title: Understanding the context of HIV risk behavior among HIV-positive and HIV-negative female sex workers and male bar clients following antiretroviral therapy rollout in Mombasa, Kenya.
abstract: This study explored perceptions of HIV following local introduction of antiretroviral therapy (ART), among 30 HIV-positive and -negative female sex workers (FSWs) and 10 male bar patrons in Mombasa, Kenya. Semi-structured interviews were analyzed qualitatively to identify determinants of sexual risk behaviors. ART was not perceived as a barrier to safer sex and in some cases led to decreased high-risk behaviors. Barriers to safer sex included economic pressure and sexual partnership types. Many women reported that negotiating condom use is more difficult in long-term partnerships. These women favored short-term partnerships to minimize risk through consistent condom use. For women living with HIV, concern about maintaining health and avoiding HIV superinfection was a strong motivator of protective behaviors. For HIV-negative women, a negative HIV test was a powerful motivator. Incorporation of context- and serostatus-specific factors (e.g., self-protection for HIV-positive women) into tailored prevention counseling may support high-risk women to reduce risk behaviors.
authors.affiliation: School of Nursing, University of Washington, Seattle, USA.
authors.forename: Lauren
authors.initials: L
authors.lastname: McClelland
authors.forename: George
authors.initials: G
authors.lastname: Wanje
authors.forename: Frances
authors.initials: F
authors.lastname: Kashonga
authors.forename: Lydiah
authors.initials: L
authors.lastname: Kibe
authors.forename: R Scott
authors.initials: RS
authors.lastname: McClelland
authors.forename: James
authors.initials: J
authors.lastname: Kiarie
authors.forename: Kishorchandra
authors.initials: K
authors.lastname: Mandaliya
authors.forename: Norbert
authors.initials: N
authors.lastname: Peshu
authors.forename: Ann
authors.initials: A
authors.lastname: Kurth
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000517:prevention & control* / Q000523:psychology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007630:Kenya; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D040242:Risk Reduction Behavior; D012309:Risk-Taking; D011477:Sex Work; D012747:Sexual Partners
chemical_list: D044966:Anti-Retroviral Agents