title: Changes in sexual behavior and contraceptive use after HIV acquisition and factors associated with risky sexual practices among people living with HIV in selected Indian cities.
abstract: BACKGROUND
  Sexual behavior and contraceptive use among HIV-infected persons are a neglected issue in public health programs.
  
  
  OBJECTIVE
  To understand sexual practices and contraceptive use of people living with HIV (PLHIV) before and after being diagnosed with the infection and assess the providers' perspectives on provision of contraceptives to PLHIV, the quality of services provided and linkages between reproductive health and HIV services.
  
  
  METHODS
  A mix method design study using a purposive sampling was undertaken enrolling PLHIV from ART centers and PLHIV networks across three cities in India. Doctors and counselors providing HIV services at public hospitals were also interviewed.
  
  
  RESULTS
  Use of condoms increased from 35% to 81% after being diagnosed with HIV. Consistent condom use was 69% compared to only 8.7% before being diagnosed with HIV. Nearly 41% (297) of participants indulged in one or more forms of risky sexual behaviors. Significant correlates of risky sexual practices were: participants who were middle-aged (25-33 years), formerly married, currently not on antiretroviral therapy, and received negligible information on contraception from service providers leading to poor knowledge on safe sex and dual protection. Information from service providers reveals a lack of specific program guidelines to comprehensively address family planning (FP) issues through HIV programs.
  
  
  CONCLUSIONS
  The study throws light on missed opportunities to address contraceptive needs of PLHIV and recommends training service providers and operationalizing a strategy to link HIV and FP services.
authors.affiliation: Scientist E, Department of Operational Research, National Institute for Research in Reproductive Health, Mumbai, Maharashtra, India.
authors.forename: Beena
authors.initials: B
authors.lastname: Joshi
authors.affiliation: Scientist - F and Head, Department of Operational Research, National Institute for Research in Reproductive Health, Mumbai, Maharashtra, India.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Chauhan
authors.affiliation: Scientist - D, Regional Medical Research Center, Dibrugarh, Assam, India.
authors.forename: Hiranya
authors.initials: H
authors.lastname: Das
authors.affiliation: Head, Department of Medicine, Incharge ART Center, Civil Hospital, Aizawl, Mizoram, India.
authors.forename: Rosangluaia
authors.initials: R
authors.lastname: Luaia
authors.affiliation: Project Research Officer, Department of Operational Research, National Institute for Research in Reproductive Health, Mumbai, Maharashtra, India.
authors.forename: Nitya
authors.initials: N
authors.lastname: Sunil
mesh_terms: D000328:Adult; D002947:Cities; D017280:Condoms; D003268:Contraception Behavior; D003270:Contraceptive Agents; D005193:Family Planning Services; D015658:HIV Infections; D006801:Humans; D007194:India; D012309:Risk-Taking; D012725:Sexual Behavior
chemical_list: D003270:Contraceptive Agents