say “a cow dies with grass in its mouth.” If you think of it, it can be considered as an accident just as if your boat has capsized in the lake.” KII15

  19. STI/HIV Prevalence: Survey Results (N=249) Results validate qualitative findings and reveal the urgent need for effective HIV risk reduction

  20. Participants’ Suggestions for HIV/AIDS Prevention • Monthly pooling of funds that rotate among members in women’s groups • Diversification of livelihoods • Cooperatives for fishermen • Savings and loans programs • Formal induction of newcomers • Use of varied media for BCC • Local dispensaries

  21. Recommendations • Support community initiatives: • Change business norms • Business/livelihoods programs • Health and social programs • Target populations • young men and boat owners • widows, single mothers and young women

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