Determinants of unprotected sex among HIV-positive patients in South Africa
Olley, B.O.; Seedat, S.; Gxamza, F.; Reuter, H.; Stein, D.J.
Aids Care 17(1): 1-9
2005
ISSN/ISBN: 0954-0121 PMID: 15832829 DOI: 10.1080/09540120500120435Document Number: 252359
The prevalence of unprotected sex, other sexual risk behaviours, and factors associated with unprotected sex among men and women recently diagnosed with HIV were examined. 149 outpatients (44 males and 105 females; aged 18-55 years) at the Infectious Diseases Clinic, Department of Internal Medicine and Infectious Diseases, Tygerberg Hospital, Cape Town, South Africa, were assessed, of whom 101 were sexually active at least 6 months prior to study entry . The subjects were asked about sexual risk behaviours with reference to their most recent sexual encounter. Logistic regression analysis was employed to determine the predictors of condom use, with independent variables selected from 5 general categories: (1) sociodemographic characteristics; (2) situational characteristics regarding sexual intercourse (i.e., alcohol or drugs used before intercourse); (3) clinical diagnoses; (4) negative life events; and (5) coping styles. 55 patients (19 males and 36 females), representing 54.4% of those sexually active in the 6 months preceding the study, had not used a condom during the most recent intercourse. Compared with those who used condoms, participants who did not significantly reported shorter duration of HIV infection (t=-2.7, P<0.001) had a current partner ( chi 2=3.98, P=0.005), and lack knowledge of their partner's HIV status ( chi 2=4.78, P=0.004). Also, they were significantly more likely to engage in denial (t=3.2, P<0.002) and to use substances (t=1.98, P<0.05) as a means of coping. Logistic regression showed that shorter duration of illness (odds ratio (OR), 1.2; 95% CI: 1.01-1.41) and coping styles characterized by denial (OR, 0.6; 95% CI: 0.45-0.96) were significantly associated with unprotected sex. These data suggest the need for interventions to further reduce sexual risk behaviours in HIV-positive patients in South Africa.