1. Changes in sexual activity and risk behaviors among PLWHA initiating ART in rural district hospitals in Cameroon -- data from the STRATALL ANRS 12110/ESTHER trial
- Author
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Gilbert Ndziessi, Eric Delaporte, Anrs, Charles Kouanfack, Jean-Paul Moatti, Bruno Spire, Christian Laurent, Sylvie Boyer, Fabienne Marcellin, Julien Cohen, and Maria Patrizia Carrieri
- Subjects
Sexual partner ,Gerontology ,Adult ,Male ,Health (social science) ,Social Psychology ,Anti-HIV Agents ,Sexual Behavior ,Population ,Context (language use) ,HIV Infections ,law.invention ,Binge Drinking ,HIV Long-Term Survivors ,Condoms ,Randomized controlled trial ,Acquired immunodeficiency syndrome (AIDS) ,law ,Medicine ,Humans ,Cameroon ,Longitudinal Studies ,education ,Africa South of the Sahara ,education.field_of_study ,Unsafe Sex ,business.industry ,Religion and Medicine ,Public Health, Environmental and Occupational Health ,medicine.disease ,Logistic Models ,Sexual Partners ,Female ,Rural area ,business ,Psychosocial ,Demography - Abstract
The continued scaling-up of antiretroviral therapy (ART) in Sub-Saharan Africa provides an opportunity to further study its impact on sexual behaviors among people living with HIV/AIDS (PLWHA). We explored time trend and correlates of sexual activity among PLWHA initiating ART in Cameroon and compared sexual risk behaviors between patients sexually active before and after initiating ART and those resuming sexual activity after ART initiation. Analyses were based on longitudinal data collected within the randomized trial (n=459) conducted in nine rural district hospitals in Cameroon. Sexual activity was defined as reporting at least one sexual partner during the previous 3 months. Inconsistent condom use (ICU) was defined as reporting to have "never," "sometimes," or "nearly always" used condoms at least once with a partner(s) either HIV-negative or of unknown HIV status during the same period. Mc Nemar tests were used to assess time trend, while mixed-effect logistic regressions were conducted to analyze the effect of time since ART initiation on sexual activity. The proportion of sexually active patients significantly increased over time: from 31.8% at baseline to 40.2 and 47.1% after 6 and 12 months of ART, respectively (p=0.001), to 55.9% after 24 months (p=0.02). After adjustment for behavioral and psychosocial factors, time since ART initiation was independently associated with reporting sexual activity (AOR [95% CI]=1.30 [1.17-1.46] per 6-month increase, p=0.001). ICU was more frequent among patients sexually active both before and after ART initiation than among those who resumed sexual activity after ART initiation (82 vs. 59%, p
- Published
- 2013