Objectives: To assess the prevalence and predictors of unprotected sex among HIV+ individuals in clinical care in urban KwaZulu-Natal, South Africa.
Design: Cross-sectional survey of 152 HIV+ individuals attending a hospital-based HIV-clinic.
Methods: Structured interviews were conducted by bilingual interviewers. Sexual risk behaviour in the preceding 3 months was assessed via event counts.
Results: In one of the first studies of its kind in South Africa we found that nearly half of the sample reported vaginal or anal sex during the preceding 3 months, and 30% of these patients reported unprotected vaginal or anal sex. Among sexually active patients, a total of 171 unprotected sex events were reported, 40% of which were with partners perceived to be HIV negative or HIV-status unknown. Nine such partners were potentially exposed to HIV. Alcohol use during sex, being forced to have sex, sex with a perceived HIV+ partner, and sex with a casual partner predicted more unprotected sex, whereas HIV-status disclosure was related to less unprotected sex.
Conclusions: HIV+ individuals in clinical care in South Africa may engage in unprotected sex that place others at risk of HIV infection and themselves at risk for infection with STIs. With a national ARV rollout currently underway in South Africa, increasing numbers of HIV+ individuals are entering care. This affords a crucial opportunity to link HIV prevention with HIV care, an approach that aims to reduce transmission risk behaviour among HIV+ individuals and is consistent with international agencies’ current prevention priorities.
Kiene, Susan M.; Christie, Sarah; Cornman, Deborah H.; Fisher, William A.; Shuper, Paul A.; Pillay, Sandy; Friedland, Gerald H.; and Fisher, Jeffrey D., "Sexual Risk Behaviour among HIV-Positive Individuals in Clinical Care in Urban KwaZulu-Natal, South Africa" (2006). CHIP Documents. Paper 28.