Skip to main content
Top
Published in: AIDS and Behavior 6/2009

01-12-2009 | Original Paper

Changes in Risk Behavior Among HIV-Positive Patients During Their First Year of Antiretroviral Therapy in Cape Town South Africa

Authors: Thomas P. Eisele, Catherine Mathews, Mickey Chopra, Mark N. Lurie, Lisanne Brown, Sarah Dewing, Carl Kendall

Published in: AIDS and Behavior | Issue 6/2009

Login to get access

Abstract

We explore changes in sexual risk behaviour over the first year of antiretroviral therapy (ART) among a cohort of patients in Cape Town South Africa initiating treatment in five public facilities in 2006 and again 1 year later (Time 1 and Time 2). Contemporaneous measures of unprotected sex were also obtained from 2 cross-sectional samples of HIV-positive patients waiting to start ART attending the same facilities. Unprotected sex at last sex among patients on ART decreased significantly from a baseline of 44.7–23.2% one year later, regardless of partner status. After controlling for confounding factors, the observed decrease in unprotected sex among the ART cohort was highly significant in relation to the 2 cross-sectional samples of patients at Time 1 and Time 2 waiting to initiate ART. Findings suggest it is critical to start positive prevention to decrease risky sexual behavior prior to the start of ART within this setting.
Literature
go back to reference Bateganya, M., Colfax, G., Shafer, L. A., Kityo, C., Mugyenyi, P., Serwadda, D., et al. (2005). Antiretroviral therapy and sexual behavior: A comparative study between antiretroviral- naive and -experienced patients at an urban HIV/AIDS care and research center in Kampala, Uganda. AIDS Patient Care and STDs, 19, 760–768. doi:10.1089/apc.2005.19.760.CrossRefPubMed Bateganya, M., Colfax, G., Shafer, L. A., Kityo, C., Mugyenyi, P., Serwadda, D., et al. (2005). Antiretroviral therapy and sexual behavior: A comparative study between antiretroviral- naive and -experienced patients at an urban HIV/AIDS care and research center in Kampala, Uganda. AIDS Patient Care and STDs, 19, 760–768. doi:10.​1089/​apc.​2005.​19.​760.CrossRefPubMed
go back to reference Bunnell, R., Ekwaru, J. P., Solberg, P., Wamai, N., Bikaako-Kajura, W., Were, W., et al. (2006). Changes in sexual behavior and risk of HIV transmission after antiretroviral therapy and prevention interventions in rural Uganda. AIDS (London, England), 20, 85–92. doi:10.1097/01.aids.0000196566.40702.28. Bunnell, R., Ekwaru, J. P., Solberg, P., Wamai, N., Bikaako-Kajura, W., Were, W., et al. (2006). Changes in sexual behavior and risk of HIV transmission after antiretroviral therapy and prevention interventions in rural Uganda. AIDS (London, England), 20, 85–92. doi:10.​1097/​01.​aids.​0000196566.​40702.​28.
go back to reference Bunnell, R., Opio, A., Musinguzi, J., Kirungi, W., Ekwaru, P., Mishra, V., et al. (2008). HIV transmission risk behavior among HIV-infected adults in Uganda: Results of a nationally representative survey. AIDS (London, England), 22, 617–624. Bunnell, R., Opio, A., Musinguzi, J., Kirungi, W., Ekwaru, P., Mishra, V., et al. (2008). HIV transmission risk behavior among HIV-infected adults in Uganda: Results of a nationally representative survey. AIDS (London, England), 22, 617–624.
