Disclosure, Multiple Sex Partners, and Consistent Condom Use among HIV Positive Adults on Antiretroviral Therapy in Johannesburg, South Africa

Abstract

Inconsistent condom use among persons on antiretroviral treatment (ART) is a major public health concern because of the risk of HIV transmission. This study examined the association between socio-demographic variables and knowing partners’ HIV status, multiple sex partners, and consistent condom use among 400 HIV-infected adults who had received ART for at least six months in Johannesburg, South Africa. The study used a cross-sectional survey and a structured interviewer administered questionnaire. Over half (n = 225, 56.3%) of participants were on ART for more than two years. Two thirds (n = 234, 63.2%) were aware of partner’s HIV status. Over a third (n = 136, 34.0%) reported having more than one sex partners. Three quarters (n = 279, 75.8%) reported consistent condom use with regular partner. Discussing HIV testing (aOR = 2.28, CI: 1.31 -3.95), awareness of partner’s HIV status (aOR = 2.59, CI: 1.50 -4.46), level of education (aOR = 0.64, CI: 0.42 -0.98), and duration on ART (aOR = 0.71, CI: 1.31 -3.95) were predictors for consistent condom use. Awareness of partner’s HIV status was associated with multiple partnership (aOR = 0.38, CI: 0.21 -0.66), living with partner (aOR = 4.75, CI: 2.86 -7.91), discussing HIV testing (aOR = 2.43, CI: 1.48 -3.99), and duration on ART (aOR = 2.04, CI: 1.43 -2.92). While gender (aOR = 5.68, CI: 3.46 -9.34), marital status (aOR = 0.44, CI: 0.25 -0.77), and awareness of partner’s HIV status (aOR = 0.52, CI: 0.30 -0.89) were associated with multiple partnerships. Risky sexual behaviours occurred in all types of partners and knowing partner’s HIV status was a predictor for consistent condom use with all types of partners. It is essential that HIV prevention strategies create an enabling environment for disclosure and reductions of risky sexual behaviours by HIV-infected persons on ART.

Share and Cite:

