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isk for STD/HIV infection through their spouses (Hunter 1994, Ulin 1992, Quigley 1997). It is
therefore very important to educate men on taking their responsibilities, by either changing
their behavior or using safe sex methods. Hence, health education at various levels must be
improved, and messages should be directed more specifically to men.
One third of the men in this study admitted to having ever paid for sex with money or gifts.
Because of the economic situation in Kenya, many women need extra income, be it for rent
or school-fees, which they obtain through one or more regular boyfriends in exchange for
sex.
The current study shows that some men and women are at high risk for STDs, including HIV
infection, through large numbers of sexual partners. Intervention strategies therefore should
aim at reducing partner change and promoting condom use. However, some individuals with
a low-risk profile, especially women, may be at risk through their spouses or regular partners.
This suggests that interventions should extend beyond the high-risk groups, and men
especially should be targeted. Simultaneously, however, the quality of existing primary health
care services should be strengthened, with STD treatment extended to more, if not all,
primary health care clinics in Nairobi. These services should include health education that
especially targets prevention strategies.
HEALTHCARE-SEEKING BEHAVIOR AND SEXUAL BEHAVIOR IN NAIROBI 45