STD Behaviour
About one-third of the women (35.7%) reported having either a genital discharge (24.4%) or genital ulcers or sores (27.8%) in the past 12 months. Three-quarters (76.1%) of these sought advice at a health facility, be it a government (68.2%), private (27.3%), workplace (14.6%) or church-run (11.4%) health facility. Almost half (46.5%) sought advice from a traditional healer, 25.8% from a pharmacist, 23.5% bought capsules on the street and 27.3% took medicines at home. Less than half (43.1%) said that they told their partner, 32.9% stopped having sex and 23.1% used condoms while symptomatic. The women interviewed in Chipata reported fewer symptoms than in the other sites (26.9% vs. 39.2% and 41.3% in Chirundu and Livingstone respectively). Those women who had symptoms more often reported seeking care at health facilities, pharmacies and drug vendors. They also reported more frequently that they informed their partner, stopped having sex and/or always used condoms while symptomatic.

Table 5.2: Behaviour related to STD

¹ Only those who reported STD symptoms are included

6. Family planning practices

Table 6 presents family planning practices by study population.

Less than half (45.2%) of the women reported using any family planning method. Of those who reported using a family planning method, only 58.5% used a method considered effective for family planning. The most common methods were oral contraception (47.5%) and injectable contraception (13.7%). None of the women had an intrauterine device (IUD) inserted. About half of the women who were using a method (49.5) said they used condoms for family planning. Other methods were rare. About one-third of the women (31.7%) reported losing a pregnancy. The reported use of family planning was significantly higher in Chipata (55.3%), followed by Livingstone (43.2%) and Chirundu (33.6%). When limited to effective methods however, the use of family planning was similar in Chipata and Livingstone (both 29.2% of the total), but lower in Chirundu (16.1%).

Table 6: Family planning practices

^1.Only those currently using a family planning method are included

7. Knowledge, opinions and attitudes related to HIV

Table 7 presents the data on knowledge, opinions and attitudes related to HIV.

Almost all women, with the exception of two, had heard of HIV/AIDS. Three-quarters (74.7%) also knew someone living with HIV/AIDS. For 89.3% of these women, this person was a close relative (42.7%), a close friend (44.0%) or both (2.7%). The women generally knew that HIV could be transmitted by infected needles (91.8%) or from mother to child during pregnancy (90.6%). The fact that HIV could also be transmitted through breastfeeding was a little less known (81.9%). Still 22.2% of the women thought mosquito bites could transmit HIV, and 8.6% believed it could be transmitted by sharing meals. Most women (93.4%) were aware that a healthy looking person could be infected with HIV. About fourth-fifths of the women knew that HIV infection can be prevented by using condoms (80.7%), by faithfulness (80.1%) or abstinence (84.0%). Only 17.3% of those who knew that HIV can be transmitted from mother to child also knew that treating pregnant infected women could prevent this infection in the child. Again, knowledge overall was better in Chipata than in the other sites.

Table 7: Knowledge, opinions and attitudes related to HIV

^1.Those who never heard of HIV are excluded.
^2.Only those who know someone with HIV/AIDS are included

8. HIV Voluntary counselling and testing

Table 8 presents the data on HIV voluntary testing and counselling.

About two-thirds of the women (66.4%) said they had access to a voluntary counselling and testing facility. Twelve percent said they had been tested. Of these, about half (46.6%) said it was not on a voluntary basis, and one-quarter (25.4%) never found out the test result.

Table 8: HIV Voluntary counselling and testing

^1. Those who never heard of HIV are excluded.
^2.Only those who were tested are included

9. Project indicators

The study serves as a baseline for the project implemented by World Vision International. Five behavioural indicators were identified. Table 9 presents the results of the indicators.

One of the indicators measures knowledge of STD symptoms; 61.4 percent of the women could cite at least two major STD symptoms in women. The following were considered as major STD symptoms: lower abdominal pain, genital discharge (foul smelling or not), genital ulcers or sores, and swelling in the groin area. The second indicator measures knowledge of HIV prevention; 84.8 percent could mention at least two HIV prevention strategies. The following were considered as prevention strategies: condom use, faithfulness, abstinence and treating pregnant women.

The third indicator measures condom availability; 96.1% reported easy access to condoms. The ability to obtain a condom in less than one hour was considered "easy access." The women who did not know the delay period were excluded. The fourth indicator measures condom use with clients; 53.9% of the women reported that they used a condom in the last commercial sex act. The fifth indicator measures condom use with regular partners; 44.0% of the women reported that they used a condom in the last sex act with a non-paying partner. The difference in results on the indicators in the three sites was statistically significant (p<0.05). The women in Chipata performed consistently better than in the two other sites.

Table 9: Project indicators

Biological data

At least one biological sample was obtained from 576 of the 630 women (91%) for which questionnaire data are available. In addition, for three women who had no questionnaire data, biological specimens were available. Therefore, biological specimens were obtained from a total of 579 women. Blood samples were available for all of these women, although in two women there was not enough serum to perform the analyses. Vaginal swabs for Trichomonas vaginalis culture were available for 571 women and vaginal swabs for DNA amplification for 568 women.

The results of the biological tests are presented in Table 10. The prevalence of gonorrhoea, genital chlamydial infection, syphilis and trichomoniasis was 19.9%, 6.7%, 29.3% and 48.9% respectively. The prevalence of gonorrhoea and syphilis was clearly higher in Livingstone than in the other sites. In Livingstone 23.2% of the women were infected with gonorrhoea and 36.5% with syphilis, while in Chirundu and Chipata these percentages were 19.8% and 16.0% respectively for gonorrhoea and 28.7% and 20.9% respectively for syphilis.

Table 10: STI prevalence