Top

Published in:

01-07-2008 | Original Paper

High Levels of Risk Behavior Among People Living with HIV Initiating and Waiting to Start Antiretroviral Therapy in Cape Town South Africa

Authors: Thomas P. Eisele, Catherine Mathews, Mickey Chopra, Lisanne Brown, Eva Silvestre, Vanessa Daries, Carl Kendall

Published in: AIDS and Behavior | Issue 4/2008

Abstract

Baseline data were collected in Cape Town during 2006 to study if patients on combination antiretroviral therapy (ART) experience decreased inhibition to avoid risky sexual behavior. A total of 924 HIV-positive individuals were recruited; 520 who initiated ART within 3 months and 404 waiting for ART. Nearly half of men (40.1%) and women (46.3%) reported having unprotected sex their last time. Men and women who did not disclose their HIV status to their partner [Odds ration (OR) = 2.57 (95% CI: 1.22–5.50) and 2.84 (95% CI: 1.84–4.39), respectively], and those with ambivalent perception about the relationship between ART and HIV transmission [OR = 2.08 (95% CI: 1.00–4.30) and 2.39 (95% CI: 1.50–3.84), respectively], were twice as likely to have had unprotected sex their last time. Results suggest an urgent need to strengthen prevention interventions among HIV-positive individuals on and about to start ART in this setting.

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, 20, 85–92.PubMedCrossRef

Centers for Disease Control, Prevention. (1999). Increases in unsafe sex and rectal gonorrhea among men who have sex with men—San Francisco, California, 1994–1997. Journal of the American Medical Association, 281, 696–697.CrossRef

Centers for Disease Control, Prevention. (2003). Increases in HIV diagnoses—29 states, 1999–2002. Morbidity and Mortality Weekly Report, 52, 1145–1148.

Crepaz, N., Hart, T. A., & Marks, G. (2004). Highly active antiretroviral therapy and sexual risk behavior: A meta-analytic review. Journal of the American Medical Association, 292, 224–236.PubMedCrossRef

Crepaz, N., & Marks, G. (2003). Serostatus disclosure, sexual communication and safer sex in HIV-positive men. AIDS Care, 15, 379–387.PubMedCrossRef

Dilley, J. W., Woods, W. J., & McFarland, W. (1997). Are advances in treatment changing views about high-risk sex? The New England Journal of Medicine, 337, 501–502.PubMedCrossRef

Dodds, J. P., Nardone, A., Mercey, D. E., & Johnson, A. M. (2000). Increase in high risk sexual behaviour among homosexual men, London 1996–8: Cross sectional, questionnaire study. British Medical Journal, 320, 1510–1511.PubMedCrossRef

Eich-Hochli, D., Niklowitz, M. W., Clement, U., Luthy, R., & Opravil, M. (1998). Predictors of unprotected sexual contacts in HIV-infected persons in Switzerland. Archives of Sexual Behaviour, 27, 77–90.CrossRef

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

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., 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

Kalichman, S. C. (1999). Psychological and social correlates of high-risk sexual behaviour among men and women living with HIV/AIDS. AIDS Care, 11, 415–427.PubMedCrossRef

Katz, M. H., Schwarcz, S. K., Kellogg, T. A., Klausner, J. D., Dilley, J. W., Gibson, S., et al. (2002). Impact of highly active antiretroviral treatment on HIV seroincidence among men who have sex with men: San Francisco. American Journal of Public Health, 92, 388–394.PubMedCrossRef

Kelly, J. A., Murphy, D. A., Bahr, G. R., Koob, J. J., Morgan, M. G., Kalichman, S. C., et al. (1993). Factors associated with severity of depression and high-risk sexual behavior among persons diagnosed with human immunodeficiency virus (HIV) infection. Health Psychology, 12, 215–219.PubMedCrossRef

Kennedy, C. A., Skurnick, J., Wan, J. Y., Quattrone, G., Sheffet, A., Quinones, M., Wang, W., & Louria, D. B. (1993). Psychological distress, drug and alcohol use as correlates of condom use in HIV-serodiscordant heterosexual couples. AIDS, 7, 1493–1499.PubMedCrossRef

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, 20, 1781–1784.PubMedCrossRef

Marks, G., & Crepaz, N. (2001). HIV-positive men’s sexual practices in the context of self-disclosure of HIV status. Journal of Acquired Immune Deficiency Syndromes, 27, 79–85.PubMed

