17th International AIDS Conference Mexico City, Mexico - August 13 - 18, 2008

CORRELATES OF HIGH-RISK SEXUAL BEHAVIOUR AMONG SEXUALLY ACTIVE HIV-POSITIVE WOMEN AND MEN IN CLINICAL CARE IN KWAZULU-NATAL, SOUTH AFRICA

Int Conf AIDS. 2008 Aug 13-18;17 Abstract No. MOAC0305

P.A. Shuper ¹, S.M. Kiene², G. Mahlase³, S.P. MacDonald⁴, S. Christie⁵, D.H. Cornman⁵, B. Kistnasamy⁶, S. Pillay⁴, L. Shepherd⁵, G.H. Friedland⁷, U.G. Lalloo⁴, J.D. Fisher⁵, W.A. Fisher^8
1Centre for Addiction and Mental Health, Social, Prevention and Health Policy Research, University of Toronto, Department of Psychology, Toronto, Canada, ²Brown University, Alpert Medical School, Providence, United States, ³Targeted AIDS Interventions, Pietermaritzburg, South Africa, ⁴Nelson Mandela School of Medicine, Enhancing Care Initiative, Durban, South Africa, ⁵University of Connecticut, Center for Health, Intervention, and Prevention, Storrs, United States, ⁶Nelson Mandela School of Medicine, Public Health Medicine, Durban, South Africa, ⁷Yale New Haven Hospital, Yale University School of Medicine, New Haven, United States, ⁸University of Western Ontario, Department of Psychology, Department of Obstetrics and Gynaecology, London, Canada

BACKGROUND: More HIV infections exist in South Africa than in any other country (UNAIDS, 2007), and particularly affected by the HIV epidemic is the South African province of KwaZulu-Natal (KZN), where HIV prevalence is estimated to be as high as 39% (DOH SA, 2007). Given the prevalence of HIV in KZN, and given that incident HIV results from high-risk contact involving people living with HIV/AIDS (PLWHA), the present investigation sought to identify factors associated with unprotected sex in a sample of PLWHA in KZN.

METHODS: A total of 202 PLWHA (mean age=35, range=19-63) receiving antiretroviral therapy at Primary Healthcare Clinics in urban, peri-urban, and rural areas of KZN completed an isiZulu or English audio computer-assisted self interview (ACASI) that assessed demographics, subjective health, sexual behaviour, alcohol and substance use, and HIV risk-related factors.

RESULTS: Chi squares and independent t-tests were used to identify factors uniquely associated with unprotected sex among female and male PLWHA who had been sexually active during the past four weeks (n=90, 44.6%). Among sexually active female PLWHA (n=38, 37.6%), unprotected sex was associated with unemployment, negative condom attitudes, weaker condom use norms, weaker condom use intentions, lower behavioural skills, lower HIV stigma, lower perceived power, being threatened with physical violence, and experiencing physical violence. Among sexually active male PLWHA (n=52, 51.5%), unprotected sex was associated with lower education, lower HIV-related knowledge, negative condom attitudes, alcohol before sex, recent clinical STI treatment, and having a partner who was trying to conceive.

CONCLUSIONS: Results from this investigation 1) indicate risk behaviour among a subgroup of South African PLWHA in clinical care, and 2) identify factors uniquely associated with unprotected sex among female versus male PLWHA. These findings will be used to guide the development of targeted interventions aimed at reducing sexual risk behaviour among South African PLWHA.

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2008-08-13
MOAC0305

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