School of Social Work, Indigenous Wellness and Research Institute, University of Washington, Seattle, WA 98195-1525, USA.
AIDS Behav. 2011 May;15(4):778-87. doi: 10.1007/s10461-010-9852-3.
We assessed sexual behaviors before and 12-months after ART initiation among 277 Mozambicans attending an HIV clinic. Measured behaviors included the number of sexual partners, condom use, concurrent relationships, disclosure of HIV status, alcohol use, and partners' serostatus. Compared to before ART initiation, increases were seen 12 months after ART in the proportion of participants who were sexually active (48% vs. 64% respondents, P < 0.001) and the proportion of participants with HIV-negative or unknown serostatus partners (45% vs. 80%, P < 0.001). Almost all (96%) concurrent partnerships reported at 12 months formed after ART initiation. Although reported correct and consist condom use increased, the number of unprotected sexual relationships remained the same (n = 45). Non-disclosure of HIV-serostatus to sexual partners was the only significant predictor of practicing unprotected sex with partners of HIV-negative or unknown serostatus. Sexual activity among HIV-positive persons on ART increased 12 months after ART initiation. Ongoing secondary transmission prevention programs addressing sexual activity with multiple partners, disclosure to partners and consistent condom use with serodisconcordant partners must be incorporated throughout HIV care programs.
我们评估了 277 名在艾滋病毒诊所就诊的莫桑比克人在开始接受抗逆转录病毒治疗前和 12 个月后的性行为。所测量的行为包括性伴侣数量、 condom 使用、同时存在的关系、艾滋病毒状况的披露、酒精使用和伴侣的血清状况。与开始抗逆转录病毒治疗前相比，在开始抗逆转录病毒治疗 12 个月后，参与者中报告有性行为的比例增加（48%比 64%的应答者，P < 0.001），艾滋病毒阴性或未知血清状况的伴侣比例增加（45%比 80%，P < 0.001）。几乎所有（96%）在开始抗逆转录病毒治疗后报告的同时存在的关系都是在这之后形成的。尽管报告的正确和一致 condom 使用有所增加，但无保护性行为的数量仍然相同（n = 45）。未向性伴侣披露艾滋病毒血清状况是与艾滋病毒阴性或未知血清状况的伴侣发生无保护性行为的唯一显著预测因素。开始抗逆转录病毒治疗后 12 个月，艾滋病毒阳性者的性活跃性增加。必须在整个艾滋病毒护理方案中纳入针对与多个性伴侣发生性行为、向伴侣披露和与血清不一致的伴侣持续使用 condom 的持续二级传播预防方案。
