Sexual Risk Behaviors of Patients with HIV/AIDS over the Course of Antiretroviral Treatment in Northern Vietnam.

Thuc Vu,Bach Tran,Carl Latkin,Tung Tran,Roger Ho,Long Nguyen,Cyrus Ho,Victoria Boggiano

doi:10.3390/ijerph15061106

Abstract

Antiretroviral therapy (ART) improves the health and well-being of people living with the human immunodeficiency virus (HIV, PLWH), and reduces their risk of transmitting the virus to sexual partners. However, patterns of sexual risk behavior among HIV-positive patients taking ART in Vietnam remain largely unknown. In this study, we sought to examine sexual risk behaviors and their associated factors among HIV-positive patients receiving ART in northern Vietnam. The socio-demographic characteristics, ART use, health status, and sexual behaviors of 1133 patients taking ART in the Hanoi and Nam Dinh provinces were explored through face-to-face interviews. There were 63.5% of patients who had one sex partner, while 3.6% and 5.6% of patients had sexual intercourse with casual partners or sex workers, respectively, in the previous 12 months. Most participants tended to use condoms more often with commercial sex partners (90.2%) and intimate partners (79.7%), and less often with casual partners (60.9%). Higher age (odds ratio, OR = 1.0; 95% CIs = 1.0, 1.1) or suffering pain/discomfort (OR = 1.7; 95% CIs = 1.2, 2.4) were factors more likely to be associated with multiple sex partners. Patients who were self-employed were more likely to have sexual intercourse with casual partners/sex workers (OR = 2.1; 95% CIs = 1.1, 4.0). Meanwhile, a higher score on the EuroQol visual analog scale (EQ-VAS), an unknown HIV stage, and a longer duration of ART were adversely associated with not using condoms with casual partners/sex workers. Patients with longer durations of ART had a lower likelihood of not using a condom with casual partners/sex workers (OR = 0.5; 95% CIs = 0.3, 0.8). Our study underscored a relatively high rate of unsafe sexual behaviors among HIV-positive patients. Continuing to improve the physical and psychological well-being of HIV-positive patients in Vietnam is important in reducing the spread of HIV via risky sexual behaviors. In addition, safe-sex education should be provided to older people, and to those who are self-employed.

Highlights

Antiretroviral therapy (ART) is used to improve the lives of people living with the human immunodeficiency virus and acquired immune deficiency syndrome (HIV/Acquired immune deficiency syndrome (AIDS), PLWH) [1,2], and to prevent the spread of the disease through both pre-exposure and post-exposure prophylaxes [3,4,5]
Another study found that Human immunodeficiency virus (HIV)-positive men who have sex with men (MSM) on ART were more likely to engage in sexual risk behaviors, as they were less concerned about HIV transmission [9]
More than 65% of the participants in this study reported no more than one sexual partner in the past year, lower than what was found in other studies in Vietnam [23], and similar to studies in Thailand and Togo [24,25]

Summary

Introduction

The effects of ART on sexual risk behaviors are controversial across settings. One study in rural Uganda found that risky sexual behavior decreased by 70% when HIV-positive patients received. ART and counseling on healthy sexual behaviors [4]. Other studies indicated an increase in the engagement of patients in sexual risk behaviors after initiating ART [6,7,8]. Another study found that HIV-positive men who have sex with men (MSM) on ART were more likely to engage in sexual risk behaviors, as they were less concerned about HIV transmission [9].

Methods

Discussion

Conclusion