Changes in sexual behaviors among HIV-infected individuals after their HIV diagnosis in a rural prefecture of Eastern China.

Haijiang Lin,Weiming Zhu,Yingying Ding,Na He,Xing Liu,Meiyang Gao,Julian W Tang

doi:10.1371/journal.pone.0059575

Abstract

ObjectiveTo describe changes in sexual behaviors among HIV-infected individuals after their HIV diagnosis.MethodsAll HIV-infected individuals diagnosed by the end of 2009 in Taizhou Prefecture were invited to participate in this 12-month prospective study. Assessments including the total number and types of sexual contacts, and condom use details for up to their most familiar eight sexual contacts were collected both at enrollment and 12-month follow-up.Results262 HIV-infected individuals were eligible for analysis. The total number of sexual contacts reported by participants was 4,017, 1,496 and 356 during the 12- month period prior to HIV diagnosis (T1), the 12-month period prior to the baseline survey (T2), and the 12-month follow-up period (T3), respectively. The difference in the number of sexual contacts between T2 and T1 was −5 in median (IQR −1, −14), and the difference between T3 and T2 was 0 in median (IQR: 0, −6). A larger proportion of spousal or long-term heterosexual contact was reported from T1(27.7%) to T2(42.5%) to T3(76.1%), whereas a smaller proportion of commercial heterosexual contacts was reported from T1 (48.6%) to T2 (33.2%) to T3 (7.0%) as well as a smaller proportion of non-commercial casual homosexual contacts was reported from T2 (8.4%) to T3 (3.8%).The proportion of consistent condom use increased significantly from T1 (9.3%) to T2 (35.3%) to T3 (91.5%).ConclusionSexual behaviors did not change in a uniform manner for the participants in our study. Sexual behaviors and sexual networks vis-à-vis HIV diagnosis and follow-up were associated with the participant’s characteristics and HIV infection and treatment status. The overall lesson is that individuals who are unaware of their HIV infection are the main drivers of secondary transmission. Early identification of HIV infection and access to antiretroviral therapy (ART ) are both key strategies to the control and prevention.

Highlights

People who are unaware of their infection are unable to benefit from prevention and health care services and are at higher risk for transmitting human immunodeficiency virus (HIV) to others [1,2,3,4]
Ethics Statement This study was approved by the Institutional Review Board (IRB) of Fudan University and written informed consent was obtained from all participants
By the end of 2011, 886 HIV/AIDS individuals had been diagnosed and registered with the Chinese National Information System for AIDS Prevention and Control (CNISAPC), with the majority (90%) diagnosed in the past five years. Among these reported HIV/AIDS individuals, 69.3% were infected through heterosexual transmission, 15.8% infected through homosexual transmission, and 7.3% infected through injection drug use (IDU)

Summary

Introduction

People who are unaware of their infection are unable to benefit from prevention and health care services and are at higher risk for transmitting human immunodeficiency virus (HIV) to others (i.e., secondary transmission) [1,2,3,4]. The international literature (e.g., United States, Zambia, Kenya, Tanzania, Trinidad, Puerto Rico, and India) reveals that people who are aware of their HIV- positive status tend to reduce their risk behaviors, and to adopt safer sex practices [12,13,14,15,16,17,18,19]. These may involve decrease in the number of sexual contacts and increase in condom use. These studies reveal that HIV related risky behavior plays a key role in the HIV transmission, but HIV related behavioral changes and patterns are the important determinants of HIV epidemic at the population-level over time [9,23,24], and dynamic changes in the pattern of connections between HIV-infected individuals and their sexual contacts can often affect infection levels much more [23,24,25,26]

Methods

Results

Discussion

Conclusion