Sexual Behaviors over a 3-Year Period among Individuals with Advanced HIV/AIDS Receiving Antiretroviral Therapy in an Urban HIV Clinic in Kampala, Uganda
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Date
2011
Journal Title
Journal ISSN
Volume Title
Publisher
Journal of acquired immune deficiency syndromes
Abstract
Few studies have prospectively examined sexual behaviors of HIV-infected person on antiretroviral therapy (ART) in Sub-Saharan Africa.From 2004 to 2005, 559 HIV-infected, ART-naïve individuals initiating ART at an HIV clinic in Kampala, Uganda were enrolled into a prospective study and followed to 2008. Clinical and sexual behavior information was assessed at enrollment and semi-annually for three years after ART initiation. Using log-binomial regression models, we estimated prevalence ratios (PRs) to determine factors associated with being sexually active and having unprotected sex over three-years after initiating ART.559 adults contributed 2,594 person-visits of follow-up. At the time of ART initiation, 323 (57.9%) were sexually active of which 176 (54.5%) had unprotected sex at last sexual intercourse. Majority (63.4%) of married individuals were unaware of their partner’s HIV status. Female gender (PR=2.97; 95% CI: 1.85, 4.79), being married (PR=1.48; 95% CI: 1.06, 2.06), and reporting unprotected sex prior to ART (PR=1.68; 95% CI: 1.16, 2.42) were among factors independently associated with unprotected sex while on ART. Overall, 7.3% of visit intervals of unprotected sex, 1.0% of intervals of sexual activity, occurred when plasma viral load >1,500 copies/ml, representing periods of greater HIV transmission risk.Although unprotected sex reduced over time, women reported unprotected sex more often than men. Disclosure of HIV status was low. Integration of comprehensive prevention programs into HIV care is needed, particularly ones specific for women.
Description
Keywords
HIV/AIDS, antiretroviral therapy, sexual behavior, unprotected sex, condom use, positive prevention, Uganda
Citation
Wandera, B., Kamya, M. R., Castelnuovo, B., Kiragga, A., Kambugu, A., Wanyama, J. N., ... & Sethi, A. K. (2011). Sexual behaviors over a 3-year period among individuals with advanced HIV/AIDS receiving antiretroviral therapy in an urban HIV clinic in Kampala, Uganda. Journal of acquired immune deficiency syndromes (1999), 57(1), 62.https://dx.doi.org/10.1097%2FQAI.0b013e318211b3f2