Musinguzi Geofrey, Bwayo Denis, Kiwanuka Noah, Coutinho Sheila, Mukose Aggrey, Kabanda Joseph, Sekabembe Lilian, Nuwaha Fred
Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda.
Civil Society Fund, Kampala, Uganda.
PLoS One. 2014 Jan 23;9(1):e85646. doi: 10.1371/journal.pone.0085646. eCollection 2014.
HIV epidemics are sustained and propagated by new cases of infection which result from transmission from infected persons to uninfected susceptible individuals. People living with HIV (PLHIV) play a critical role in prevention if they adopt safer sexual behaviors. This study estimated the prevalence of and factors associated with safer sexual behaviors among PLHIV seeking care from civil society organizations (CSOs).
In a cross sectional study PLHIV were interviewed about their sexual practices, use of alcohol, HIV status of their regular sexual partners, desire for more children and about their socio-demographic characteristics. We calculated the proportion of PLHIV who abstained and consistently used condoms in the previous twelve months. Independent associations between safer sex and other variables were estimated using adjusted prevalence ratios (aPR) and their 95% confidence intervals (CI).
Of the 939 PLHIV, 54% (508) were either abstaining or using condoms consistently and 291 (31%) desired more children. The prevalence of consistent condom use among the sexually active was 41.3% (300/731). Consistent condom use was higher among PLHIV who: didn't use alcohol (aPR 1.30, CI 1.03-1.63); were educated about re-infection with a new strain of HIV (aPR 1.84, CI 1.08-3.12) and had regular sexual partner who was HIV negative (aPR 1.29, CI 1.05-1.57). Prevalence of abstinence was 22.2% (208/939). Abstinence increased with age from 9.4% among PLHIV <25 years to 40.5% among those >50 years. Abstinence was extremely low (2.5%) among PLHIV who were married.
Effective interventions that reduce alcohol consumption among PLHIV are needed to avert HIV transmission, prevent acquisition of new HIV strains and STIs. In addition, strategies are needed to address needs of PLHIV who desire more children.
艾滋病病毒（HIV）疫情通过感染病例的新增得以持续和传播，这些新增病例源于感染者将病毒传播给未感染的易感个体。如果感染HIV的人（PLHIV）采取更安全性行为，他们在预防工作中起着关键作用。本研究估计了向民间社会组织（CSO）寻求治疗的PLHIV中更安全性行为的流行率及其相关因素。
在一项横断面研究中，对PLHIV进行了访谈，内容涉及他们的性行为、饮酒情况、固定性伴侣的HIV感染状况、生育意愿以及社会人口学特征。我们计算了在过去十二个月中禁欲和持续使用避孕套的PLHIV的比例。使用调整后的患病率比值（aPR）及其95%置信区间（CI）估计更安全性行为与其他变量之间的独立关联。
在939名PLHIV中，54%（508名）要么禁欲要么持续使用避孕套，291名（31%）希望生育更多子女。性活跃的PLHIV中持续使用避孕套的比例为41.3%（300/731）。在以下PLHIV中，持续使用避孕套的比例更高：不饮酒者（aPR 1.30，CI 1.03 - 1.63）；接受过关于感染新毒株HIV再感染教育者（aPR 1.84，CI 1.08 - 3.12）；固定性伴侣为HIV阴性者（aPR 1.29，CI 1.05 - 1.57）。禁欲率为22.2%（208/939）。禁欲率随年龄增长而上升，25岁以下的PLHIV中为9.4%，50岁以上的PLHIV中为40.5%。已婚的PLHIV中禁欲率极低（2.5%）。
需要采取有效的干预措施来减少PLHIV的酒精消费，以避免HIV传播、预防感染新的HIV毒株和性传播感染（STIs）。此外，需要制定策略来满足希望生育更多子女的PLHIV的需求。
