Sexual Risk Behaviors Among HIV-Infected South African Men and Women with Their Partners in a Primary Care Program: Implications for Couples-Based Prevention

Venkatesh, Kartik K.; Bruyn, Guy de; Lurie, Mark N.; Modisenyane, Tebogo; Triche, Elizabeth W.; Gray, Glenda; Welte, Alex; Martinson, Neil

doi:10.1007/s10461-011-9941-y

Cited by 15 publications

(22 citation statements)

References 52 publications

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“…The results of this study support prior reports of South African couples engaging in sexual risk behaviors (Dunkle et al, 2008; Mantell et al, 2011; Venkatesh et al, 2011; Venkatesh et al, 2012). Couples in our study had high numbers of lifetime sexual partners, concurrent partners, and high rates of HIV (Dunkle et al, 2008; Mantell et al, 2011; Venkatesh et al, 2011; Venkatesh et al, 2012).…”

Section: Discussionsupporting

confidence: 89%

Sexual communication self-efficacy, hegemonic masculine norms and condom use among heterosexual couples in South Africa

et al. 2015

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Hegemonic masculine norms (HMN), which promote sexual risk-taking among males and the subordination of women, are believed to play a key role in the HIV epidemic among heterosexual couples in South Africa (SA). Sexual communication self-efficacy (SCSE) (i.e. a couple’s confidence in their ability to communicate about HIV prevention) may be a key leverage point for increasing HIV prevention behaviors among this population. We interviewed 163 sexually active heterosexual couples in Soweto, SA to investigate the association between SCSE, HMN and consistent condom use. We collected information on demographics, relationship dynamics and sexual activity. We utilized the SCSE scale to measure couples’ SCSE, and a subscale of the Gender Equitable Men scale to measure HMN among males. We performed bivariate and multivariable analyses to determine the association of consistent condom use with couples’ SCSE as well as the male partner’s endorsement of HMN. We found that couples with higher SCSE have greater odds of consistent condom use (aOR=1.30, 95% CI: 1.15–1.47). Furthermore, male endorsement of HMN was found to be negatively associated with consistent condom use among couples (aOR=0.47, 95% CI: 0.24–0.89). Joint HIV serostatus was not significantly associated with the outcome. Future interventions that equip heterosexual couples with sexual communication skills, while simultaneously promoting more gender equitable norms, may increase consistent condom use and thereby reduce the transmission of HIV among this at-risk population.

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Section: Discussionsupporting

confidence: 89%

Sexual communication self-efficacy, hegemonic masculine norms and condom use among heterosexual couples in South Africa

et al. 2015

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“…Data on the impact of ARTon sexual risk behaviors are gradually emerging from developing world settings. Although most of the early studies were cross-sectional in design, increasingly observational cohorts have assessed changing patterns of sexual risk behaviors before and after ART initiation (Table 1) [40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56].…”

Section: Assessing the Relationship Between Antiretroviral Therapy Usmentioning

confidence: 99%

“…A national survey in the Cameroon found that not being on ARTwas associated with an over two-fold higher rate of inconsistent condom use [47], which also held for those who reported a partner who was HIV-uninfected or of unknown status [48]. A recent study conducted in South Africa assessed whether sexual risk behaviors differed by self-reported partner HIV status and found that although patients on ART demonstrated consistent decreases in sexual risk behaviors, those patients who reported having a HIV-negative or status unknown partner had similar levels of sexual risk behaviors compared to those with a HIV-positive partner [49].…”

Section: Assessing the Relationship Between Antiretroviral Therapy Usmentioning

confidence: 99%

Is expanded HIV treatment preventing new infections? Impact of antiretroviral therapy on sexual risk behaviors in the developing world

Venkatesh

Flanigan

Mayer

2011

Aids

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There have been dramatic increases in access to antiretroviral therapy (ART) across the developing world, and growing public health attention has focused on the possibility of utilizing ART as a means of slowing the global HIV epidemic. The preventive impact of ART will likely depend on decreasing levels of sexual risk behaviors following treatment initiation. The current review study examines the impact of wider access to ART on sexual risk behaviors among HIV-infected individuals in the developing world. The observational studies to date demonstrate that ART is associated with a significant reduction in unprotected sex following treatment initiation. Although data on the impact of ART on possible risk compensation are rapidly expanding across the developing world, more evidence is still needed before we can safely conclude expanded treatment will result in durable decreases in sexual risk behaviors.

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“…[23][24][25][26][27] We know there are differences in sexual risk behavior patterns between HIV-infected MSM, men who have sex with women (MSW), and women who have sex with men (WSM). [28][29][30][31][32][33] These differences suggest that the costs, benefits, and outcomes associated with serostatus disclosure may also differ between groups. 22 In fact, several studies have found differences between these three groups in serostatus disclosure to sex partners.…”

Section: Introductionmentioning

confidence: 99%

“…Study designs that combine sexual behavior groups may miss important between-group differences that can aid in development of effective interventions targeting unique behaviors within and among these three groups. 28,30,31 Inconsistencies in previous research and the relatively few studies directly comparing sexual behavior groups suggest that critical gaps exist in our understanding of the relationship between serostatus disclosure and unprotected sexual activity among PLHIV.…”

Section: Introductionmentioning

confidence: 99%

Examining the Role of Serostatus Disclosure on Unprotected Sex Among People Living with HIV

Przybyla

Golin

Widman

et al. 2014

AIDS Patient Care and STDs

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Given the increasing prevalence of HIV, it is important to identify factors associated with safer sex behaviors between people living with HIV and their partners. Utilizing a diverse sample of 242 HIV-infected adults [n = 69 men who have sex with men (MSM); n = 68 men who have sex with women (MSW); n = 105 women who have sex with men (WSM)], we examined the association between serostatus disclosure and unprotected anal or vaginal intercourse (UAVI) and the moderating effect of sexual behavior group on this association. Overall, 88.7% disclosed to their current partner. Approximately 18.8% of MSM, 17.7% of MSW, and 29.5% of WSM reported UAVI. Controlling for age, time since diagnosis, and partner serostatus, we found main effects on UAVI for disclosure and sexual behavior group; specifically, disclosure was inversely related to unprotected sex [AOR = 0.09, 95% CI (0.02, 0.43), p < 0.001], and MSM were less likely to engage in UAVI relative to WSM [AOR = 0.11, 95% CI (0.17, 0.82), p < 0.05]. However, the relationship between disclosure and UAVI was not moderated by sexual behavior group. Future strategies that aim to increase disclosure to partners may consider focusing on its value as a means by which to reduce sexual risk behavior.

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Sexual Risk Behaviors Among HIV-Infected South African Men and Women with Their Partners in a Primary Care Program: Implications for Couples-Based Prevention

Cited by 15 publications

References 52 publications

Sexual communication self-efficacy, hegemonic masculine norms and condom use among heterosexual couples in South Africa

Sexual communication self-efficacy, hegemonic masculine norms and condom use among heterosexual couples in South Africa

Is expanded HIV treatment preventing new infections? Impact of antiretroviral therapy on sexual risk behaviors in the developing world

Examining the Role of Serostatus Disclosure on Unprotected Sex Among People Living with HIV

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