146248 High levels of risk behavior reported among people living with HIV initiating and waiting to start antiretroviral therapy in Cape Town South Africa

Monday, November 5, 2007: 8:30 PM

Thomas Eisele, PhD , Department of International Health and Development, Tulane University, New Orleans, LA
Mickey Chopra, MSc , Health Systems Research Unit, Medical Research Council, Tygerberg, South Africa
Catherine Mathews, MD , Health Systems Research Unit, Medical Research Council, Tygerberg, South Africa
Lisanne Brown, PhD , Department of International Health and Development, Tulane University, New Orleans, LA
Vanessa Daries , Health Systems Research Unit, Medical Research Council, Tygerberg, South Africa
Eva Silvestre, MA , Department of International Health and Development/SPHTM, Tulane University, New Orleans, LA
Carl Kendall , Department of International Health and Development, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
        
Background: We recently completed baseline data of a prospective cohort study of HIV-positive individuals in Cape Town to assess if patients on ART experience decreased inhibition to avoid risky sexual behavior.

Methods: Baseline measures of sexual behavior were ascertained from a census of HIV-positive patients on and waiting to start ART at six high-capacity public ARV facilities in Cape Town from August – October 2006. Measures of self-reported sexual behavior were obtained using self-administered / interviewer-assisted electronic questionnaires.

Results: A total of 924 HIV-positive individuals [520 ART; 404 non-ART] completed the questionnaire. Over half the men (59.7%, 95% confidence interval (CI): 54.1–65.3) and women (62.3%, 95% CI: 58.4–66.2) reported at least one sexual partner in the past four weeks. With little difference among men on ART and those waiting for treatment, 40.1% (95% CI: 34.6–45.6) reported having unprotected sex the last time they had sex. Nearly half (46.3%, 95% CI: 42.3–50.3) the women also reported unprotected sex at their last sexual encounter, regardless of ART status. Overall, over a third of men (33.7%, 95% CI: 28.3–39.1) and one in five women (18.8%, 95% CI: 15.7–21.9) reported having had sex with a casual partner without a condom in the past year.

Conclusions. An unacceptably high proportion of HIV-positive men and women aware of their HIV status in Cape Town are engaging in unprotected sex, suggesting there is opportunity to decrease risky sexual behavior among patients in ART clinical care through an effective risk prevention behavioral intervention.

Learning Objectives:
1. Describe the level of risk behavior among HIV-positive patients in Cape Town imitating combination antiretroviral therapy. 2. Discuss potential behavioral interventions that could be implemented within the clinical setting for reducing risky sexual behavior.

Keywords: HIV/AIDS, Sexual Risk Behavior

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Prevention for Persons Living with HIV/AIDS
See more of: HIV/AIDS