title: Antiretroviral therapy and sexual behavior: a comparative study between antiretroviral- naive and -experienced patients at an urban HIV/AIDS care and research center in Kampala, Uganda.
abstract: We examined whether use of antiretroviral (ARV) therapy is associated with increased sexual risk behavior in a cross-sectional study of patients undergoing ARV therapy (ARV experienced) compared to patients not undergoing ARV therapy (ARV-naïve) attending an urban HIV clinic in Kampala, Uganda. Sexual behavior during the prior 6 months and sexually transmitted disease (STD) treatment was determined by face-to-face structured interviews. Multiple logistic regression was used to identify independent correlates of sexual activity, multiple sexual partners, inconsistent condom use, and STD treatment during the prior 6 months. Three hundred forty-seven (48%) of the 723 respondents reported a history of sexual intercourse in the 6 months prior to the interview (sexually active). Receipt of ARV therapy was not associated with a significantly higher likelihood of being sexually active (adjusted odds ratio [AOR], 2.0 95% confidence interval [CI], 0.3-9.9). Among both ARV-experienced and ARV-naïve persons who were sexually active, 35% (120) reported one or more casual sexual partners in addition to a main partner (no difference by ARV status). Consistent condom use with spouse, regular, casual, and commercial partners was reported by 57%, 65%, 85%, and 85% of the sexually active respondents, respectively. The ARV-experienced respondents were more likely to report consistent condom use with their spouses than were ARV-naïve respondents (OR 2.82 95% CI 1.74-4.6). ARV-experienced respondents were more likely than ARV-naïve respondents to have disclosed their HIV status to their spouses (OR 1.57 95% CI 1.07-2.30).The ARV-experienced group was more likely to report STD treatment in the prior 6 months (AOR 2.62 95% CI 1.8-3.83) than the ARV-naïve group. The findings suggest that in this population, use of ARV therapy was not associated with risky sexual behavior in the prior 6 months. Still, recall and social desirability biases remain important limitations in interpreting these conclusions.
authors.affiliation: Makerere University Institute of Public Health/Centers for Disease Control and Prevention (IPHCDC) HIV/AIDS Fellowship Program, Kampala, Uganda. bateganmo@fxbguyana.org
authors.forename: Moses
authors.initials: M
authors.lastname: Bateganya
authors.forename: Grant
authors.initials: G
authors.lastname: Colfax
authors.forename: Leigh Anne
authors.initials: LA
authors.lastname: Shafer
authors.forename: Cissy
authors.initials: C
authors.lastname: Kityo
authors.forename: Peter
authors.initials: P
authors.lastname: Mugyenyi
authors.forename: David
authors.initials: D
authors.lastname: Serwadda
authors.forename: Harriet
authors.initials: H
authors.lastname: Mayanja
authors.forename: David
authors.initials: D
authors.lastname: Bangsberg
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy*; D000328:Adult; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D017280:Condoms / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D006801:Humans; D008297:Male; D012725:Sexual Behavior; D014454:Uganda; D014505:Urban Population
chemical_list: D044966:Anti-Retroviral Agents