Behavioural interventions to reduce sexual risk for HIV in heterosexual couples: a meta-analysis

LaCroix, Jessica M.; Pellowski, Jennifer; Lennon, Carter A.; Johnson, Blair T.

doi:10.1136/sextrans-2013-051135

Cited by 59 publications

(59 citation statements)

References 53 publications

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“…Mitchell 13 cites studies indicating that the non-use of condoms in intercourse among men-who-have-sex-with-men (MSM) are attributed to feelings of trust, satisfaction, safety, commitment, and desire for intimacy. Similar findings regarding heterossexual relationships were reported by La Croix et al 14 Reis and Gir 15 discuss about feelings such as guilt, anxiety and fear of infecting the female or male partner, highlighting that several stable serodiscordant couples have opted for reducing sexual activity, and even chosing abstinence, as a strategy to avoid those feelings. Loiola, 16 reflecting on the theme of condom use, states that there is a highest incidence of condom use only in the early relationships or in sporadic relationships.…”

Section: Comunicação Saúde Educação 2015; 19(54):467-78supporting

confidence: 80%

Sorodiscordância e prevenção do HIV: percepções de pessoas em relacionamentos estáveis e não estáveis

Said

Seidl

2015

Interface (Botucatu)

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Policies regarding post-sexual exposure prophylaxis (PEP) and the "treatment as prevention" strategy have strengthened preventive measures against HIV transmission. This study aimed to describe the perceptions of people with HIV/AIDS regarding prevention of sexual transmission of HIV in the context of serodiscordance. Two focus groups were conducted, with 13 HIV-positive participants who were in serodiscordant relationships: one group with people in stable partnerships and the other in non-stable relationships. Just over a third of participants were aware of PEP and "treatment as prevention". There was a consensus that it is easier to use safe-sex practices in non-stable serodiscordant relationships, it is easier to use safe-sex practices. Some advantages of the new policies were mentioned, despite the concern that condom use might be neglected. The importance of healthcare teams' actions among serodiscordant couples regarding prevention of sexual transmission of HIV was highlighted. A great number of advances can be perceived since Acquired Immunodeficiency Syndrome (AIDS) was first identified in the early 1980s. Nevertheless, AIDS still remains at epidemic rates, representing a public health problem in Brazil. 1 With the advent of antirretroviral therapy (ART) -which acts on the multiplication of HIV causing a reduction in the viral load and, consequently, an increase in CD4 T-cells and recovering of the immune system -AIDS is currently considered a chronic disease that, even with no cure, enables that people living with HIV/AIDS (PLWHA) have a satisfactory quality of life. [2][3][4][5] By promoting the distribution of antirretroviral therapy from 1996, the Brazilian Public Health System enabled access to treatment as a possibility of PLWHA achieving a good quality of life. As a consequence, other issues have taken place, such as the constitution of serodiscordant couples -a term used to refer to heterossexual or homossexual couples where only one of the partners is HIV-positive. 6,7 Preventive measures against sexually transmitted HIV undergone significant changes over the course of the HIV epidemic. The regular and consistent use of male condoms, followed by the female condoms, was the first preventive measure for fighting against HIV, with good efficacy levels at relatively low costs, being adopted worldwide as a public health measure. Moreover, scientific evidence has recently consolidated additional actions which are being implemented: the so-called "treatment as prevention", referring to the HIV-positive person receiving ART regardless of his/her own immune status (CD4 T-cells count). That treatment enables the patient to obtain a minimum level of viral copies in the body, situation where the virus is undetectable, significantly reducing the chances of transmission.Evidences indicate a 96% sexual transmission reduction of HIV when the HIV-positive female or male partner has been on ART and has an undetectable viral load. 8,9 Another preventive measure backed up by scientific evidence and adopted by the B...

