Skip to main content
Erschienen in: AIDS and Behavior 4/2008

01.07.2008 | Original Paper

High Levels of Risk Behavior Among People Living with HIV Initiating and Waiting to Start Antiretroviral Therapy in Cape Town South Africa

verfasst von: Thomas P. Eisele, Catherine Mathews, Mickey Chopra, Lisanne Brown, Eva Silvestre, Vanessa Daries, Carl Kendall

Erschienen in: AIDS and Behavior | Ausgabe 4/2008

Einloggen, um Zugang zu erhalten

Abstract

Baseline data were collected in Cape Town during 2006 to study if patients on combination antiretroviral therapy (ART) experience decreased inhibition to avoid risky sexual behavior. A total of 924 HIV-positive individuals were recruited; 520 who initiated ART within 3 months and 404 waiting for ART. Nearly half of men (40.1%) and women (46.3%) reported having unprotected sex their last time. Men and women who did not disclose their HIV status to their partner [Odds ration (OR) = 2.57 (95% CI: 1.22–5.50) and 2.84 (95% CI: 1.84–4.39), respectively], and those with ambivalent perception about the relationship between ART and HIV transmission [OR = 2.08 (95% CI: 1.00–4.30) and 2.39 (95% CI: 1.50–3.84), respectively], were twice as likely to have had unprotected sex their last time. Results suggest an urgent need to strengthen prevention interventions among HIV-positive individuals on and about to start ART in this setting.
Literatur
Zurück zum Zitat Bunnell, R., Ekwaru, J. P., Solberg, P., Wamai, N., Bikaako-Kajura, W., Were, W., et al. (2006). Changes in sexual behavior and risk of HIV transmission after antiretroviral therapy and prevention interventions in rural Uganda. AIDS, 20, 85–92.PubMedCrossRef Bunnell, R., Ekwaru, J. P., Solberg, P., Wamai, N., Bikaako-Kajura, W., Were, W., et al. (2006). Changes in sexual behavior and risk of HIV transmission after antiretroviral therapy and prevention interventions in rural Uganda. AIDS, 20, 85–92.PubMedCrossRef
Zurück zum Zitat Centers for Disease Control, Prevention. (1999). Increases in unsafe sex and rectal gonorrhea among men who have sex with men—San Francisco, California, 1994–1997. Journal of the American Medical Association, 281, 696–697.CrossRef Centers for Disease Control, Prevention. (1999). Increases in unsafe sex and rectal gonorrhea among men who have sex with men—San Francisco, California, 1994–1997. Journal of the American Medical Association, 281, 696–697.CrossRef
Zurück zum Zitat Centers for Disease Control, Prevention. (2003). Increases in HIV diagnoses—29 states, 1999–2002. Morbidity and Mortality Weekly Report, 52, 1145–1148. Centers for Disease Control, Prevention. (2003). Increases in HIV diagnoses—29 states, 1999–2002. Morbidity and Mortality Weekly Report, 52, 1145–1148.
Zurück zum Zitat Crepaz, N., Hart, T. A., & Marks, G. (2004). Highly active antiretroviral therapy and sexual risk behavior: A meta-analytic review. Journal of the American Medical Association, 292, 224–236.PubMedCrossRef Crepaz, N., Hart, T. A., & Marks, G. (2004). Highly active antiretroviral therapy and sexual risk behavior: A meta-analytic review. Journal of the American Medical Association, 292, 224–236.PubMedCrossRef
Zurück zum Zitat Crepaz, N., & Marks, G. (2003). Serostatus disclosure, sexual communication and safer sex in HIV-positive men. AIDS Care, 15, 379–387.PubMedCrossRef Crepaz, N., & Marks, G. (2003). Serostatus disclosure, sexual communication and safer sex in HIV-positive men. AIDS Care, 15, 379–387.PubMedCrossRef
Zurück zum Zitat Dilley, J. W., Woods, W. J., & McFarland, W. (1997). Are advances in treatment changing views about high-risk sex? The New England Journal of Medicine, 337, 501–502.PubMedCrossRef Dilley, J. W., Woods, W. J., & McFarland, W. (1997). Are advances in treatment changing views about high-risk sex? The New England Journal of Medicine, 337, 501–502.PubMedCrossRef