go back to reference Chan, D. J., McNally, L., Batterham, M., & Smith, D. E. (2008). Relationship between HIV-RNA load in blood and semen in antiretroviral-naive and experienced men and effect of asymptomatic sexually transmissible infections. Current HIV Research, 6, 138–142. doi:10.2174/157016208783885074.CrossRefPubMed Chan, D. J., McNally, L., Batterham, M., & Smith, D. E. (2008). Relationship between HIV-RNA load in blood and semen in antiretroviral-naive and experienced men and effect of asymptomatic sexually transmissible infections. Current HIV Research, 6, 138–142. doi:10.​2174/​1570162087838850​74.CrossRefPubMed
go back to reference Diamond, C., Richardson, J. L., Milam, J., Stoyanoff, S., McCutchan, J. A., Kemper, C., et al. (2005). Use of and adherence to antiretroviral therapy is associated with decreased sexual risk behavior in HIV clinic patients. Journal of Acquired Immune Deficiency Syndrome, 39, 211–218. Diamond, C., Richardson, J. L., Milam, J., Stoyanoff, S., McCutchan, J. A., Kemper, C., et al. (2005). Use of and adherence to antiretroviral therapy is associated with decreased sexual risk behavior in HIV clinic patients. Journal of Acquired Immune Deficiency Syndrome, 39, 211–218.
go back to reference Eisele, T. P., Mathews, C., Chopra, M., Brown, L., Silvestre, E., Daries, V., et al. (2008). High levels of risk behavior among people living with HIV initiating and waiting to start antiretroviral therapy in Cape Town South Africa. AIDS and Behavior, 12, 570–577. doi:10.1007/s10461-007-9279-7.CrossRefPubMed Eisele, T. P., Mathews, C., Chopra, M., Brown, L., Silvestre, E., Daries, V., et al. (2008). High levels of risk behavior among people living with HIV initiating and waiting to start antiretroviral therapy in Cape Town South Africa. AIDS and Behavior, 12, 570–577. doi:10.​1007/​s10461-007-9279-7.CrossRefPubMed
go back to reference Fairall, L. R., Bachmann, M. O., Louwagie, G. M., van Vuuren, C., Chikobvu, P., Steyn, D., et al. (2008). Effectiveness of antiretroviral treatment in a South African program: A cohort study. Archives of Internal Medicine, 168, 86–93. doi:10.1001/archinternmed.2007.10.CrossRefPubMed Fairall, L. R., Bachmann, M. O., Louwagie, G. M., van Vuuren, C., Chikobvu, P., Steyn, D., et al. (2008). Effectiveness of antiretroviral treatment in a South African program: A cohort study. Archives of Internal Medicine, 168, 86–93. doi:10.​1001/​archinternmed.​2007.​10.CrossRefPubMed
go back to reference Filmer, D., & Pritchett, L. H. (2001). Estimating wealth effects without expenditure data-or tears: An application to educational enrollments in states of India. Demography, 38, 115–132.PubMed Filmer, D., & Pritchett, L. H. (2001). Estimating wealth effects without expenditure data-or tears: An application to educational enrollments in states of India. Demography, 38, 115–132.PubMed
go back to reference Gray, R. H., Li, X., Wawer, M. J., Gange, S. J., Serwadda, D., Sewankambo, N. K., et al. (2003). Stochastic simulation of the impact of antiretroviral therapy and HIV vaccines on HIV transmission; Rakai, Uganda. AIDS (London, England), 17, 1941–1951. doi:10.1097/00002030-200309050-00013. Gray, R. H., Li, X., Wawer, M. J., Gange, S. J., Serwadda, D., Sewankambo, N. K., et al. (2003). Stochastic simulation of the impact of antiretroviral therapy and HIV vaccines on HIV transmission; Rakai, Uganda. AIDS (London, England), 17, 1941–1951. doi:10.​1097/​00002030-200309050-00013.
