Angdembe Mirak Raj, Lohani Shyam Prasad, Karki Deepak Kumar, Bhattarai Kreepa, Shrestha Niraj
Department of Public Health, Central Institute of Science and Technology, Pokhara University, Kathmandu, Nepal.
Centre for Health Research and International Relations, Nobel College, Pokhara University, Kathmandu, Nepal.
BMC Res Notes. 2015 Nov 2;8:629. doi: 10.1186/s13104-015-1559-0.
Clinical improvements that follow antiretroviral therapy (ART) may lead to increase or resumption of high risk activities that could unintentionally result in HIV transmission. The objective was to investigate whether treatment status is a significant predictor of sexual risk behaviour (unprotected sex).
A cross sectional study was conducted among 160 people living with HIV (PLHIV) (89 ART experienced and 71 ART naïve) attending Sukraraj Tropical and Infectious Disease Hospital in Kathmandu, Nepal. A structured questionnaire was used for data collection. Logistic regression with stepwise modeling was used to obtain adjusted odds ratios (OR) with 95 % CI.
In this study, 92 % of sexually active respondents reported sex with a regular partner. ART experienced PLHIV were significantly more likely to report consistent condom use with their regular partners compared to ART naïve PLHIV (83 vs. 53 %; P = 0.006) during the past six months. In multivariate analysis, sex (OR = 4.59, 95 % CI: 1.15-18.39), treatment status (OR = 4.76, 95 % CI: 1.29-17.52) and alcohol consumption during last sex with regular partners (OR = 14.75, 95 % CI: 2.75-79.29) were significantly associated with unprotected sex.
ART naïve PLHIV were five times more likely to exhibit sexual risk behaviour (have unprotected sex) than ART experienced PLHIV. Thus the study provided no evidence to suggest that ART experienced PLHIV exhibit greater sexual risk behaviour compared to ART naïve PLHIV. Prevention programmes need to emphasize on counselling to PLHIV and their regular partners with focused interventions such as couple counselling and education programmes.
抗逆转录病毒疗法（ART）带来的临床改善可能会导致高危行为增加或恢复，这可能会意外导致艾滋病毒传播。目的是调查治疗状态是否是性风险行为（无保护性行为）的重要预测因素。
在尼泊尔加德满都苏克拉拉杰热带和传染病医院对160名艾滋病毒感染者（PLHIV）（89名有ART治疗经历者和71名未接受ART治疗者）进行了一项横断面研究。使用结构化问卷收集数据。采用逐步建模的逻辑回归来获得调整后的优势比（OR）及95%置信区间（CI）。
在本研究中，92%有性活动的受访者报告与固定性伴侣发生性行为。在过去六个月中，有ART治疗经历的PLHIV与未接受ART治疗的PLHIV相比，更有可能报告与固定性伴侣始终使用避孕套（83%对53%；P = 0.006）。在多变量分析中，性别（OR = 4.59，95% CI：1.15 - 18.39）、治疗状态（OR = 4.76，95% CI：1.29 - 17.52）以及上次与固定性伴侣性行为时饮酒（OR = 14.75，95% CI：2.75 - 79.29）与无保护性行为显著相关。
未接受ART治疗的PLHIV出现性风险行为（进行无保护性行为）的可能性是有ART治疗经历的PLHIV的五倍。因此，该研究没有证据表明有ART治疗经历的PLHIV比未接受ART治疗的PLHIV表现出更大的性风险行为。预防项目需要强调为PLHIV及其固定性伴侣提供咨询，并开展诸如伴侣咨询和教育项目等有针对性的干预措施。