Zurück zum Zitat Dodds, J. P., Nardone, A., Mercey, D. E., & Johnson, A. M. (2000). Increase in high risk sexual behaviour among homosexual men, London 1996–8: Cross sectional, questionnaire study. British Medical Journal, 320, 1510–1511.PubMedCrossRef Dodds, J. P., Nardone, A., Mercey, D. E., & Johnson, A. M. (2000). Increase in high risk sexual behaviour among homosexual men, London 1996–8: Cross sectional, questionnaire study. British Medical Journal, 320, 1510–1511.PubMedCrossRef
Zurück zum Zitat Eich-Hochli, D., Niklowitz, M. W., Clement, U., Luthy, R., & Opravil, M. (1998). Predictors of unprotected sexual contacts in HIV-infected persons in Switzerland. Archives of Sexual Behaviour, 27, 77–90.CrossRef Eich-Hochli, D., Niklowitz, M. W., Clement, U., Luthy, R., & Opravil, M. (1998). Predictors of unprotected sexual contacts in HIV-infected persons in Switzerland. Archives of Sexual Behaviour, 27, 77–90.CrossRef
Zurück zum Zitat Filmer, D., & Pritchett, L. H. (2001). Estimating wealth effects without expenditure data—or tears: An application to educational enrollments in states of India. Demography, 38, 115–132.PubMed Filmer, D., & Pritchett, L. H. (2001). Estimating wealth effects without expenditure data—or tears: An application to educational enrollments in states of India. Demography, 38, 115–132.PubMed
Zurück zum Zitat Jelsma, J., & Ferguson, G. (2004). The determinants of self-reported health-related quality of life in a culturally and socially diverse South African community. Bulletin of the World Health Organization, 82, 206–212.PubMed Jelsma, J., & Ferguson, G. (2004). The determinants of self-reported health-related quality of life in a culturally and socially diverse South African community. Bulletin of the World Health Organization, 82, 206–212.PubMed
Zurück zum Zitat Jelsma, J., Maclean, E., Hughes, J., Tinise, X., & Darder, M. (2005). An investigation into the health-related quality of life of individuals living with HIV who are receiving HAART. AIDS Care, 17, 579–588.PubMed Jelsma, J., Maclean, E., Hughes, J., Tinise, X., & Darder, M. (2005). An investigation into the health-related quality of life of individuals living with HIV who are receiving HAART. AIDS Care, 17, 579–588.PubMed
Zurück zum Zitat Kalichman, S. C. (1999). Psychological and social correlates of high-risk sexual behaviour among men and women living with HIV/AIDS. AIDS Care, 11, 415–427.PubMedCrossRef Kalichman, S. C. (1999). Psychological and social correlates of high-risk sexual behaviour among men and women living with HIV/AIDS. AIDS Care, 11, 415–427.PubMedCrossRef
Zurück zum Zitat Katz, M. H., Schwarcz, S. K., Kellogg, T. A., Klausner, J. D., Dilley, J. W., Gibson, S., et al. (2002). Impact of highly active antiretroviral treatment on HIV seroincidence among men who have sex with men: San Francisco. American Journal of Public Health, 92, 388–394.PubMedCrossRef Katz, M. H., Schwarcz, S. K., Kellogg, T. A., Klausner, J. D., Dilley, J. W., Gibson, S., et al. (2002). Impact of highly active antiretroviral treatment on HIV seroincidence among men who have sex with men: San Francisco. American Journal of Public Health, 92, 388–394.PubMedCrossRef
Zurück zum Zitat Kelly, J. A., Murphy, D. A., Bahr, G. R., Koob, J. J., Morgan, M. G., Kalichman, S. C., et al. (1993). Factors associated with severity of depression and high-risk sexual behavior among persons diagnosed with human immunodeficiency virus (HIV) infection. Health Psychology, 12, 215–219.PubMedCrossRef Kelly, J. A., Murphy, D. A., Bahr, G. R., Koob, J. J., Morgan, M. G., Kalichman, S. C., et al. (1993). Factors associated with severity of depression and high-risk sexual behavior among persons diagnosed with human immunodeficiency virus (HIV) infection. Health Psychology, 12, 215–219.PubMedCrossRef
