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01.08.2010 | Original Paper

Two-Year Follow-Up of Sexual Behavior Among HIV-Uninfected Household Members of Adults Taking Antiretroviral Therapy in Uganda: No Evidence of Disinhibition

verfasst von: Stevens Bechange, Rebecca Bunnell, Anna Awor, David Moore, Rachel King, Jonathan Mermin, Jordan Tappero, Kenneth Khana, Bradford Bartholow

Erschienen in: AIDS and Behavior | Ausgabe 4/2010

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Abstract

This paper examines HIV risk behavior among HIV-uninfected adults living with people taking antiretroviral therapy (ART) in Uganda. A prospective cohort of 455 HIV-uninfected non-spousal household members of ART patients receiving home-based AIDS care was enrolled. Sexual behavior, HIV risk perceptions, AIDS-related anxiety, and the perception that AIDS is curable were assessed at baseline, 6, 12 and 24 months. Generalized linear mixture models were used to model risk behavior over time and to identify behavioral correlates. Overall, risky sex decreased from 29% at baseline to 15% at 24-months. Among women, risky sex decreased from 31% at baseline to 10% at 6 months and 15% at 24 months. Among men, risky sex decreased from 30% at baseline to 8% at 6 months and 13% at 24 months. Perceiving HIV/AIDS as curable and lower AIDS-related anxiety were independently associated with risky sex. No evidence of behavioral disinhibition was observed. Concerns regarding behavioral disinhibition should not slow down efforts to increase ART access in Africa.

Abbas, U. L., Anderson, R. M., & Mellors, J. W. (2006). Potential impact of antiretroviral therapy on HIV-1 transmission and AIDS mortality in resource-limited settings. Journal of Acquired Immune Deficiency Syndromes, 41, 632–641. doi:10.1097/01.qai.0000194234.31078.bf.CrossRefPubMed

Baggaley, R. F., Garnett, G. P., & Ferguson, N. M. (2006). Modelling the impact of antiretroviral use in resource-poor settings. PLoS Medicine, 3, e124. doi:10.1371/journal.pmed.0030124.CrossRefPubMed

Bunnell, R., Ekwaru, J. P., King, R., Bechange, S., Moore, D., Khana, K., et al. (2008). 3-Year follow-up of sexual behavior and HIV transmission risk of persons taking ART in Rural Uganda. Paper presented at the 15th Conference on Retroviruses and Opportunistic Infections, Boston, MA, February.

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 (London, England), 20, 85–92. doi:10.1097/01.aids.0000196566.40702.28.

Cassell, M. M., Halperin, D. T., Shelton, J. D., & Stanton, D. (2006). Risk compensation: The Achilles’ heel of innovations in HIV prevention? BMJ (Clinical Research Edition), 332, 605–607. doi:10.1136/bmj.332.7541.605.CrossRef

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. doi:10.1001/jama.292.2.224.CrossRefPubMed

Dukers, N. H., Goudsmit, J., de Wit, J. B., Prins, M., Weverling, G. J., & Coutinho, R. A. (2001). Sexual risk behaviour relates to the virological and immunological improvements during highly active antiretroviral therapy in HIV-1 infection. AIDS (London, England), 15, 369–378. doi:10.1097/00002030-200102160-00010.

Elford, J., Bolding, G., & Sherr, L. (2002). High-risk sexual behaviour increases among London gay men between 1998 and 2001: What is the role of HIV optimism? AIDS (London, England), 16, 1537–1544. doi:10.1097/00002030-200207260-00011.

Fitzmaurice, G. M., & Laird, N. M. (2000). Generalized linear mixture models for handling nonignorable dropouts in longitudinal studies. Biostatistics (Oxford, England), 1, 141–156. doi:10.1093/biostatistics/1.2.141.

Gray, R. H., Li, X., Wawer, M. J., Gange, S. J., Serwadda, D., Sewankambo, N. K., et al. (2003). Stochastic simulation of the impact of antiretroviral therapy and HIV vaccines on HIV transmission; Rakai, Uganda. AIDS (London, England), 17, 1941–1951. doi:10.1097/00002030-200309050-00013.

Huebner, D. M., Rebchook, G. M., & Kegeles, S. M. (2004). A longitudinal study of the association between treatment optimism and sexual risk behavior in young adult gay and bisexual men. Journal of Acquired Immune Deficiency Syndromes, 37, 1514–1519. doi:10.1097/01.qai.0000127027.55052.22.CrossRefPubMed

International Collaboration on HIV Optimism. (2003). HIV treatments optimism among gay men: an international perspective. Journal of Acquired Immune Deficiency Syndromes, 32, 545–550. doi:10.1097/00126334-200304150-00013.CrossRef

Kalichman, S. C., Nachimson, D., Cherry, C., & Williams, E. (1998). AIDS treatment advances and behavioral prevention setbacks: Preliminary assessment of reduced perceived threat of HIV-AIDS. Health Psychology, 17, 546–550. doi:10.1037/0278-6133.17.6.546.CrossRefPubMed

Kelly, J. A., Otto-Salaj, L. L., Sikkema, K. J., Pinkerton, S. D., & Bloom, F. R. (1998). Implications of HIV treatment advances for behavioral research on AIDS: Protease inhibitors and new challenges in HIV secondary prevention. Health Psychology, 17, 310–319. doi:10.1037/0278-6133.17.4.310.CrossRefPubMed

Kennedy, C., O’Reilly, K., Medley, A., & Sweat, M. (2007). The impact of HIV treatment on risk behaviour in developing countries: A systematic review. AIDS Care, 19, 707–720. doi:10.1080/09540120701203261.CrossRefPubMed

Liden J., Low-Beer D., Archer J., Benn C., Schwartlander B., Rogerson A., and Schrade C. (2005). The Global Fund at three years. [Retrieved from: http://www.theglobalfund.org/en/files/about/replenishment/progress_report_en.pdf].

