Dahab, M., Spiegel, P.B., Njogu, P.M., et al. AIDS Care (January 2013), Epub ahead of print.
To address research gaps about the relationship between sexual risk behaviors among refugees, the United Nations Refugee Agency and the Great Lakes Initiative on HIV/AIDS conducted behavioral surveillance surveys (baseline years were 2004 and2005; follow-up years were 2010 and 2011) to estimate the change in prevalence of key HIV-related indicators among refugee camp inhabitants and members of neighboring communities in Kenya, Tanzania, and Uganda. In total, 11,582 participants were interviewed (6,448 at baseline and 5,134 at follow-up). The results indicated a significant and consistent decrease in multiple and casual partnerships among adults, and the same results were also generally observed across age and gender subgroups. Notably, the prevalence of multiple partners and casual sex in Kenyan and Ugandan refugee camps was slightly lower than in the surrounding community. Rates of HIV testing substantially increased at all sites, and improvements in HIV knowledge were also found in the Tanzanian refugee camp and community and in the Ugandan refugee camp. Although the authors note that the positive behavioral changes may be associated with recent increases in HIV prevention efforts, this data is not reflected in the study. Abstinence and condom use significantly increased in all of the groups studied, and forced sex against females decreased in the Kenyan camp. However, despite these improvements, the overall levels of risky sexual partnerships remained high in casual sex among youth and multiple partners among men.