HIV prevention: What have we learned from community experiences in concentrated epidemics?

Spire, Bruno; Zoysa, Isabelle de; Himmich, Hakima

doi:10.1186/1758-2652-11-5

Cited by 33 publications

(25 citation statements)

References 54 publications

(51 reference statements)

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“…The role of peer involvement should also be stressed, as emphasized in technical guidance documents relating ''positive prevention'' (International HIV Alliance, 2006; The Guttmacher Institute & the Joint United Nation Programme on HIV/AIDS (UNAIDS), 2006; WHO, 2006). Clinicians need the additional support of community health actors to achieve a substantial change in community norms (Spire, de Zoysa, & Himmich, 2008). Approaching prevention from a salutogenetic perspective (Antonovsky & Franke, 1997), we may draw valuable lessons from looking at factors enabling gay men living with HIV to use condoms more consistently, as done in this study.…”

Section: Discussionmentioning

confidence: 92%

Sexual Protection Behavior in HIV-Positive Gay Men: Testing a Modified Information-Motivation-Behavioral Skills Model

et al. 2010

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This study on determinants of sexual protection behavior among HIV-positive gay men used the empirically tested information-motivation-behavioral skills (IMB) model. HIV-specific variables were added to the model to determine factors decisive for condom use with steady and casual partners. Data were collected using an anonymous, standardized self-administered questionnaire. Study participants were recruited at HIV outpatient clinics associated with the Eurosupport Study Group and the Swiss HIV Cohort Study. To identify factors associated with condom use, backward elimination regression analyses were performed. Overall, 838 HIV-infected gay men from 14 European countries were included in this analysis. About 53% of them reported at least one sexual contact with a steady partner; 62.5% had sex with a casual partner during the last 6 months. Forty-three percent always used condoms with steady partners and 44% with casual partners. High self-efficacy and subjective norms in favor of condom-use were associated with increased condom use with casual and steady partners, whereas feeling depressed was associated with decreased condom use with casual partners. Condoms were used less often with HIV-positive partners. Self-efficacy as an important behavioral skill to perform protection behavior was influenced by lower perceived vulnerability, higher subjective norms, and more positive safer sex attitudes. The IMB-model constructs appeared to be valid; however, not all the model predictors could be determined as hypothesized. Besides the original IMB constructs, HIV-specific variables, including sexual partners' serostatus and mental health, explained condom use. Such factors should be considered in clinical interventions to promote "positive prevention."

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Section: Discussionmentioning

confidence: 92%

Sexual Protection Behavior in HIV-Positive Gay Men: Testing a Modified Information-Motivation-Behavioral Skills Model

et al. 2010

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“…We attribute reductions in unprotected sex and multiple sexual partners to interventional effects of HIV care with ongoing counseling throughout the follow up period38. Findings from this study may be used as a resource in designing effective “prevention for positives” programs, maintenance of safer sexual behavior39 and informing estimation of trends in the HIV incidence and potential spread of drug-resistant HIV40,41.…”

Section: Discussionmentioning

confidence: 93%

Sexual Behaviors Over a 3-Year Period Among Individuals With Advanced HIV/AIDS Receiving Antiretroviral Therapy in an Urban HIV Clinic in Kampala, Uganda

Wandera

Kamya²,

Castelnuovo³

et al. 2011

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background Few studies have prospectively examined sexual behaviors of HIV-infected person on antiretroviral therapy (ART) in Sub-Saharan Africa. Methods From 2004 to 2005, 559 HIV-infected, ART-naïve individuals initiating ART at an HIV clinic in Kampala, Uganda were enrolled into a prospective study and followed to 2008. Clinical and sexual behavior information was assessed at enrollment and semi-annually for three years after ART initiation. Using log-binomial regression models, we estimated prevalence ratios (PRs) to determine factors associated with being sexually active and having unprotected sex over three-years after initiating ART. Results 559 adults contributed 2,594 person-visits of follow-up. At the time of ART initiation, 323 (57.9%) were sexually active of which 176 (54.5%) had unprotected sex at last sexual intercourse. Majority (63.4%) of married individuals were unaware of their partner’s HIV status. Female gender (PR=2.97; 95% CI: 1.85, 4.79), being married (PR=1.48; 95% CI: 1.06, 2.06), and reporting unprotected sex prior to ART (PR=1.68; 95% CI: 1.16, 2.42) were among factors independently associated with unprotected sex while on ART. Overall, 7.3% of visit intervals of unprotected sex, 1.0% of intervals of sexual activity, occurred when plasma viral load >1,500 copies/ml, representing periods of greater HIV transmission risk. Conclusions Although unprotected sex reduced over time, women reported unprotected sex more often than men. Disclosure of HIV status was low. Integration of comprehensive prevention programs into HIV care is needed, particularly ones specific for women.

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“…Whereas, earlier studies have shown an association of stigma, discrimination and domestic violence with unsafe sex. [31323334]…”

Section: Discussionmentioning

confidence: 99%

Predictors of unsafe sexual behavior among people living with human immunodeficiency virus/AIDS attending antiretroviral therapy center in Western India

Mehta¹,

Baxi

Chavda³

et al. 2016

Indian J Sex Transm Dis

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Background:As more and more people with human immunodeficiency virus (HIV) live longer and healthier lives because of antiretroviral therapy (ART), an increasing number of sexual transmissions of HIV may arise from these people living with HIV/AIDS (PLWHA). Hence, this study is conducted to assess the predictors of unsafe sexual behavior among PLWHA on ART in Western India.Materials and Methods:The current cross-sectional study was carried out among 175 PLWHAs attending ART center of a Tertiary Care Hospital in Western India. Unsafe sex was defined as inconsistent and/or incorrect condom use. A total of 39 variables from four domains viz., sociodemographic, relationship-related, medical and psycho-social factors were studied for their relationship to unsafe sexual behavior. The variables found to be significantly associated with unsafe sex practices in bivariate analysis were explored by multivariate analysis using multiple logistic regression in SPSS 17.0 version.Results:Fifty-eight percentage of PLWHAs were practicing unsafe sex. 15 out of total 39 variables showed significant association in bivariate analysis. Finally, 11 of them showed significant association in multivariate analysis. Young age group, illiteracy, lack of counseling, misbeliefs about condom use, nondisclosure to spouse and lack of partner communication were the major factors found to be independently associated with unsafe sex in multivariate analysis.Conclusion:Appropriate interventions like need-based counseling are required to address risk factors associated with unsafe sex.

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HIV prevention: What have we learned from community experiences in concentrated epidemics?

Cited by 33 publications

References 54 publications

Sexual Protection Behavior in HIV-Positive Gay Men: Testing a Modified Information-Motivation-Behavioral Skills Model

Sexual Protection Behavior in HIV-Positive Gay Men: Testing a Modified Information-Motivation-Behavioral Skills Model

Sexual Behaviors Over a 3-Year Period Among Individuals With Advanced HIV/AIDS Receiving Antiretroviral Therapy in an Urban HIV Clinic in Kampala, Uganda

Predictors of unsafe sexual behavior among people living with human immunodeficiency virus/AIDS attending antiretroviral therapy center in Western India

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