Zurück zum Zitat Kennedy, C. A., Skurnick, J., Wan, J. Y., Quattrone, G., Sheffet, A., Quinones, M., Wang, W., & Louria, D. B. (1993). Psychological distress, drug and alcohol use as correlates of condom use in HIV-serodiscordant heterosexual couples. AIDS, 7, 1493–1499.PubMedCrossRef Kennedy, C. A., Skurnick, J., Wan, J. Y., Quattrone, G., Sheffet, A., Quinones, M., Wang, W., & Louria, D. B. (1993). Psychological distress, drug and alcohol use as correlates of condom use in HIV-serodiscordant heterosexual couples. AIDS, 7, 1493–1499.PubMedCrossRef
Zurück zum Zitat Kiene, S. M., Christie, S., Cornman, D. H., Fisher, W. A., Shuper, P. A., Pillay, S., et al. (2006). Sexual risk behaviour among HIV-positive individuals in clinical care in urban KwaZulu-Natal, South Africa. AIDS, 20, 1781–1784.PubMedCrossRef Kiene, S. M., Christie, S., Cornman, D. H., Fisher, W. A., Shuper, P. A., Pillay, S., et al. (2006). Sexual risk behaviour among HIV-positive individuals in clinical care in urban KwaZulu-Natal, South Africa. AIDS, 20, 1781–1784.PubMedCrossRef
Zurück zum Zitat Marks, G., & Crepaz, N. (2001). HIV-positive men’s sexual practices in the context of self-disclosure of HIV status. Journal of Acquired Immune Deficiency Syndromes, 27, 79–85.PubMed Marks, G., & Crepaz, N. (2001). HIV-positive men’s sexual practices in the context of self-disclosure of HIV status. Journal of Acquired Immune Deficiency Syndromes, 27, 79–85.PubMed
Zurück zum Zitat Nattrass, N. (2006). South Africa’s “Rollout” of highly active antiretroviral therapy: A critical assessment. Journal of Acquired Immune Deficiency Syndromes, 43, 618–623.PubMed Nattrass, N. (2006). South Africa’s “Rollout” of highly active antiretroviral therapy: A critical assessment. Journal of Acquired Immune Deficiency Syndromes, 43, 618–623.PubMed
Zurück zum Zitat Olley, B. O., Seedat, S., Gxamza, F., Reuter, H., & Stein, D. J. (2005). Determinants of unprotected sex among HIV-positive patients in South Africa. AIDS Care, 17, 1–9.PubMedCrossRef Olley, B. O., Seedat, S., Gxamza, F., Reuter, H., & Stein, D. J. (2005). Determinants of unprotected sex among HIV-positive patients in South Africa. AIDS Care, 17, 1–9.PubMedCrossRef
Zurück zum Zitat Preston-Whyte, E. (1999). Reproductive health and the condom dilemma: Identifying situational barriers to HIV protection in South Africa. In J. Caldwell, P. Caldwell, J. Anarfi, K. Awusabo-Asare, J. Ntozi, I. O. Orubuloye, J. Marck, W. Cosford, R. Colombo, & E. Hollings (Eds.), Resistances to behavioural change to reduce HIV/AIDS infection in predominantly heterosexual epidemics in 3rd world countries (pp. 135–155). Canberra: Health Transition Centre, National Centre for Epidemiology and Population Health, Australian National University. Preston-Whyte, E. (1999). Reproductive health and the condom dilemma: Identifying situational barriers to HIV protection in South Africa. In J. Caldwell, P. Caldwell, J. Anarfi, K. Awusabo-Asare, J. Ntozi, I. O. Orubuloye, J. Marck, W. Cosford, R. Colombo, & E. Hollings (Eds.), Resistances to behavioural change to reduce HIV/AIDS infection in predominantly heterosexual epidemics in 3rd world countries (pp. 135–155). Canberra: Health Transition Centre, National Centre for Epidemiology and Population Health, Australian National University.
Zurück zum Zitat Salomon, J. A., Hogan, D. R., Stover, J., Stanecki, K. A., Walker, N., Ghys, P. D., et al. (2005). Integrating HIV prevention and treatment: From slogans to impact. PLoS Medicine, 2, e16.PubMedCrossRef Salomon, J. A., Hogan, D. R., Stover, J., Stanecki, K. A., Walker, N., Ghys, P. D., et al. (2005). Integrating HIV prevention and treatment: From slogans to impact. PLoS Medicine, 2, e16.PubMedCrossRef
