HIV transmission risk behavior among HIV-infected adults in Uganda: results of a nationally representative survey

被引:122
作者
Bunnell, Rebecca [1 ,2 ]
Opio, Alex [3 ]
Musinguzi, Joshua [3 ]
Kirungi, Wilford [3 ]
Ekwaru, Paul [2 ]
Mishra, Vinod [4 ]
Hladik, Wolfgang
Kafuko, Jessica [5 ]
Madraa, Elizabeth [3 ]
Mermin, Jonathan [2 ]
机构
[1] CDC Kenya, Kenya Med Res Inst, Global AIDS Program, Nairobi 00621, Kenya
[2] Natl Ctr HIV, Ctr Dis Control & Prevent, Global AIDS Program, STD & TB Prevent, Entebbe, Uganda
[3] Uganda Minist Hlth, Kampala, Uganda
[4] Macro Int Inc, Bethesda, MD USA
[5] Agcy Int Dev, Kampala, Uganda
关键词
Africa; discordant couples; HIV/AIDS; positive prevention; sexual behavior; transmission risk; Uganda;
D O I
10.1097/QAD.0b013e3282f56b53
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Objective: Evaluate factors associated with HIV transmission risk behavior among HIV-infected adults in Uganda. Design: Cross-sectional and nationally representative study (2004-2005 Uganda HIV/AIDS Sero-Behavioral Survey) tested 18525 adults (15-59 years old) for HIV and herpes simplex virus type 2 (HSV-2). Methods: Data were weighted to obtain nationally representative results. Sexual-risk behavior by HIV-infected individuals was defined as unprotected sex at last encounter. Using multivariate analysis, we identified factors associated with being sexually active, knowing HIV status, and using contraception and condoms. Results: Of 1092 HIV-infected respondents, 64% were female (median age was 33 years), 84% had HSV-2, and 13% reported one lifetime partner (1% of men and 23% of women). Twenty-one percent of adults knew their HIV status and 9% knew their partners'. Seventy-seven percent were sexually active, of whom 27% reported condom use at last sex. Of last unprotected sexual encounters, 84% were with spouses and 13% with steady partners. Of cohabitating persons, 40% had an HIV-negative spouse. Those who knew their HIV status were three times more likely to use a condom at last sex encounter [adjusted odds ratio (AOR), 3.0; 95% confidence intervals (CI), 1.9-4.71 and those who knew their partners' HIV status were 2.3 ti mes more likely to use condoms (AOR, 2.3; 95% Cl, 1.2-4.3). Conclusions: A minority of HIV-infected adults in Uganda knew they had HIV infection; nearly half were in an HIV-discordant relationship, and few used condoms. Knowledge of HIV status, both one's own and one's partner's, was associated with increased condom use. Interventions to support HIV-infected persons and their partners to be tested are urgently needed. (C) 2008 Wolters Kluwer Health Lippincott Williams & Wilkins.
引用
收藏
页码:617 / 624
页数:8
相关论文
共 26 条
[1]   Sexual behavior of HIV discordant couples after HIV counseling and testing [J].
Allen, S ;
Meinzen-Derr, L ;
Kautzman, M ;
Zulu, I ;
Trask, S ;
Fideli, U ;
Musonda, R ;
Kasolo, F ;
Gao, F ;
Haworth, A .
AIDS, 2003, 17 (05) :733-740
[2]   EFFECT OF SEROTESTING WITH COUNSELING ON CONDOM USE AND SEROCONVERSION AMONG HIV DISCORDANT COUPLES IN AFRICA [J].
ALLEN, S ;
TICE, J ;
VANDEPERRE, P ;
SERUFILIRA, A ;
HUDES, E ;
NSENGUMUREMYI, F ;
BOGAERTS, J ;
LINDAN, C ;
HULLEY, S .
BRITISH MEDICAL JOURNAL, 1992, 304 (6842) :1605-1609
[3]  
[Anonymous], 2006, UG HIV AIDS SER BEH
[4]   Changes in sexual behavior and risk of HIV transmission after antiretroviral therapy and prevention interventions in rural Uganda [J].
Bunnell, R ;
Ekwaru, JP ;
Solberg, P ;
Wamai, N ;
Bikaako-Kajura, W ;
Were, W ;
Coutinho, A ;
Liechty, C ;
Madraa, E ;
Rutherford, G ;
Mermin, J .
AIDS, 2006, 20 (01) :85-92
[5]   HIV prevention for a threatened continent - Implementing positive prevention in Africa [J].
Bunnell, Rebecca ;
Mermin, Jonathan ;
De Cock, Kevin M. .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2006, 296 (07) :855-858
[6]   Effectiveness of highly active antiretroviral therapy in reducing heterosexual transmission of HIV [J].
Castilla, J ;
del Romero, J ;
Hernando, V ;
Marincovich, B ;
García, S ;
Rodríguez, C .
JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES, 2005, 40 (01) :96-101
[7]   Potential effect of HIV type 1 antiretroviral and herpes simplex virus type 2 antiviral therapy on transmission and acquisition of HIV type 1 infection [J].
Celum, CL ;
Robinson, NJ ;
Cohen, MS .
JOURNAL OF INFECTIOUS DISEASES, 2005, 191 :S107-S114
[8]  
Centers for Disease Control and Prevention (CDC), 2003, MMWR Recomm Rep, V52, P1
[9]  
Cohen MS, 1998, LANCET, V351, P5, DOI 10.1016/S0140-6736(98)90002-2
[10]   Do prevention interventions reduce HIV risk behaviours among people living with HIV? A meta-analytic review of controlled trials [J].
Crepaz, N ;
Lyles, CM ;
Wolitski, RJ ;
Passin, WF ;
Rama, SM ;
Herbst, JH ;
Purcell, DW ;
Malow, RA ;
Stall, R .
AIDS, 2006, 20 (02) :143-157