OBJECTIVE: The objective of this study was to test the hypothesis that sexual risk behavior would increase following initiation of antiretroviral therapy (ART) in Kenyan female sex workers (FSWs). DESIGN: Prospective cohort study. SETTING: FSW cohort in Mombasa, Kenya, 1993-2008. SUBJECTS: Eight hundred and ninety-eight women contributed HIV-1-seropositive follow-up visits, of whom 129 initiated ART. INTERVENTION: Beginning in March 2004, ART was provided to women qualifying for treatment according to Kenyan National Guidelines. Participants received sexual risk reduction education and free condoms at every visit. MAIN OUTCOME MEASURES: Main outcome measures included unprotected intercourse, abstinence, 100% condom use, number of sexual partners, and frequency of sex. Outcomes were evaluated at monthly follow-up visits using a 1-week recall interval. RESULTS: Compared with non-ART-exposed follow-up, visits following ART initiation were not associated with an increase in unprotected sex [adjusted odds ratio (AOR) 0.86, 95% confidence interval (CI) 0.62-1.19, P = 0.4]. There was a nonsignificant decrease in abstinence (AOR 0.81, 95% CI 0.65-1.01, P = 0.07), which was offset by a substantial increase in 100% condom use (AOR 1.54, 95% CI 1.07-2.20, P = 0.02). Numbers of sex partners and frequency of sex were similar before versus after starting ART. A trend for decreased sexually transmitted infections following ART initiation provides additional support for the validity of the self-reported behavioral outcomes (AOR 0.67, 95% CI 0.44-1.02, P = 0.06). CONCLUSION: In the setting of ongoing risk reduction education and provision of free condoms, initiation of ART was not associated with increased sexual risk behavior in this cohort of Kenyan FSWs.
OBJECTIVE: The objective of this study was to test the hypothesis that sexual risk behavior would increase following initiation of antiretroviral therapy (ART) in Kenyan female sex workers (FSWs). DESIGN: Prospective cohort study. SETTING: FSW cohort in Mombasa, Kenya, 1993-2008. SUBJECTS: Eight hundred and ninety-eight women contributed HIV-1-seropositive follow-up visits, of whom 129 initiated ART. INTERVENTION: Beginning in March 2004, ART was provided to women qualifying for treatment according to Kenyan National Guidelines. Participants received sexual risk reduction education and free condoms at every visit. MAIN OUTCOME MEASURES: Main outcome measures included unprotected intercourse, abstinence, 100% condom use, number of sexual partners, and frequency of sex. Outcomes were evaluated at monthly follow-up visits using a 1-week recall interval. RESULTS: Compared with non-ART-exposed follow-up, visits following ART initiation were not associated with an increase in unprotected sex [adjusted odds ratio (AOR) 0.86, 95% confidence interval (CI) 0.62-1.19, P = 0.4]. There was a nonsignificant decrease in abstinence (AOR 0.81, 95% CI 0.65-1.01, P = 0.07), which was offset by a substantial increase in 100% condom use (AOR 1.54, 95% CI 1.07-2.20, P = 0.02). Numbers of sex partners and frequency of sex were similar before versus after starting ART. A trend for decreased sexually transmitted infections following ART initiation provides additional support for the validity of the self-reported behavioral outcomes (AOR 0.67, 95% CI 0.44-1.02, P = 0.06). CONCLUSION: In the setting of ongoing risk reduction education and provision of free condoms, initiation of ART was not associated with increased sexual risk behavior in this cohort of Kenyan FSWs.
Authors: Thomas P Eisele; Catherine Mathews; Mickey Chopra; Mark N Lurie; Lisanne Brown; Sarah Dewing; Carl Kendall Journal: AIDS Behav Date: 2008-10-10
Authors: T C Quinn; M J Wawer; N Sewankambo; D Serwadda; C Li; F Wabwire-Mangen; M O Meehan; T Lutalo; R H Gray Journal: N Engl J Med Date: 2000-03-30 Impact factor: 91.245
Authors: Moses Bateganya; Grant Colfax; Leigh Anne Shafer; Cissy Kityo; Peter Mugyenyi; David Serwadda; Harriet Mayanja; David Bangsberg Journal: AIDS Patient Care STDS Date: 2005-11 Impact factor: 5.078
Authors: Frances M Cowan; Lisa F Langhaug; John W Hargrove; Shabbar Jaffar; Lovemore Mhuriyengwe; Todd D Swarthout; Rosanna Peeling; Ahmed Latif; Mary T Basset; David W G Brown; David Mabey; Richard J Hayes; David Wilson Journal: J Acquir Immune Defic Syndr Date: 2005-11-01 Impact factor: 3.731
Authors: H L Martin; P M Nyange; B A Richardson; L Lavreys; K Mandaliya; D J Jackson; J O Ndinya-Achola; J Kreiss Journal: J Infect Dis Date: 1998-10 Impact factor: 5.226
Authors: Ronald H Gray; Xianbin Li; Maria J Wawer; Stephen J Gange; David Serwadda; Nelson K Sewankambo; Richard Moore; Fred Wabwire-Mangen; Tom Lutalo; Thomas C Quinn Journal: AIDS Date: 2003-09-05 Impact factor: 4.177
Authors: Bea Vuylsteke; Gisèle Semdé; Andrew F Auld; Jennifer Sabatier; Joseph Kouakou; Virginie Ettiègne-Traoré; Anne Buvé; Marie Laga Journal: J Acquir Immune Defic Syndr Date: 2015-03-01 Impact factor: 3.731
Authors: Kate Shannon; Steffanie A Strathdee; Shira M Goldenberg; Putu Duff; Peninah Mwangi; Maia Rusakova; Sushena Reza-Paul; Joseph Lau; Kathleen Deering; Michael R Pickles; Marie-Claude Boily Journal: Lancet Date: 2014-07-22 Impact factor: 79.321
Authors: Lauren McClelland; George Wanje; Frances Kashonga; Lydiah Kibe; R Scott McClelland; James Kiarie; Kishorchandra Mandaliya; Norbert Peshu; Ann Kurth Journal: AIDS Educ Prev Date: 2011-08
Authors: Eduard J Sanders; Haile S Okuku; Adrian D Smith; Mary Mwangome; Elizabeth Wahome; Gregory Fegan; Norbert Peshu; Elisabeth M van der Elst; Matthew A Price; R Scott McClelland; Susan M Graham Journal: AIDS Date: 2013-01-28 Impact factor: 4.177
Authors: Raphael J Landovitz; Thuy Tien T Tran; Susan E Cohn; Ighovwhera Ofotokun; Catherine Godfrey; Daniel R Kuritzkes; Jeffrey L Lennox; Judith S Currier; Heather J Ribaudo Journal: AIDS Behav Date: 2016-12