Madiba, S. and Letsoalo, B. (2014) Disclosure, Multiple Sex Partners, and Consistent Condom Use among HIV Positive Adults on Antiretroviral Therapy in Johannesburg, South Africa. World Journal of AIDS, 4, 62-73. doi: 10.4236/wja.2014.41008.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Sarna, A., Luchters, S., Geibel, S., Kaai, S., Munyao, P., et al. (2008) Sexual Risk Behaviour and HAART: A Comparative Study of HIV-Infected Persons on HAART and on Preventive Therapy in Kenya. International Journal of STD & AIDS, 19, 85-89. http://dx.doi.org/10.1258/ijsa.2007.007097
[2] Yalew, E., Zegeye, D.T. and Meseret, S. (2012) Patterns of Condom Use and Associated Factors among Adult HIV Positive Clients in North Western Ethiopia: A Comparative Cross Sectional Study. BMC Public Health, 12, 308.
http://dx.doi.org/10.1186/1471-2458-12-308
[3] Venkatesh, K.K., de Bruyn, G., Lurie, M.N., Mohapi, L., Pronyk, P., et al. (2010) Decreased Sexual Risk Behavior in the Era of HAART among HIV-Infected Urban and Rural South Africans Attending Primary Care Clinics. AIDS (London, England), 24, 2687-2696.
http://dx.doi.org/10.1097/QAD.0b013e32833e78d4
[4] Ayiga, N. (2012) Rates and Predictors of Consistent Condom-Use by People Living with HIV/AIDS on Antiretroviral Treatment in Uganda. Journal of Health, Population, and Nutrition, 30, 270-280.
http://dx.doi.org/10.3329/jhpn.v30i3.12290
[5] Dessie, Y., Gerbaba, M., Bedru, A. and Davey, G. (2011) Risky Sexual Practices and Related Factors among ART Attendees in Addis Ababa Public Hospitals, Ethiopia: A Cross-Sectional Study. BMC Public Health, 11, 422.
http://dx.doi.org/10.1186/1471-2458-11-422
[6] Luchters, S., Sarna, A., Geibel, S., Chersich, M.F., Munyao, P., et al. (2008) Safer Sexual Behaviors after 12 Months of Antiretroviral Treatment in Mombasa, Kenya: A Prospective Cohort. AIDS patient care and STDs, 22, 587-594.
http://dx.doi.org/10.1089/apc.2007.0247
[7] Eisele, T.P., Mathews, C., Chopra, M., Lurie, M.N., Brown, L., et al. (2009) Changes in Risk Behavior among HIV-Positive Patients during Their First Year of Antiretroviral Therapy in Cape Town South Africa. AIDS and Behavior, 13, 1097-1105. http://dx.doi.org/10.1007/s10461-008-9473-2
[8] Apondi, R., Bunnell, R., Ekwaru, J.P., Moore, D., Bechange, S., et al. (2011) Sexual Behavior and HIV Transmission Risk of Ugandan Adults Taking Antiretroviral Therapy: 3 Year Follow-Up. AIDS, 25, 1317-1327.
http://dx.doi.org/10.1097/QAD.0b013e328347f775
[9] Shafer, L.A., Nsubuga, R.N., White, R., Mayanja, B.N., Chapman, R., et al. (2011) Antiretroviral Therapy and Sexual Behavior in Uganda: A Cohort Study. AIDS, 25, 671-678.
http://dx.doi.org/10.1097/QAD.0b013e328341fb18
[10] Wandera, B., Kamya, M.R., Castelnuovo, B., Kiragga, A., Kambugu, A., et al. (1999) Sexual Behaviors over a 3-Year Period among Individuals with Advanced HIV/AIDS Receiving Antiretroviral Therapy in an Urban HIV Clinic in Kampala, Uganda. Journal of Acquired Immune Deficiency Syndromes, 57, 62-68.
http://dx.doi.org/10.1097/QAI.0b013e318211b3f2
[11] Kaye, D.K., Kakaire, O., Osinde, M.O., Lule, J.C., and Kakande, N. (2013) The Impact of Highly Active Antiretroviral Therapy on High-Risk Behaviour of HIV-Infected Patients in Sub-Saharan Africa. The Journal of Infection in Developing Countries, 7, 436-447. http://dx.doi.org/10.3855/jidc.2644
[12] Conserve, D., Sevilla, L., Younge, S., Mbwambo, J. and King, G. (2012) Condom Use among HIV-Positive Sexually Active Adults and Partner’s HIV Status in Dares Salaam, Tanzania. Journal of Health Care for the Poor and Underserved, 23, 191-203. http://dx.doi.org/10.1353/hpu.2012.0010
[13] Ragnarsson, A., Ekström, A.M., Carter, J., Ilako, F., Lukhwaro, A., et al. (2011) Sexual Risk Taking among Patients on Antiretroviral Therapy in an Urban Informal Settlement in Kenya: A Cross-Sectional Survey. Journal of the International AIDS Society, 14, 20. http://dx.doi.org/10.1186/1758-2652-14-20
