Antiretroviral Therapy and Sexual Behavior in Uganda: A Cohort Study
March 11, 2011
The current study examined evidence for sexual behavior change in response to antiretroviral therapy (ART) among participants of a clinical cohort in Uganda. In addition, the investigators assessed factors associated with both sexual behavior and ART independently, with the goal of understanding the impact ART is likely to have on the epidemic.
A retrospective analysis was conducted on an open cohort where ART roll-out began in 2004. Three-month data from 2002 to 2009 were used to examine associations between ART initiation timing and sexual behavior among HIV-infected participants, and timing of ART availability and sexual behavior among uninfected participants. Partner turnover rates and the proportion of HIV-infected participants on ART, two key factors for modeling the potential impact of ART on the epidemic, were also studied.
Though risky sexual behavior among HIV-infected people rose on several indicators following ART initiation, it was not seen at levels higher than two or more years before initiation. "Some evidence suggests that the availability of ART may impact risky behavior among HIV-uninfected people, although this was inconsistent across different reported behavior variables," according to the results.
"The HIV-uninfected is larger than the HIV-infected population. If risky behavior among this population increases due to the feeling of safety that ART provides, this will affect the impact of ART on the HIV epidemic," the investigators concluded. "Policy makers are urged to intensify messages associating sexual behavior and HIV and to target both HIV-infected and uninfected people."
03.13.2011; Vol. 25; No. 5: P. 671-678; Leigh Anne Shafer; Rebecca Nsubuga; Richard White; Billy N. Mayanja; Ruth Chapman; Katie O'Brien; Lieve van der Paal; Heiner Grosskurth; Dermot Maher
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