go back to reference Jelsma, J., & Ferguson, G. (2004). The determinants of self-reported health-related quality of life in a culturally and socially diverse South African community. Bulletin of the World Health Organization, 82, 206–212.PubMed Jelsma, J., & Ferguson, G. (2004). The determinants of self-reported health-related quality of life in a culturally and socially diverse South African community. Bulletin of the World Health Organization, 82, 206–212.PubMed
go back to reference Jelsma, J., Maclean, E., Hughes, J., Tinise, X., & Darder, M. (2005). An investigation into the health-related quality of life of individuals living with HIV who are receiving HAART. AIDS Care, 17, 579–588.PubMed Jelsma, J., Maclean, E., Hughes, J., Tinise, X., & Darder, M. (2005). An investigation into the health-related quality of life of individuals living with HIV who are receiving HAART. AIDS Care, 17, 579–588.PubMed
go back to reference Kaida, A., Gray, G., Bastos, F. I., Andia, I., Maier, M., McIntyre, J., et al. (2008). The relationship between HAART use and sexual activity among HIV-positive women of reproductive age in Brazil, South Africa, and Uganda. AIDS Care, 20, 21–25. doi:10.1080/09540120701426540.CrossRefPubMed Kaida, A., Gray, G., Bastos, F. I., Andia, I., Maier, M., McIntyre, J., et al. (2008). The relationship between HAART use and sexual activity among HIV-positive women of reproductive age in Brazil, South Africa, and Uganda. AIDS Care, 20, 21–25. doi:10.​1080/​0954012070142654​0.CrossRefPubMed
go back to reference Kalichman, S. C., Simbayi, L. C., Jooste, S., & Cain, D. (2007a). Frequency, quantity, and contextual use of alcohol among sexually transmitted infection clinic patients in Cape Town, South Africa. The American Journal of Drug and Alcohol Abuse, 33, 687–698. doi:10.1080/00952990701522716.CrossRefPubMed Kalichman, S. C., Simbayi, L. C., Jooste, S., & Cain, D. (2007a). Frequency, quantity, and contextual use of alcohol among sexually transmitted infection clinic patients in Cape Town, South Africa. The American Journal of Drug and Alcohol Abuse, 33, 687–698. doi:10.​1080/​0095299070152271​6.CrossRefPubMed
go back to reference Kalichman, S. C., Simbayi, L. C., Kaufman, M., Cain, D., & Jooste, S. (2007b). Alcohol use and sexual risks for HIV/AIDS in sub-Saharan Africa: Systematic review of empirical findings. Prevention Science, 8, 141–151. doi:10.1007/s11121-006-0061-2.CrossRefPubMed Kalichman, S. C., Simbayi, L. C., Kaufman, M., Cain, D., & Jooste, S. (2007b). Alcohol use and sexual risks for HIV/AIDS in sub-Saharan Africa: Systematic review of empirical findings. Prevention Science, 8, 141–151. doi:10.​1007/​s11121-006-0061-2.CrossRefPubMed
go back to reference Kamb, M. L., Fishbein, M., Douglas, J. M., Jr., Rhodes, F., Rogers, J., Bolan, G., et al. (1998). Efficacy of risk-reduction counseling to prevent human immunodeficiency virus and sexually transmitted diseases: A randomized controlled trial. Project RESPECT Study Group. Journal of the American Medical Association, 280, 1161–1167. doi:10.1001/jama.280.13.1161.CrossRefPubMed Kamb, M. L., Fishbein, M., Douglas, J. M., Jr., Rhodes, F., Rogers, J., Bolan, G., et al. (1998). Efficacy of risk-reduction counseling to prevent human immunodeficiency virus and sexually transmitted diseases: A randomized controlled trial. Project RESPECT Study Group. Journal of the American Medical Association, 280, 1161–1167. doi:10.​1001/​jama.​280.​13.​1161.CrossRefPubMed