[14] Venkatesh, K.K., Srikrishnan, A., Safren, S.A., Triche, E.W., Thamburaj, E., et al. (2011) Sexual Risk Behaviors among HIV-Infected South Indian Couples in the HAART Era: Implications for Reproductive Health and HIV Care Delivery. AIDS Care, 23, 722-733.
http://dx.doi.org/10.1080/09540121.2010.525616
[15] Wagner, G.J., Holloway, I., Ghosh-Dastidar, B., Ryan, G. and Kityo, C. (2010) Factors Associated with Condom Use among HIV Clients in Stable Relationships with Partners at Varying Risk for HIV in Uganda. AIDS and Behavior, 14, 1055-1065. http://dx.doi.org/10.1007/s10461-010-9673-4
[16] Gari, T., Habte, D. and Markos, E., (2010) HIV Positive Status Disclosure to Sexual Partner among Women Attending ART Clinic at Hawassa University Referral Hospital, SNNPR, Ethiopia. Ethiopian Journal of Health Development, 24, 87-91. http://dx.doi.org/10.4314/ejhd.v24i1.62940
[17] Mlambo, M. and Peltzer, K. (2011) HIV Sero-Status Disclosure and Sexual Behaviour among HIV Positive Patients Who Are on Antiretroviral Treatment (ART) in Mpumalanga, South Africa. Journal of Human Ecology, 35, 29-41.
[18] Benki-Nugent, S., Chung, M.H., Ackers, M., Richardson, B.A., McGrath, C.J., et al. (2011) Knowing a Sexual Partner Is HIV-1-Uninfected Is Associated With Higher Condom Use among HIV-1-Infected Adults in Kenya. Sexually transmitted diseases, 38, 808-810.
http://dx.doi.org/10.1097/OLQ.0b013e31821c3713
[19] Pearson, C.R., Cassels, S., Kurth, A.E., Montoya, P. and Micek, M.A. (2011) Change in Sexual Activity 12 Months after ART Initiation among HIV-Positive Mozambicans. AIDS and Behavior, 15, 778-787.
http://dx.doi.org/10.1007/s10461-010-9852-3
[20] StataCorp (2007) Stata Statistical Software. Release 10. TX: StataCorp LP.
[21] Bajunirwe, F., Bangsberg, D.R. and Sethi, A.K. (2013) Alcohol Use and HIV Serostatus of Partner Predict High-Risk Sexual Behavior among Patients Receiving Antiretroviral Therapy in South Western Uganda. BMC Public Health, 13, 430. http://dx.doi.org/10.1186/1471-2458-13-430
[22] Akinyemi, J.O., Awolude, O.A., Adewole, I.F. and Kanki, P.J. (2010) Condom Use among Antiretroviral Therapy Patients in Ibadan, Nigeria. The Journal of Infection in Developing Countries, 4, 495-502.
http://dx.doi.org/10.3855/jidc.732
[23] Osinde, M., Kaye, D. and Kakaire, O. (2011) Sexual Behaviour and HIV Sero-Discordance among HIV Patients Receiving HAART in Rural Uganda. Journal of Obstetrics & Gynaecology, 31, 436-440.
http://dx.doi.org/10.3109/01443615.2011.578228
[24] Simbayi, L.C., Kalichman, S.C., Strebel, A., Cloete, A. and Henda, N. (2007) Disclosure of HIV Status to Sex Partners and Sexual Risk Behaviours among HIV-Positive Men and Women, Cape Town, South Africa. Sexually Transmitted Infections, 83, 29-34. http://dx.doi.org/10.1136/sti.2006.019893
[25] Deribe, K., Woldemichael, K., Wondafrash, M., Haile, A. and Amberbir, A. (2008) High-Risk Behaviours and Associated Factors among HIV-Positive Individuals in Clinical Care in Southwest Ethiopia. Tropical Doctor, 38, 237-239.
http://dx.doi.org/10.1258/td.2008.070405
[26] Chakrapani, V., Newman, P.A., Shunmugam, M. and Dubrow, R. (2010) Prevalence and Contexts of Inconsistent Condom Use among Heterosexual Men and Women Living with HIV in India: Implications for Prevention. AIDS Patient Care and STDs, 24, 49-58.
http://dx.doi.org/10.1089/apc.2009.0214
[27] Bunnell, R., Ekwaru, J.P., Solberg, P., Wamai, N., Bikaako-Kajura, W., et al. (2006) Changes in Sexual Behavior and Risk of HIV Transmission after Antiretroviral Therapy and Prevention Interventions in Rural Uganda. AIDS, 20, 85-92.
http://dx.doi.org/10.1097/01.aids.0000196566.40702.28
[28] Kalichman, S.C., Ntseane, D., Nthomang, K., Segwabe, M. and Phorano, O. (2007) Recent Multiple Sexual Partners and HIV Transmission Risks among People Living with HIV/AIDS in Botswana. Sexually Transmitted Infections, 83, 371-375. http://dx.doi.org/10.1136/sti.2006.023630

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.