BACKGROUND: Few studies have prospectively examined sexual behaviors of HIV-infected person on antiretroviral therapy (ART) in sub-Saharan Africa. METHODS: Between 2004 and 2005, 559 HIV-infected, ART-naïve individuals initiating ART at an HIV clinic in Kampala, Uganda, were enrolled into a prospective study and followed to 2008. Clinical and sexual behavior information was assessed at enrollment and semiannually for 3 years after ART initiation. Using log-binomial regression models, we estimated prevalence ratios (PRs) to determine factors associated with being sexually active and having unprotected sex over 3 years after initiating ART. RESULTS: Five hundred fifty-nine adults contributed 2594 person-visits of follow-up. At the time of ART initiation, 323 (57.9%) were sexually active of which 176 (54.5%) had unprotected sex at last sexual intercourse. The majority (63.4%) of married individuals were unaware of their partner's HIV status. Female gender (PR, 2.97; 95% confidence interval, 1.85-4.79), being married (PR, 1.48; 95% confidence interval, 1.06-2.06), and reporting unprotected sex before ART (PR, 1.68; 95% confidence interval, 1.16-2.42) were among the factors independently associated with unprotected sex while on ART. Overall, 7.3% of visit intervals of unprotected sex, 1.0% of intervals of sexual activity, occurred when plasma viral load greater than 1500 copies/mL, representing periods of greater HIV transmission risk. CONCLUSIONS: Although unprotected sex reduced over time, women reported unprotected sex more often than men. Disclosure of HIV status was low. Integration of comprehensive prevention programs into HIV care is needed, particularly ones specific for women.
BACKGROUND: Few studies have prospectively examined sexual behaviors of HIV-infectedperson on antiretroviral therapy (ART) in sub-Saharan Africa. METHODS: Between 2004 and 2005, 559 HIV-infected, ART-naïve individuals initiating ART at an HIV clinic in Kampala, Uganda, were enrolled into a prospective study and followed to 2008. Clinical and sexual behavior information was assessed at enrollment and semiannually for 3 years after ART initiation. Using log-binomial regression models, we estimated prevalence ratios (PRs) to determine factors associated with being sexually active and having unprotected sex over 3 years after initiating ART. RESULTS: Five hundred fifty-nine adults contributed 2594 person-visits of follow-up. At the time of ART initiation, 323 (57.9%) were sexually active of which 176 (54.5%) had unprotected sex at last sexual intercourse. The majority (63.4%) of married individuals were unaware of their partner's HIV status. Female gender (PR, 2.97; 95% confidence interval, 1.85-4.79), being married (PR, 1.48; 95% confidence interval, 1.06-2.06), and reporting unprotected sex before ART (PR, 1.68; 95% confidence interval, 1.16-2.42) were among the factors independently associated with unprotected sex while on ART. Overall, 7.3% of visit intervals of unprotected sex, 1.0% of intervals of sexual activity, occurred when plasma viral load greater than 1500 copies/mL, representing periods of greater HIV transmission risk. CONCLUSIONS: Although unprotected sex reduced over time, women reported unprotected sex more often than men. Disclosure of HIV status was low. Integration of comprehensive prevention programs into HIV care is needed, particularly ones specific for women.
Authors: Marguerita Lightfoot; Mary Jane Rotheram-Borus; W Scott Comulada; Vanessa S Reddy; Naihua Duan Journal: J Acquir Immune Defic Syndr Date: 2010-03 Impact factor: 3.731
Authors: S C Kalichman; D Rompa; M Cage; K DiFonzo; D Simpson; J Austin; W Luke; J Buckles; F Kyomugisha; E Benotsch; S Pinkerton; J Graham Journal: Am J Prev Med Date: 2001-08 Impact factor: 5.043
Authors: A Mocroft; S Vella; T L Benfield; A Chiesi; V Miller; P Gargalianos; A d'Arminio Monforte; I Yust; J N Bruun; A N Phillips; J D Lundgren Journal: Lancet Date: 1998-11-28 Impact factor: 79.321
Authors: Julie Lifshay; Sylvia Nakayiwa; Rachel King; Olga Grinstead Reznick; David Katuntu; Richard Batamwita; Enoch Ezati; Alex Coutinho; Cissy Kazibwe; Rebecca Bunnell Journal: AIDS Care Date: 2009-06
Authors: Rebecca Bunnell; Alex Opio; Joshua Musinguzi; Wilford Kirungi; Paul Ekwaru; Vinod Mishra; Wolfgang Hladik; Jessica Kafuko; Elizabeth Madraa; Jonathan Mermin Journal: AIDS Date: 2008-03-12 Impact factor: 4.177
Authors: Moses R Kamya; Harriet Mayanja-Kizza; Andrew Kambugu; Sabrina Bakeera-Kitaka; Fred Semitala; Patricia Mwebaze-Songa; Barbara Castelnuovo; Petra Schaefer; Lisa A Spacek; Anne F Gasasira; Elly Katabira; Robert Colebunders; Thomas C Quinn; Allan Ronald; David L Thomas; Adeodata Kekitiinwa Journal: J Acquir Immune Defic Syndr Date: 2007-10-01 Impact factor: 3.731
Authors: Tsung-chieh Fu; Ryan P Westergaard; Bryan Lau; David D Celentano; David Vlahov; Shruti H Mehta; Gregory D Kirk Journal: AIDS Date: 2012-11-28 Impact factor: 4.177
Authors: Wing Young Nicola Man; Angela Kelly; Heather Worth; Andrew Frankland; Patti Shih; Martha Kupul; Thiri Lwin; Agnes Mek; Barbara Kepa; Rebecca Emori; Frances Akuani; Brenda Cangah; Lucy Walizopa; Lawrencia Pirpir; Somu Nosi; Peter M Siba Journal: AIDS Res Ther Date: 2013-06-27 Impact factor: 2.250
Authors: Gilbert Ndziessi; Sylvie Boyer; Charles Kouanfack; Julien Cohen; Fabienne Marcellin; Jean-Paul Moatti; Eric Delaporte; Bruno Spire; Christian Laurent; Maria Patrizia Carrieri Journal: PLoS One Date: 2012-06-06 Impact factor: 3.240
Authors: Avina Sarna; Stanley Luchters; Melissa Pickett; Matthew Chersich; Jerry Okal; Scott Geibel; Nzioki Kingola; Marleen Temmerman Journal: AIDS Res Ther Date: 2012-03-19 Impact factor: 2.250