AEGiS-14IAC: Sexual behaviours among HIV infected patients in the context of the drug access initiative in Cote d'Ivoire.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

Sexual behaviours among HIV infected patients in the context of the drug access initiative in Cote d'Ivoire.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. ThOrD1452)

Prudhomme J, Msellati P, Souville M, Moatti JP
Observatoire regional de la sante, Marseille, France

BACKGROUND: Few data are available in Africa on the impact of antiretroviral treatment on risk behaviors among HIV-infected patients. We aimed to identify factors associated with sexual risky behaviours among HIV-infected patients who consult for HIV in Cote d'Ivoire.

METHODS: A cross-sectional survey was carried out from December 99 to April 00 in 8 health centres including 5 accredited centres for HAART prescription among HIV-infected patients informed of their serostatus. Logistic regression was used to analyse factors associated with abstinence of sex and occurrence of episode of unprotected sex during the prior 6 months.

RESULTS: Among the 711 patients, 53% declared they had no sexual relations in the prior 6 months. In multivariate analysis, female gender, being older than 35, being illiterate, unemployed, not having a main partner, not having heard about HAART, not being under cotrimoxazole prophylaxis, having physical pain limiting daily activities, and CD4<350 were associated with abstinence. Among those who had sexual activities, women were more likely to declare only 1 sexual partner in the prior 6 months. 44% of respondents declared at least 1 episode of unprotected sex. Patients who had access to HAART were less likely to practice risky sexual behaviors (37% vs 50% in the rest of the sample, p=0.02). Multivariate analysis confirmed that unprotected sex was associated with not being HAART-treated, knowledge of HIV serostatus<9 months, ignorance of HIV status of main partner, and high depression score.

CONCLUSIONS: While the majority of HIV-infected patients have renounced to sexual activity, access to HAART tends to increase the persistence of an active sexual life. However, access to treatment is associated with greater adherence to preventive behaviour among sexually active HIV+ patients. Fear that access to HAART may create incentives for "irresponsible" behaviours toward transmission of HIV among African patients is not supported by our data

Keywords: AEGIS, Sex Behavior, HIV Infections, Antiretroviral Therapy, Highly Active, Risk-Taking, HIV Seropositivity, Sexual Partners, Safe Sex, Cross-Sectional Studies, Trimethoprim-Sulfamethoxazole Combination, Pharmaceutical Preparations, Cote d'Ivoire, Africa, Human, Female

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ThOrD1452