Decreased sexual risk behavior in the era of HAART among HIV-infected urban and rural South Africans attending primary care clinics

Kartik K. Venkatesh, Guy De Bruyn, Mark N. Lurie, Lerato Mohapi, Paul Pronyk, Mosa Moshabela, Edmore Marinda, Glenda E. Gray, Elizabeth W. Triche, Neil A. Martinson

Research output: Contribution to journalArticle

Abstract

Objective: In light of increasing access to HAART in sub-Saharan Africa, we conducted a longitudinal study to assess the impact of HAART on sexual risk behaviors among HIV-infected South Africans in urban and rural primary care clinics. Design: Prospective observational cohort. Methods: We conducted a cohort study at rural and urban primary care HIV clinics in South Africa consisting of 1544 men and 4719 women enrolled from 2003 to 2010, representing 19703 clinic visits. The primary outcomes were being sexually active, unprotected sex, and more than one sex partner and were evaluated at 6 monthly intervals. Generalized estimated equations assessed the impact of HAART on sexual risk behaviors. Results: Among 6263 HIV-infected men and women, over a third (37.2%) initiated HAART during study follow-up. In comparison to pre-HAART follow-up, visits while receiving HAART were associated with a decrease in those reporting being sexually active [adjusted odds ratio: 0.86 (95% confidence interval: 0.78-0.95)]. Unprotected sex and having more than one sex partner were reduced at visits following HAART initiation compared to pre-HAART visits [adjusted odds ratio: 0.40 (95% confidence interval: 0.34-0.46) and adjusted odds ratio: 0.20 (95% confidence interval: 0.14-0.29), respectively]. Conclusion: Sexual risk behavior significantly decreased following HAART initiation among HIV-infected South African men and women in primary care programs. The further expansion of antiretroviral treatment programs could enhance HIV prevention efforts in Africa.

Original languageEnglish (US)
Pages (from-to)2687-2696
Number of pages10
JournalAIDS
Volume24
Issue number17
DOIs
StatePublished - Nov 13 2010

Fingerprint

Highly Active Antiretroviral Therapy
Risk-Taking
Sexual Behavior
Primary Health Care
HIV
Unsafe Sex
Odds Ratio
Confidence Intervals
Africa South of the Sahara
Ambulatory Care
South Africa
Longitudinal Studies
Cohort Studies

Keywords

  • AIDS
  • antiretroviral therapy
  • HAART
  • HIV
  • HIV transmission
  • sexual behavior
  • South Africa

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

Cite this

Venkatesh, K. K., De Bruyn, G., Lurie, M. N., Mohapi, L., Pronyk, P., Moshabela, M., ... Martinson, N. A. (2010). Decreased sexual risk behavior in the era of HAART among HIV-infected urban and rural South Africans attending primary care clinics. AIDS, 24(17), 2687-2696. https://doi.org/10.1097/QAD.0b013e32833e78d4

Decreased sexual risk behavior in the era of HAART among HIV-infected urban and rural South Africans attending primary care clinics. / Venkatesh, Kartik K.; De Bruyn, Guy; Lurie, Mark N.; Mohapi, Lerato; Pronyk, Paul; Moshabela, Mosa; Marinda, Edmore; Gray, Glenda E.; Triche, Elizabeth W.; Martinson, Neil A.

In: AIDS, Vol. 24, No. 17, 13.11.2010, p. 2687-2696.

Research output: Contribution to journalArticle

Venkatesh, KK, De Bruyn, G, Lurie, MN, Mohapi, L, Pronyk, P, Moshabela, M, Marinda, E, Gray, GE, Triche, EW & Martinson, NA 2010, 'Decreased sexual risk behavior in the era of HAART among HIV-infected urban and rural South Africans attending primary care clinics', AIDS, vol. 24, no. 17, pp. 2687-2696. https://doi.org/10.1097/QAD.0b013e32833e78d4
Venkatesh, Kartik K. ; De Bruyn, Guy ; Lurie, Mark N. ; Mohapi, Lerato ; Pronyk, Paul ; Moshabela, Mosa ; Marinda, Edmore ; Gray, Glenda E. ; Triche, Elizabeth W. ; Martinson, Neil A. / Decreased sexual risk behavior in the era of HAART among HIV-infected urban and rural South Africans attending primary care clinics. In: AIDS. 2010 ; Vol. 24, No. 17. pp. 2687-2696.
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abstract = "Objective: In light of increasing access to HAART in sub-Saharan Africa, we conducted a longitudinal study to assess the impact of HAART on sexual risk behaviors among HIV-infected South Africans in urban and rural primary care clinics. Design: Prospective observational cohort. Methods: We conducted a cohort study at rural and urban primary care HIV clinics in South Africa consisting of 1544 men and 4719 women enrolled from 2003 to 2010, representing 19703 clinic visits. The primary outcomes were being sexually active, unprotected sex, and more than one sex partner and were evaluated at 6 monthly intervals. Generalized estimated equations assessed the impact of HAART on sexual risk behaviors. Results: Among 6263 HIV-infected men and women, over a third (37.2{\%}) initiated HAART during study follow-up. In comparison to pre-HAART follow-up, visits while receiving HAART were associated with a decrease in those reporting being sexually active [adjusted odds ratio: 0.86 (95{\%} confidence interval: 0.78-0.95)]. Unprotected sex and having more than one sex partner were reduced at visits following HAART initiation compared to pre-HAART visits [adjusted odds ratio: 0.40 (95{\%} confidence interval: 0.34-0.46) and adjusted odds ratio: 0.20 (95{\%} confidence interval: 0.14-0.29), respectively]. Conclusion: Sexual risk behavior significantly decreased following HAART initiation among HIV-infected South African men and women in primary care programs. The further expansion of antiretroviral treatment programs could enhance HIV prevention efforts in Africa.",
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AU - Mohapi, Lerato

AU - Pronyk, Paul

AU - Moshabela, Mosa

AU - Marinda, Edmore

AU - Gray, Glenda E.

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AU - Martinson, Neil A.

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