Lin, P., Simoni, J. M., & Zemon, V. (2005). The health belief model, sexual behaviors, and HIV risk among Taiwanese immigrants. AIDS Education and Prevention, 17, 469–483. doi:10.1521/aeap.2005.17.5.469.CrossRefPubMed

Little, R. J. A. (1995). Modelling the drop-out mechanism in repeated measures studies. Journal of the American Statistical Association, 88, 125–134. doi:10.2307/2290705.CrossRef

Mbulaiteye, S. M., Mahe, C., Whitworth, J. A. G., Nakiyingi, J. S., Ojwiya, A., & Kamali, A. (2002). Declining HIV-1 incidence and associated prevalence over 10-years period in a rural population in South-West Uganda: A cohort study. Lancet, 360, 41–46. doi:10.1016/S0140-6736(02)09331-5.CrossRefPubMed

Moatti, J. P., Prudhomme, J., Traore, D. C., Juillet-Amari, A., Akribi, H. A., & Msellati, P. (2003). Access to antiretroviral treatment and sexual behaviours of HIV-infected patients aware of their serostatus in Cote d’Ivoire. AIDS (London, England), 17(Suppl. 3), S69–S77. doi:10.1097/00002030-200317003-00010.

Osmond, D. H., Pollack, L. M., Paul, J. P., & Catania, J. A. (2007). Changes in prevalence of HIV infection and sexual risk behavior in men who have sex with men in San Francisco: 1997 2002. American Journal of Public Health, 97, 1677–1683. doi:10.2105/AJPH.2005.062851.CrossRefPubMed

Ostrow, D. E., Fox, K. J., Chmiel, J. S., Silvestre, A., Visscher, B. R., Vanable, P. A., et al. (2002). Attitudes towards highly active antiretroviral therapy are associated with sexual risk taking among HIV-infected and uninfected homosexual men. AIDS (London, England), 16, 775–780. doi:10.1097/00002030-200203290-00013.

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. doi:10.1207/S15324796ABM2602_02.CrossRefPubMed

Smith, D. J. (2003). Imagining HIV/AIDS: morality and perceptions of personal risk in Nigeria. Medical Anthropology, 22, 343–372. doi:10.1080/714966301.CrossRefPubMed

Stolte, I. G., Dukers, N. H., Geskus, R. B., Coutinho, R. A., & de Wit, J. B. (2004). Homosexual men change to risky sex when perceiving less threat of HIV/AIDS since availability of highly active antiretroviral therapy: A longitudinal study. AIDS (London, England), 18, 303–309. doi:10.1097/00002030-200401230-00021.

Stoneburner, R. L., & Low-Beer, D. (2004). Population-level HIV declines and behavioral risk avoidance in Uganda. Science, 304, 714–718. doi:10.1126/science.1093166.CrossRefPubMed

UNAIDS and WORLD HEALTH ORGANIZATION. (2005). Progress on global access to HIV antiretroviral therapy: An update on 3” by 5” (June).

Van de Ven, P., Kippax, S., Knox, S., Prestage, G., & Crawford, J. (1999). HIV treatments optimism and sexual behaviour among gay men in Sydney and Melbourne. AIDS, 13, 2289–2294.CrossRefPubMed

Vanable, P. A., Ostrow, D. G., McKirnan, D. J., Taywaditep, K. J., & Hope, B. A. (2000). Impact of combination therapies on HIV risk perceptions and sexual risk among HIV-positive and HIV-negative gay and bisexual men. Health Psychology, 19, 134–145.CrossRefPubMed

Weidle, P. J., Wamai, N., Solberg, P., Liechty, C., Sendagala, S., Were, W., et al. (2006). Adherence to antiretroviral therapy in a home-based AIDS care programme in rural Uganda. Lancet, 368, 1587–1594.CrossRefPubMed

Were, W. A., Mermin, J. H., Wamai, N., Awor, A. C., Bechange, S., Moss, S., et al. (2006). Undiagnosed HIV infection and couple HIV discordance among household members of HIV-infected people receiving antiretroviral therapy in Uganda. Journal of Acquired Immune Deficiency Syndromes, 43, 1–5.CrossRef

Zeger, S. L., Liang, K. Y., & Albert, P. S. (1988). Models for longitudinal data: a generalized estimating equation approach. Biometrics, 44, 1049–1060.CrossRefPubMed

Titel: Two-Year Follow-Up of Sexual Behavior Among HIV-Uninfected Household Members of Adults Taking Antiretroviral Therapy in Uganda: No Evidence of Disinhibition
verfasst von: Stevens Bechange
Rebecca Bunnell
Anna Awor
David Moore
Rachel King
Jonathan Mermin
Jordan Tappero
Kenneth Khana
Bradford Bartholow
Publikationsdatum: 01.08.2010
Verlag: Springer US
Erschienen in: AIDS and Behavior / Ausgabe 4/2010
Print ISSN: 1090-7165
Elektronische ISSN: 1573-3254
DOI: https://doi.org/10.1007/s10461-008-9481-2

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