Department of Community Health, Mbarara University of Science and Technology, Mbarara, Uganda.
BMC Public Health. 2013 May 3;13:430. doi: 10.1186/1471-2458-13-430.
Antiretroviral treatment restores the physical and immunological function for patients with HIV/AIDS and the return of sexual desire. The frequency and correlates of sexual activity among patients receiving ART have not been widely studied. There is concern that widespread availability of ART may result in sexual disinhibition including practice of high-risk sexual behavior. We determined the correlates of sexual activity and high-risk sexual behavior in an ART-treated population in rural and urban Uganda.
We conducted a cross-sectional study among 329 ART-treated adult patients at two hospitals, one located in rural and another in urban western Uganda. We collected data on sexual activity, frequency of condom use, pregnancy, viral load (VL) and CD4. Patients were considered sexually active if they had had sexual intercourse in the last 6 months. Any unprotected sex was considered high-risk sex. A two-stage logistic regression was performed to determine factors associated with sexual activity and high-risk sex among those sexually active.
Overall, 222 (67%) patients were women, 138 (41.2%) had been on ART for at least one year, and 168 (51.4%) were sexually active of whom 127 (75.6%) used condoms at the last intercourse. Younger age (<=30 years) (Odds ratio; OR=2.3, 95% CI 1.2, 4.2), higher monthly income (OR=4.1, 95% CI 2.4, 7.4), and being married (OR=22.7, 95% CI 8.2, 62.9) were associated with being sexually active. Undetectable VL, CD4 count and treatment duration were not significantly associated with sexual activity. Among the sexually active, alcohol consumption (OR=3.3, 95% CI 1.2, 9.1) and unknown serostatus of partner (OR=5.8, 95% CI 1.5, 21.4) were significant predictors of high-risk sexual behavior. The frequency of unprotected sex at the last intercourse was 25.9% and 22.1% among the men and women respectively and was not significantly different (p value for chi square test =0.59).
Younger persons receiving ART are more likely to be sexually active. ART clients are more likely to engage in unprotected sex when sero-status of partner is unknown or report use of alcohol. Counseling on alcohol use and disclosure of sero-status may be useful in reducing high risk sexual behavior.
抗逆转录病毒治疗可恢复 HIV/AIDS 患者的身体和免疫功能，并恢复其性欲。接受抗逆转录病毒治疗的患者的性行为频率和相关情况尚未得到广泛研究。人们担心，抗逆转录病毒治疗的广泛普及可能导致性抑制解除，包括高危性行为的发生。我们在乌干达农村和城市的两家医院对接受抗逆转录病毒治疗的成年人患者中进行了一项横断面研究，以确定与性活动和高危性行为相关的因素。
我们对 329 名在两家医院接受抗逆转录病毒治疗的成年患者进行了横断面研究，一家位于农村，另一家位于乌干达西部城市。我们收集了性行为、 condom 使用频率、怀孕、病毒载量 (VL) 和 CD4 等数据。如果患者在过去 6 个月内有过性行为，则被认为具有性活跃性。任何无保护的性行为都被认为是高危性行为。对性活跃者进行了两阶段逻辑回归分析，以确定与性活动和高危性行为相关的因素。
总的来说，222 名（67%）患者为女性，138 名（41.2%）患者接受抗逆转录病毒治疗至少一年，168 名（51.4%）患者具有性活跃性，其中 127 名（75.6%）患者在最后一次性交时使用了 condom。年龄较小（<=30 岁）（优势比；OR=2.3，95%CI 1.2, 4.2）、月收入较高（OR=4.1，95%CI 2.4, 7.4）和已婚（OR=22.7，95%CI 8.2, 62.9）与性行为活跃相关。不可检测的 VL、CD4 计数和治疗持续时间与性行为活跃性无显著相关性。在性活跃者中，饮酒（OR=3.3，95%CI 1.2, 9.1）和伴侣血清学状况未知（OR=5.8，95%CI 1.5, 21.4）是高危性行为的显著预测因素。最后一次性交时无保护性行为的频率在男性和女性中分别为 25.9%和 22.1%，差异无统计学意义（卡方检验 p 值=0.59）。
接受抗逆转录病毒治疗的年轻人更容易发生性行为。当伴侣的血清学状况未知或报告使用酒精时，抗逆转录病毒治疗的患者更有可能发生无保护性行为。关于饮酒和血清学状况披露的咨询可能有助于减少高危性行为。
