Psychosocial correlates of inconsistent condom use among HIV-infected patients enrolled in a structured ART interruptions trial in Côte d'Ivoire: results from the TRIVACAN trial (ANRS 1269).
OBJECTIVE
To investigate the relationship between unsafe sexual behaviours and poor self-perceived health among people living with HIV and AIDS (PLWHA) in western Africa.


METHODS
In March 2006, a survey was conducted among patients continuing their participation in the TRIVACAN trial (ANRS 1269) in Côte d'Ivoire, in which patients had been randomized to either continuous or interrupted antiretroviral therapy (ART) (2-months-off/4-months-on cycles [2/4-ART]) after 6-18 months of continuous ART (C-ART). Socio-demographic and psychosocial information, including data on sexual behaviours during the previous 6 months, was collected using face-to-face interviews. Sexually active patients with either a steady partner (serodiscordant or of unknown HIV status) or casual partners were considered to have unsafe sexual behaviours if they reported inconsistent condom use (ICU).


RESULTS
Seventy-seven of the 192 patients reported ICU. In multivariate logistic regression, men were significantly less likely to report ICU than women (OR [95% CI] = 0.45 [0.20-0.98]). After adjustment for educational level and reduced sexual activity since ART initiation, concealment of HIV status (2.08 [1.02-4.25]) and poor self-perceived health (2.32 [0.97-5.52]) were independently associated with ICU.


CONCLUSIONS
HIV prevention strategies in resource-limited settings should take into account self-perceived health and difficulties to disclose HIV status. Counselling interventions need to be developed to help PLWHA to adopt or negotiate safe behaviours respecting their individual cultures.
Protopopescu
Camelia
C
INSERM, U912, Marseille, France.
Marcellin
Fabienne
F
Préau
Marie
M
Gabillard
Delphine
D
Moh
Raoul
R
Minga
Albert
A
Anzian
Amani
A
Carrieri
Maria Patrizia
MP
Danel
Christine
C
Spire
Bruno
B
D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D017280:Condoms / Q000706:statistics & numerical data*; D007560:Cote d'Ivoire; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000523:psychology*; D015497:HIV-1; D015498:HIV-2; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D012307:Risk Factors; D012309:Risk-Taking; D012649:Self Concept; D012650:Self Disclosure; D012747:Sexual Partners; D047568:Unsafe Sex / Q000523:psychology*
D044966:Anti-Retroviral Agents