Nattrass, N. (2006). South Africa’s “Rollout” of highly active antiretroviral therapy: A critical assessment. Journal of Acquired Immune Deficiency Syndromes, 43, 618–623.PubMed

Olley, B. O., Seedat, S., Gxamza, F., Reuter, H., & Stein, D. J. (2005). Determinants of unprotected sex among HIV-positive patients in South Africa. AIDS Care, 17, 1–9.PubMedCrossRef

Preston-Whyte, E. (1999). Reproductive health and the condom dilemma: Identifying situational barriers to HIV protection in South Africa. In J. Caldwell, P. Caldwell, J. Anarfi, K. Awusabo-Asare, J. Ntozi, I. O. Orubuloye, J. Marck, W. Cosford, R. Colombo, & E. Hollings (Eds.), Resistances to behavioural change to reduce HIV/AIDS infection in predominantly heterosexual epidemics in 3rd world countries (pp. 135–155). Canberra: Health Transition Centre, National Centre for Epidemiology and Population Health, Australian National University.

Salomon, J. A., Hogan, D. R., Stover, J., Stanecki, K. A., Walker, N., Ghys, P. D., et al. (2005). Integrating HIV prevention and treatment: From slogans to impact. PLoS Medicine, 2, e16.PubMedCrossRef

Schroder, K. E., Carey, M. P., & Vanable, P. A. (2003). Methodological challenges in research on sexual risk behavior: I. Item content, scaling, and data analytical options. Annals of Behavioral Medicine, 26, 76–103.PubMedCrossRef

Sheeran, P., & Abraham, C. (1994). Measurement of condom use in 72 studies of HIV-preventive behaviour: A critical review. Patient Education and Counseling, 24, 199–216.PubMedCrossRef

Simbayi, L. C., Kalichman, S. C., Strebel, A., Cloete, A., Henda, N., & Mqeketo, A. (2007a). 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.PubMedCrossRef

Simbayi, L. C., Kalichman, S., Strebel, A., Cloete, A., Henda, N., & Mqeketo, A. (2007b). Internalized stigma, discrimination, and depression among men and women living with HIV/AIDS in Cape Town, South Africa. Social Science and Medicine, 64, 1823–1831.PubMedCrossRef

Stolte, I. G., & Dukers, N. H. (2003). Response to ‘High-risk sexual behaviour increases among London gay men between 1998 and 2001: what is the role of HIV optimism?’ AIDS, 17, 2011–2012; author reply 2012-3.

Sullivan, K. M. (2005). Male self-disclosure of HIV-positive serostatus to sex partners: A review of the literature. Journal of the Association of Nurses in AIDS Care, 16, 33–47.PubMedCrossRef

Western Cape Department of Health. (2006). The Western Cape Antiretroviral Programme: Monitoring Report, June (2006). Cape Town: Provincial Government of the Western Cape.

Yamey, G. (2001). San Francisco’s HIV infection rate doubles. British Medical Journal, 322, 260.PubMedCrossRef

Title: High Levels of Risk Behavior Among People Living with HIV Initiating and Waiting to Start Antiretroviral Therapy in Cape Town South Africa
Authors: Thomas P. Eisele
Catherine Mathews
Mickey Chopra
Lisanne Brown
Eva Silvestre
Vanessa Daries
Carl Kendall
Publication date: 01-07-2008
Publisher: Springer US
Published in: AIDS and Behavior / Issue 4/2008
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI: https://doi.org/10.1007/s10461-007-9279-7

ACC 2024 Congress Coverage

Heart Failure Video

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

High Levels of Risk Behavior Among People Living with HIV Initiating and Waiting to Start Antiretroviral Therapy in Cape Town South Africa

Abstract

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 4/2008

Between Tradition and Change: Condom Use with Primary Sexual Partners Among Mexican Migrants

Behavioral Studies of Female Sex Workers in China: A Literature Review and Recommendation for Future Research

Shooting Gallery Attendance among IDUs in Tijuana and Ciudad Juarez, Mexico: Correlates, Prevention Opportunities, and the Role of the Environment

Sexual Risk and Bridging Behaviors Among Young People in Hai Phong, Vietnam

The Relationship Between Alcohol Consumption and Unprotected Sex Among Known HIV-discordant Couples in Rwanda and Zambia

Sexual Difficulties in People Living with HIV in France—Results from a Large Representative Sample of Outpatients Attending French Hospitals (ANRS-EN12-VESPA)

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page