Zurück zum Zitat Schroder, K. E., Carey, M. P., & Vanable, P. A. (2003). Methodological challenges in research on sexual risk behavior: I. Item content, scaling, and data analytical options. Annals of Behavioral Medicine, 26, 76–103.PubMedCrossRef Schroder, K. E., Carey, M. P., & Vanable, P. A. (2003). Methodological challenges in research on sexual risk behavior: I. Item content, scaling, and data analytical options. Annals of Behavioral Medicine, 26, 76–103.PubMedCrossRef
Zurück zum Zitat Sheeran, P., & Abraham, C. (1994). Measurement of condom use in 72 studies of HIV-preventive behaviour: A critical review. Patient Education and Counseling, 24, 199–216.PubMedCrossRef Sheeran, P., & Abraham, C. (1994). Measurement of condom use in 72 studies of HIV-preventive behaviour: A critical review. Patient Education and Counseling, 24, 199–216.PubMedCrossRef
Zurück zum Zitat Simbayi, L. C., Kalichman, S. C., Strebel, A., Cloete, A., Henda, N., & Mqeketo, A. (2007a). Disclosure of HIV status to sex partners and sexual risk behaviours among HIV-positive men and women, Cape Town, South Africa. Sexually Transmitted Infections, 83, 29–34.PubMedCrossRef Simbayi, L. C., Kalichman, S. C., Strebel, A., Cloete, A., Henda, N., & Mqeketo, A. (2007a). Disclosure of HIV status to sex partners and sexual risk behaviours among HIV-positive men and women, Cape Town, South Africa. Sexually Transmitted Infections, 83, 29–34.PubMedCrossRef
Zurück zum Zitat Simbayi, L. C., Kalichman, S., Strebel, A., Cloete, A., Henda, N., & Mqeketo, A. (2007b). Internalized stigma, discrimination, and depression among men and women living with HIV/AIDS in Cape Town, South Africa. Social Science and Medicine, 64, 1823–1831.PubMedCrossRef Simbayi, L. C., Kalichman, S., Strebel, A., Cloete, A., Henda, N., & Mqeketo, A. (2007b). Internalized stigma, discrimination, and depression among men and women living with HIV/AIDS in Cape Town, South Africa. Social Science and Medicine, 64, 1823–1831.PubMedCrossRef
Zurück zum Zitat Stolte, I. G., & Dukers, N. H. (2003). Response to ‘High-risk sexual behaviour increases among London gay men between 1998 and 2001: what is the role of HIV optimism?’ AIDS, 17, 2011–2012; author reply 2012-3. Stolte, I. G., & Dukers, N. H. (2003). Response to ‘High-risk sexual behaviour increases among London gay men between 1998 and 2001: what is the role of HIV optimism?’ AIDS, 17, 2011–2012; author reply 2012-3.
Zurück zum Zitat Sullivan, K. M. (2005). Male self-disclosure of HIV-positive serostatus to sex partners: A review of the literature. Journal of the Association of Nurses in AIDS Care, 16, 33–47.PubMedCrossRef Sullivan, K. M. (2005). Male self-disclosure of HIV-positive serostatus to sex partners: A review of the literature. Journal of the Association of Nurses in AIDS Care, 16, 33–47.PubMedCrossRef
Zurück zum Zitat Western Cape Department of Health. (2006). The Western Cape Antiretroviral Programme: Monitoring Report, June (2006). Cape Town: Provincial Government of the Western Cape. Western Cape Department of Health. (2006). The Western Cape Antiretroviral Programme: Monitoring Report, June (2006). Cape Town: Provincial Government of the Western Cape.
Zurück zum Zitat Yamey, G. (2001). San Francisco’s HIV infection rate doubles. British Medical Journal, 322, 260.PubMedCrossRef Yamey, G. (2001). San Francisco’s HIV infection rate doubles. British Medical Journal, 322, 260.PubMedCrossRef
Metadaten
Titel
High Levels of Risk Behavior Among People Living with HIV Initiating and Waiting to Start Antiretroviral Therapy in Cape Town South Africa
verfasst von
Thomas P. Eisele
Catherine Mathews
Mickey Chopra
Lisanne Brown
Eva Silvestre
Vanessa Daries
Carl Kendall
Publikationsdatum
01.07.2008
Verlag
Springer US
Erschienen in
AIDS and Behavior / Ausgabe 4/2008
Print ISSN: 1090-7165
Elektronische ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-007-9279-7

Weitere Artikel der Ausgabe 4/2008

AIDS and Behavior 4/2008 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.