Abstract
BackgroundMany HIV-positive persons avoid risky sexual practices after testing HIV sero-positive. However, a substantial number continue to engage in risky sexual practices that may further transmit the virus, put them at risk of contracting secondary sexually transmitted infections and lead to problems with drug resistance. Thus, this study was intended to assess risky sexual practices and related factors among HIV- positive ART attendees in public hospitals of Addis Ababa.MethodsA cross-sectional study was conducted among ART attendees from February to March, 2009. Questionnaire-based face-to-face interviews were used to gather data. SPSS software was used to perform descriptive and logistic regression analyses.ResultsSix hundred and one ART attendees who fulfilled the inclusion criteria was included in the study and interviewed. More than one-third (36.9%) had a history of risky sexual practices in the three months prior to the study. The major reasons given for not using condoms were: partner's dislike of them, both partners being positive for HIV and the desire to have a child. Factors associated with risky sexual practices included: lack of discussion about condom use (Adjusted Odds Ratio (AOR = 7.23, 95% CI: 4.14, 12.63); lack of self-efficacy in using condoms (AOR = 3.29, 95% CI: 2.07, 5.23); lack of sexual pleasure when using a condom (AOR = 2.39, 95% CI: 1.52, 3.76); and multiple sexual partners (AOR = 2.67, 95% CI: 1.09, 6.57). Being with a negative sero-status partner (AOR = 0.33, 95% CI: 0.14, 0.80), or partners of unknown sero-status (AOR = 0.19, 95% CI: 0.09, 0.39) were associated with less risky practice.ConclusionsA considerable proportion (36.9%) of respondents engaged in unprotected sexual intercourse, potentially resulting in re-infection by a new virus strain, other sexually transmitted infections and onward transmission of the HIV virus. Health education and counseling which focuses on the identified factors has to be provided. The health education and counseling can be provided to these people at ART appointments on follow- up care. It can be provided in a one-on-one basis or through patient group educational discussions at the clinics.
Highlights
Many HIV-positive persons avoid risky sexual practices after testing HIV sero-positive
The majority (62.4%) of participants felt they had selfefficacy in condom use; those without condom use self efficacy were more likely to have engaged in unprotected sex (21.1% v 63.3%, p < 0.001)
Many people who learn they are HIV infected alter their behavior to reduce their risk of transmitting the virus [38]. Among those who remain sexually active, many complain of having trouble in using a condom regularly and there are still men and women living with HIV who experience difficulty maintaining safe sex even though the rates vary widely according to the specific group, the period under observation and the definition of safe sex [6,39]
Summary
Many HIV-positive persons avoid risky sexual practices after testing HIV sero-positive. The. Public health experts emphasize the importance of addressing HIV prevention activities with HIV- infected persons while at the same time scaling up access to antiretroviral (ARV) treatment [3]. With increased access to highly active antiretroviral therapy (HAART), there has been a dramatic decline in morbidity and mortality from HIV disease [4]. Apart from their beneficial clinical effect, treatment advances may have unintended effects on sexual behavior [5]. Unprotected sexual intercourse among persons receiving HAART is a concern because of the risk of HIV-transmission to sero-discordant partners and the risk of re-infection with new drug resistant viral strains [6]
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