Monday, November 9, 2015

Sexual Behaviour of People Living with HIV Attending a Tertiary Care Government Hospital in Kathmandu, Nepal

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

Predictors of unprotected sex with regular partners
VariablesUnprotected n (%)Protected n (%)Univariate OR (95 % CI)P-valueMultivariate OR (95 % CI)P-value
Sex
 Female9 (45.0)11 (55.0)2.46 (0.84–7.15)0.1004.59 (1.15–18.39)0.031
 Male14 (25.0)42 (75.0)
Marital status
 Not living with a partner1 (50.0)1 (50.0)2.36 (0.14–39.5)0.549
 Living with a partner22 (30.0)52 (70.0)
Education levelb
 Formal education18 (30.5)41 (69.5)1.05 (0.32–3.43)0.931
 No formal education5 (29.4)12 (70.6)
Occupation
 Unemployed6 (46.2)7 (53.8)2.32 (0.68–7.89)0.178
 Employed17 (26.9)46 (73.1)
Treatment status
 ART naïve16 (47.1)18 (52.9)4.44 (1.55–12.76)0.0064.76 (1.29–17.52)0.019
 ART experienced7 (16.7)35 (83.3)
Partner’s HIV status
 Not known7 (41.2)10 (58.8)1.35 (0.43–4.27)0.606
 HIV negative1 (6.7)14 (93.3)0.14 (0.02–1.15)0.068
 HIV positive15 (34.1)29 (65.9)
Disclosure of own HIV status
 No5 (50.0)5 (50.0)2.67 (0.69–10.31)0.155
 Yes18 (27.3)48 (72.7)
Alcohol consumption during last sex
 Yes9 (69.2)4 (30.8)7.88 (2.11–29.45)0.00214.75 (2.75–79.29)0.002
 No14 (22.2)49 (77.8)
Time since HIV was diagnoseda
 ≤24 months14 (40.0)21 (60.0)2.37 (0.87–6.46)0.091
 >24 months9 (21.9)32 (78.1)
CD4 Cell count (cells/mm3)a
 ≤22412 (37.5)20 (62.5)2.18 (0.75–6.28)0.151
 >2248 (21.6)29 (78.4)
Can ART prevent the transmission of HIV
 Yes/don’t know14 (35.0)26 (65.0)1.61 (0.60–4.37)0.345
 No9 (25.0)27 (75.0)
With availability of ART would it make a difference if HIV transmits from you to others
 Yes18 (27.7)47 (72.3)0.46 (0.12–1.70)0.243
 No/don’t know5 (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

  • 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.
 

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