go back to reference Kiene, S. M., Christie, S., Cornman, D. H., Fisher, W. A., Shuper, P. A., Pillay, S., et al. (2006). Sexual risk behaviour among HIV-positive individuals in clinical care in urban KwaZulu-Natal, South Africa. AIDS (London, England), 20, 1781–1784. doi:10.1097/01.aids.0000242827.05120.55. Kiene, S. M., Christie, S., Cornman, D. H., Fisher, W. A., Shuper, P. A., Pillay, S., et al. (2006). Sexual risk behaviour among HIV-positive individuals in clinical care in urban KwaZulu-Natal, South Africa. AIDS (London, England), 20, 1781–1784. doi:10.​1097/​01.​aids.​0000242827.​05120.​55.
go back to reference Luchters, S., Sarna, A., Geibel, S., Chersich, M. F., Munyao, P., Kaai, S., et al. (2008). Safer sexual behaviors after 12 months of antiretroviral treatment in Mombasa, Kenya: A prospective cohort. AIDS Patient Care and STDs, 22, 587–594. doi:10.1089/apc.2007.0247.CrossRefPubMed Luchters, S., Sarna, A., Geibel, S., Chersich, M. F., Munyao, P., Kaai, S., et al. (2008). Safer sexual behaviors after 12 months of antiretroviral treatment in Mombasa, Kenya: A prospective cohort. AIDS Patient Care and STDs, 22, 587–594. doi:10.​1089/​apc.​2007.​0247.CrossRefPubMed
go back to reference Moatti, J. P., Prudhomme, J., Traore, D. C., Juillet-Amari, A., Akribi, H. A., & Msellati, P. (2003). Access to antiretroviral treatment and sexual behaviours of HIV-infected patients aware of their serostatus in Cote d’Ivoire. AIDS (London, England), 17(Supplement 3), S69–S77. doi:10.1097/00002030-200317003-00010. Moatti, J. P., Prudhomme, J., Traore, D. C., Juillet-Amari, A., Akribi, H. A., & Msellati, P. (2003). Access to antiretroviral treatment and sexual behaviours of HIV-infected patients aware of their serostatus in Cote d’Ivoire. AIDS (London, England), 17(Supplement 3), S69–S77. doi:10.​1097/​00002030-200317003-00010.
go back to reference Salomon, J. A., & Murray, C. J. (2001). Modelling HIV/AIDS epidemics in sub-Saharan Africa using seroprevalence data from antenatal clinics. Bulletin of the World Health Organization, 79, 596–607.PubMed Salomon, J. A., & Murray, C. J. (2001). Modelling HIV/AIDS epidemics in sub-Saharan Africa using seroprevalence data from antenatal clinics. Bulletin of the World Health Organization, 79, 596–607.PubMed
go back to reference Shisana, O., Rehle, T., Simbayi, L., Parker, W., Zuma, K., Bhana, A., et al.(2005). South African National HIV Prevalence, HIV Incidence, Behaviour and Communication Survey, 2005. H. Press: Cape Town. Shisana, O., Rehle, T., Simbayi, L., Parker, W., Zuma, K., Bhana, A., et al.(2005). South African National HIV Prevalence, HIV Incidence, Behaviour and Communication Survey, 2005. H. Press: Cape Town.
go back to reference Simbayi, L. C., Kalichman, S., Strebel, A., Cloete, A., Henda, N., & Mqeketo, A. (2007a). Internalized stigma, discrimination, and depression among men and women living with HIV/AIDS in Cape Town, South Africa. Social Science & Medicine, 64, 1823–1831. doi:10.1016/j.socscimed.2007.01.006.CrossRef Simbayi, L. C., Kalichman, S., Strebel, A., Cloete, A., Henda, N., & Mqeketo, A. (2007a). Internalized stigma, discrimination, and depression among men and women living with HIV/AIDS in Cape Town, South Africa. Social Science & Medicine, 64, 1823–1831. doi:10.​1016/​j.​socscimed.​2007.​01.​006.CrossRef
