title: Sexual behaviour of people living with HIV attending a tertiary care government hospital in Kathmandu, Nepal: a cross sectional study.
abstract: BACKGROUND
  Clinical improvements that follow antiretroviral therapy (ART) may lead to increase or resumption of high risk activities that could unintentionally result in HIV transmission. The objective was to investigate whether treatment status is a significant predictor of sexual risk behaviour (unprotected sex).
  
  
  METHODS
  A cross sectional study was conducted among 160 people living with HIV (PLHIV) (89 ART experienced and 71 ART naïve) attending Sukraraj Tropical and Infectious Disease Hospital in Kathmandu, Nepal. A structured questionnaire was used for data collection. Logistic regression with stepwise modeling was used to obtain adjusted odds ratios (OR) with 95 % CI.
  
  
  RESULTS
  In this study, 92 % of sexually active respondents reported sex with a regular partner. ART experienced PLHIV were significantly more likely to report consistent condom use with their regular partners compared to ART naïve PLHIV (83 vs. 53 %; P = 0.006) during the past six months. In multivariate analysis, sex (OR = 4.59, 95 % CI: 1.15-18.39), treatment status (OR = 4.76, 95 % CI: 1.29-17.52) and alcohol consumption during last sex with regular partners (OR = 14.75, 95 % CI: 2.75-79.29) were significantly associated with unprotected sex.
  
  
  CONCLUSIONS
  ART naïve PLHIV were five times more likely to exhibit sexual risk behaviour (have unprotected sex) than ART experienced PLHIV. Thus the study provided no evidence to suggest that ART experienced PLHIV exhibit greater sexual risk behaviour compared to ART naïve PLHIV. Prevention programmes need to emphasize on counselling to PLHIV and their regular partners with focused interventions such as couple counselling and education programmes.
authors.affiliation: Department of Public Health, Central Institute of Science and Technology, Pokhara University, Kathmandu, Nepal. mirak.angdembe@gmail.com.
authors.forename: Mirak Raj
authors.initials: MR
authors.lastname: Angdembe
authors.affiliation: Centre for Health Research and International Relations, Nobel College, Pokhara University, Kathmandu, Nepal. lohanis@gmail.com.
authors.forename: Shyam Prasad
authors.initials: SP
authors.lastname: Lohani
authors.affiliation: National Centre for AIDS and STD Control, Kathmandu, Nepal. dekarki@gmail.com.
authors.forename: Deepak Kumar
authors.initials: DK
authors.lastname: Karki
authors.affiliation: Braun School of Public Health and Community Medicine, Hebrew University, Jerusalem, Israel. kreepa.bhattarai@gmail.com.
authors.forename: Kreepa
authors.initials: K
authors.lastname: Bhattarai
authors.affiliation: Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia. nirajshrestha44@gmail.com.
authors.forename: Niraj
authors.initials: N
authors.lastname: Shrestha
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D017280:Condoms / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006779:Hospitals, Public; D006801:Humans; D016015:Logistic Models; D008297:Male; D009390:Nepal; D012309:Risk-Taking; D021841:Safe Sex / Q000706:statistics & numerical data; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012747:Sexual Partners; D012923:Social Class; D011795:Surveys and Questionnaires; D063128:Tertiary Health Care; D047568:Unsafe Sex / Q000706:statistics & numerical data
chemical_list: D044966:Anti-Retroviral Agents