Risky sexual behavior and associated factors among domestic workers in Kigali, Rwanda

Abstract

Risky sexual behavior (RSB) significantly increases global health risks, particularly for sexually transmitted infections (STIs) such as Human Immunodeficiency Virus (HIV). The risk is higher among vulnerable groups, such as domestic workers, who face unique challenges due to limited access to sexual health education and resources. Research on RSB among domestic workers is scarce. This study assessed the extent of RSB and identified associated factors among domestic workers in Kigali, Rwanda. This cross-sectional study design involved 874 domestic workers in Kigali. Data were collected using the 23-item Sexual Risk Survey (SRS) to assess RSB in the six months preceding the study. We used descriptive statistics to determine the proportion of RSB among domestic workers and the associated factors related to their RSB. The median age was 23 (interquartile range[IQR]: 20–25), with a median of 3 years of work experience (IQR: 2–6). Most participants were female (73.91%) and single (94.05%). The median score for RSB was 7 (IQR: 2–13). Increased RSB were positively associated with age (adjusted incidence rate ratio [aIRR]: 1.01; 95% Confidence Interval [CI]: 1.004–1.03, P value = 0.007), being male (aIRR: 1.17; 95% CI: 1.05–1.31, P value = 0.002), being single (aIRR: 1.54; 95% CI: 1.18–2.01, P value < 0.001), having children (aIRR: 1.58; 95% CI: 1.42–1.76, P value < 0.001), and being aware of HIV status (aIRR: 1.26; 95% CI: 1.13–1.41, P value < 0.001). The extent of Risky sexual behavior was considerable among domestic workers in Kigali, with higher engagement observed among older individuals, males, those with children, and those aware of their HIV status. These findings emphasize the need for targeted interventions, including sexual health education and integrated support services, which may help reduce risk and promote well-being in this vulnerable group.