title: Sexual risk behaviors among HIV-infected South African men and women with their partners in a primary care program: implications for couples-based prevention.
abstract: We studied 1163 sexually-active HIV-infected South African men and women in an urban primary care program to understand patterns of sexual behaviors and whether these behaviors differed by partner HIV status. Overall, 40% reported a HIV-positive partner and 60% a HIV-negative or status unknown partner; and 17.5% reported >2 sex acts in the last 2 weeks, 16.4% unprotected sex in the last 6 months, and 3.7% >1 sex partner in the last 6 months. Antiretroviral therapy (ART) was consistently associated with decreased sexual risk behaviors, as well as with reporting a HIV-negative or status unknown partner. The odds of sexual risk behaviors differed by sex; and were generally higher among participants reporting a HIV-positive partner, but continued among those with a HIV-negative or status unknown partner. These data support ART as a means of HIV prevention. Engaging in sexual risk behaviors primarily with HIV-positive partners was not widely practiced in this setting, emphasizing the need for couples-based prevention.
authors.affiliation: Department of Community Health, Alpert Medical School, Brown University, Providence, RI, USA. kartik_venkatesh@brown.edu
authors.forename: Kartik K
authors.initials: KK
authors.lastname: Venkatesh
authors.forename: Guy
authors.initials: G
authors.lastname: de Bruyn
authors.forename: Mark N
authors.initials: MN
authors.lastname: Lurie
authors.forename: Tebogo
authors.initials: T
authors.lastname: Modisenyane
authors.forename: Elizabeth W
authors.initials: EW
authors.lastname: Triche
authors.forename: Glenda E
authors.initials: GE
authors.lastname: Gray
authors.forename: Alex
authors.initials: A
authors.lastname: Welte
authors.forename: Neil A
authors.initials: NA
authors.lastname: Martinson
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D044383:Black People; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D005191:Family Characteristics; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011320:Primary Health Care / Q000706:statistics & numerical data; D012309:Risk-Taking; D012650:Self Disclosure; D012725:Sexual Behavior / Q000523:psychology*; D012747:Sexual Partners / Q000523:psychology*; D012959:Socioeconomic Factors; D013019:South Africa / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014505:Urban Population; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents