Disclosure, Multiple Sex Partners, and Consistent Condom Use among HIV Positive Adults on Antiretroviral Therapy in Johannesburg, South Africa

Abstract

Inconsistent condom use\ramong persons on antiretroviral treatment (ART) is a major public health\rconcern because of the risk of HIV transmission. This study examined the\rassociation between socio-demographic variables and knowing partners’ HIV\rstatus, multiple sex partners, and consistent condom use among 400 HIV-infected\radults who had received ART for at least six months in Johannesburg, South\rAfrica. The study used a cross-sectional survey and a structured interviewer\radministered questionnaire. Over half (n = 225, 56.3%) of participants were on\rART for more than two years. Two thirds (n = 234, 63.2%) were aware of\rpartner’s HIV status. Over a third (n = 136, 34.0%) reported having more than\rone sex partners. Three quarters (n = 279, 75.8%) reported consistent condom\ruse with regular partner. Discussing HIV testing (aOR = 2.28, CI: 1.31 -3.95),\rawareness of partner’s HIV status (aOR = 2.59, CI: 1.50 -4.46), level of\reducation (aOR = 0.64, CI: 0.42 -0.98), and duration on ART (aOR = 0.71, CI:\r1.31 -3.95) were predictors for consistent condom use. Awareness of partner’s\rHIV status was associated with multiple partnership (aOR = 0.38, CI: 0.21 -0.66),\rliving with partner (aOR = 4.75, CI: 2.86 -7.91), discussing HIV testing (aOR =\r2.43, CI: 1.48 -3.99), and duration on ART (aOR = 2.04, CI: 1.43 -2.92).\rWhile gender (aOR = 5.68, CI: 3.46 -9.34), marital status (aOR = 0.44, CI:\r0.25 -0.77), and awareness of partner’s HIV status (aOR = 0.52, CI: 0.30 -0.89) were associated with multiple partnerships. Risky sexual behaviours\roccurred in all types of partners and knowing partner’s HIV status was a\rpredictor for consistent condom use with all types of partners. It is essential\rthat HIV prevention strategies create an enabling environment for disclosure\rand reductions of risky sexual behaviours by HIV-infected persons on ART.