Ghana: Changes in Sexual Risk Behavior Among Participants in PrEP HIV Prevention Trial

The researchers introduced the study by noting, "One of the concerns raised regarding the introduction of any new HIV-prevention measure, such as PrEP [pre-exposure prophylaxis], is the potential for risk disinhibition or sexual risk compensation." In this regard, the oral tenofovir HIV prevention trial has been the subject of international discussion.

The current report documents the changes in sexual risk behavior among women in Ghana taking part in the oral tenofovir HIV prevention trial. In-depth interviews with participants were conducted to obtain qualitative data; these were then subjected to content-driven, thematic analysis. Self-reported sexual behavior data were collected monthly; growth curve analysis was the principal method used to document trends.

The results indicate that sexual risk behavior did not increase during the trial. Across the 12-month period of study enrollment, the number of sexual partners and the rate of unprotected sex acts decreased. However, certain subgroups of women exhibited different growth curves. The data indicate that the HIV prevention counseling delivered with the trial was effective.

"Counseling during the trial was effective," the authors concluded. "Different types of counseling and messaging may be needed for different subgroups within a population. These findings also have implications for required sample sizes for future HIV prevention trials where seroconversion is the main outcome."

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