go back to reference Simbayi, L. C., Kalichman, S. C., Strebel, A., Cloete, A., Henda, N., & Mqeketo, A. (2007b). Disclosure of HIV status to sex partners and sexual risk behaviours among HIV-positive men and women, Cape Town, South Africa. Sexually Transmitted Infections, 83, 29–34. doi:10.1136/sti.2006.019893.CrossRefPubMed Simbayi, L. C., Kalichman, S. C., Strebel, A., Cloete, A., Henda, N., & Mqeketo, A. (2007b). Disclosure of HIV status to sex partners and sexual risk behaviours among HIV-positive men and women, Cape Town, South Africa. Sexually Transmitted Infections, 83, 29–34. doi:10.​1136/​sti.​2006.​019893.CrossRefPubMed
go back to reference Sweat, M., Gregorich, S., Sangiwa, G., Furlonge, C., Balmer, D., Kamenga, C., et al. (2000). Cost-effectiveness of voluntary HIV-1 counselling and testing in reducing sexual transmission of HIV-1 in Kenya and Tanzania. Lancet, 356, 113–121. doi:10.1016/S0140-6736(00)02447-8.CrossRefPubMed Sweat, M., Gregorich, S., Sangiwa, G., Furlonge, C., Balmer, D., Kamenga, C., et al. (2000). Cost-effectiveness of voluntary HIV-1 counselling and testing in reducing sexual transmission of HIV-1 in Kenya and Tanzania. Lancet, 356, 113–121. doi:10.​1016/​S0140-6736(00)02447-8.CrossRefPubMed
go back to reference UNAIDS. (2006). Report on the global AIDS epidemic 2006. Geneva: UNAIDS. UNAIDS. (2006). Report on the global AIDS epidemic 2006. Geneva: UNAIDS.
go back to reference UNAIDS. (2007). UNAIDS/WHO AIDS epidemic update: December 2007. Geneva: UNAIDS. UNAIDS. (2007). UNAIDS/WHO AIDS epidemic update: December 2007. Geneva: UNAIDS.
go back to reference Vernazza, P. L., Troiani, L., Flepp, M. J., Cone, R. W., Schock, J., Roth, F., et al. (2000). Potent antiretroviral treatment of HIV-infection results in suppression of the seminal shedding of HIV. The Swiss HIV Cohort Study. AIDS (London, England), 14, 117–121. doi:10.1097/00002030-200001280-00006. Vernazza, P. L., Troiani, L., Flepp, M. J., Cone, R. W., Schock, J., Roth, F., et al. (2000). Potent antiretroviral treatment of HIV-infection results in suppression of the seminal shedding of HIV. The Swiss HIV Cohort Study. AIDS (London, England), 14, 117–121. doi:10.​1097/​00002030-200001280-00006.
go back to reference Weinhardt, L. S., Carey, M. P., Johnson, B. T., & Bickham, N. L. (1999). Effects of HIV counseling and testing on sexual risk behavior: A meta-analytic review of published research, 1985–1997. American Journal of Public Health, 89, 1397–1405.CrossRefPubMed Weinhardt, L. S., Carey, M. P., Johnson, B. T., & Bickham, N. L. (1999). Effects of HIV counseling and testing on sexual risk behavior: A meta-analytic review of published research, 1985–1997. American Journal of Public Health, 89, 1397–1405.CrossRefPubMed
go back to reference Western Cape Department of Health. (2008). The Western Cape Antiretroviral Programme: Monitoring Report, 2008. Cape Town: Provincial Government of the Western Cape. Western Cape Department of Health. (2008). The Western Cape Antiretroviral Programme: Monitoring Report, 2008. Cape Town: Provincial Government of the Western Cape.
Metadata
Title
Changes in Risk Behavior Among HIV-Positive Patients During Their First Year of Antiretroviral Therapy in Cape Town South Africa
Authors
Thomas P. Eisele
Catherine Mathews
Mickey Chopra
Mark N. Lurie
Lisanne Brown
Sarah Dewing
Carl Kendall
Publication date
01-12-2009
Publisher
Springer US
Published in
AIDS and Behavior / Issue 6/2009
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-008-9473-2

Other articles of this Issue 6/2009

AIDS and Behavior 6/2009 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.