Clinical improvements that follow antiretroviral therapy
(ART) may lead to increase or resumption of high risk activities that could
unintentionally result in HIV transmission. The objective was to investigate
whether treatment status is a significant predictor of sexual risk behaviour
(unprotected sex).
A cross sectional study was conducted among 160 people
living with HIV (PLHIV) (89 ART experienced and 71 ART naïve) attending
Sukraraj Tropical and Infectious Disease Hospital in Kathmandu, Nepal. A
structured questionnaire was used for data collection. Logistic regression with
stepwise modeling was used to obtain adjusted odds ratios (OR) with 95 %
CI.
In this study, 92 % of sexually active respondents
reported sex with a regular partner. ART experienced PLHIV were significantly
more likely to report consistent condom use with their regular partners
compared to ART naïve PLHIV (83 vs. 53%) during the
past six months. In multivariate analysis, sex, treatment status and alcohol consumption during last sex with regular partners were significantly associated
with unprotected sex.
ART naïve PLHIV were five times more likely to exhibit
sexual risk behaviour (have unprotected sex) than ART experienced PLHIV. Thus
the study provided no evidence to suggest that ART experienced PLHIV exhibit
greater sexual risk behaviour compared to ART naïve PLHIV. Prevention
programmes need to emphasize on counselling to PLHIV and their regular partners
with focused interventions such as couple counselling and education programmes.
Table 3
Variables | Unprotected n (%) | Protected n (%) | Univariate OR (95 % CI) | P-value | Multivariate OR (95 % CI) | P-value |
---|---|---|---|---|---|---|
Sex | ||||||
Female | 9 (45.0) | 11 (55.0) | 2.46 (0.84–7.15) | 0.100 | 4.59 (1.15–18.39) | 0.031 |
Male | 14 (25.0) | 42 (75.0) | ||||
Marital status | ||||||
Not living with a partner | 1 (50.0) | 1 (50.0) | 2.36 (0.14–39.5) | 0.549 | ||
Living with a partner | 22 (30.0) | 52 (70.0) | ||||
Education levelb | ||||||
Formal education | 18 (30.5) | 41 (69.5) | 1.05 (0.32–3.43) | 0.931 | ||
No formal education | 5 (29.4) | 12 (70.6) | ||||
Occupation | ||||||
Unemployed | 6 (46.2) | 7 (53.8) | 2.32 (0.68–7.89) | 0.178 | ||
Employed | 17 (26.9) | 46 (73.1) | ||||
Treatment status | ||||||
ART naïve | 16 (47.1) | 18 (52.9) | 4.44 (1.55–12.76) | 0.006 | 4.76 (1.29–17.52) | 0.019 |
ART experienced | 7 (16.7) | 35 (83.3) | ||||
Partner’s HIV status | ||||||
Not known | 7 (41.2) | 10 (58.8) | 1.35 (0.43–4.27) | 0.606 | ||
HIV negative | 1 (6.7) | 14 (93.3) | 0.14 (0.02–1.15) | 0.068 | ||
HIV positive | 15 (34.1) | 29 (65.9) | ||||
Disclosure of own HIV status | ||||||
No | 5 (50.0) | 5 (50.0) | 2.67 (0.69–10.31) | 0.155 | ||
Yes | 18 (27.3) | 48 (72.7) | ||||
Alcohol consumption during last sex | ||||||
Yes | 9 (69.2) | 4 (30.8) | 7.88 (2.11–29.45) | 0.002 | 14.75 (2.75–79.29) | 0.002 |
No | 14 (22.2) | 49 (77.8) | ||||
Time since HIV was diagnoseda | ||||||
≤24 months | 14 (40.0) | 21 (60.0) | 2.37 (0.87–6.46) | 0.091 | ||
>24 months | 9 (21.9) | 32 (78.1) | ||||
CD4 Cell count (cells/mm3)a | ||||||
≤224 | 12 (37.5) | 20 (62.5) | 2.18 (0.75–6.28) | 0.151 | ||
>224 | 8 (21.6) | 29 (78.4) | ||||
Can ART prevent the transmission of HIV | ||||||
Yes/don’t know | 14 (35.0) | 26 (65.0) | 1.61 (0.60–4.37) | 0.345 | ||
No | 9 (25.0) | 27 (75.0) | ||||
With availability of ART would it make a difference if HIV transmits from you to others | ||||||
Yes | 18 (27.7) | 47 (72.3) | 0.46 (0.12–1.70) | 0.243 | ||
No/don’t know | 5 (45.4) | 6 (54.6) |
aDichotomization based on sample median
bFormal education includes primary (grade 1–5), secondary (grade 6–10), higher secondary/high school (grade 11–12), under graduate and post graduate
Full article at: http://goo.gl/BXRxrG
By: Angdembe MR1, Lohani SP2, Karki DK3, Bhattarai K4, Shrestha N5.
- 1Department of Public Health, Central Institute of Science and Technology, Pokhara University, Kathmandu, Nepal. mirak.angdembe@gmail.com.
- 2Centre for Health Research and International Relations, Nobel College, Pokhara University, Kathmandu, Nepal. lohanis@gmail.com.
- 3National Centre for AIDS and STD Control, Kathmandu, Nepal. dekarki@gmail.com.
- 4Braun School of Public Health and Community Medicine, Hebrew University, Jerusalem, Israel. kreepa.bhattarai@gmail.com.
- 5Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia. nirajshrestha44@gmail.com.
More at: https://twitter.com/hiv_insight
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