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Section: Comunicação Saúde Educação 2015; 19(54):467-78supporting

confidence: 80%

Sorodiscordância e prevenção do HIV: percepções de pessoas em relacionamentos estáveis e não estáveis

Said

Seidl

2015

Interface (Botucatu)

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“…This mode of infection is responsible for most new cases of infection worldwide. The frequency of heterosexual transmission is growing and women are more becoming vulnerable to being infected by their male partners rather than the other way around 17 . For many couples, unprotected sex can be interpreted as intimacy and confidence, resulting in a barrier to the use of condoms 17,18 .…”

Section: Discussionmentioning

confidence: 99%

“…The frequency of heterosexual transmission is growing and women are more becoming vulnerable to being infected by their male partners rather than the other way around 17 . For many couples, unprotected sex can be interpreted as intimacy and confidence, resulting in a barrier to the use of condoms 17,18 . Therefore, measures to raise awareness among the general population to prevent the risk of new infections must be predicated principally on risky sexual behavior.…”

Section: Discussionmentioning

confidence: 99%

Treatment adherence in patients living with HIV/AIDS assisted at a specialized facility in Brazil

Miyada

Garbín

Gatto

et al. 2017

Rev. Soc. Bras. Med. Trop.

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Introduction:In the 1990s, Brazil adopted a public policy that allowed for universal, free access to antiretroviral therapy (ART). Since then, treatment adherence has become a new challenge for administrators of sexually transmitted disease/acquired immunodeficiency syndrome (STD/AIDS) policies. This study quantified adherence to ART and verified whether there is an association between sociodemographic variables and clinical/laboratory data in human immunodeficiency virus (HIV)-infected patients. Methods: This was a cross-sectional, exploratory study with a quantitative approach that was conducted over 8 months.The target population contained patients who were assisted at the ambulatory care facility specialized in STD/AIDS of a mediumsize city located in Northwest São Paulo. In order to verify the level of adherence to ART, a validated CEAT-VIH (Assessment of Adherence to Antiretroviral Therapy Questionnaire) questionnaire was used. Sociodemographic aspects and clinical/laboratory data were obtained from the medical records. The results were analyzed using the Student's t-test and Pearson's coefficient. Results: Herein, 109 patients were interviewed, 56% of whom were male. The age of the population ranged 18-74 years (mean 45.67 years). Adherence to ART was classified as insufficient in 80.7% of cases. There was an association between ART adherence and presence of symptoms and/or opportunistic infection (p=0.008) and economic status (p<0.001). Conclusions: Adherence to ART among HIV carriers cared for by the public health system is low. Patients who reported a favorable economic status and those without symptoms and/or opportunistic infection demonstrated greater treatment adherence than those who needed to take more than 3 pills a day.

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“…The literature is dominated by public health and behavioural research, which continues to conceptualise serodiscordant couples through the lens of sexual risk behaviour and risk management (e.g. LaCroix et al 2013;Starks et al 2014;Baggaley et al 2013), along with an enduring tendency to describe such partnerships as beset by psychosocial stressors, relationship tensions and prevention pitfalls, requiring an array of interventions (e.g. Mendelsohn et al 2015;Talley and Bettencourt 2010;Beckerman and Auerbach 2002).…”

Section: Introductionmentioning

confidence: 99%

Bridging the HIV Divide: Stigma, Stories and Serodiscordant Sexuality in the Biomedical Age

Persson

Ellard

Newman

2015

Sexuality & Culture

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Behavioural interventions to reduce sexual risk for HIV in heterosexual couples: a meta-analysis

Abstract: Couple-based interventions are efficacious in reducing unprotected sex within the context of romantic relationships. Future research should continue to improve risk reduction for couples.

Cited by 59 publications

References 53 publications

Sorodiscordância e prevenção do HIV: percepções de pessoas em relacionamentos estáveis e não estáveis

Sorodiscordância e prevenção do HIV: percepções de pessoas em relacionamentos estáveis e não estáveis

Treatment adherence in patients living with HIV/AIDS assisted at a specialized facility in Brazil

Bridging the HIV Divide: Stigma, Stories and Serodiscordant Sexuality in the Biomedical Age

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