Sexual behavior of HIV-positive adults not accessing HIV treatment in Mombasa, Kenya Defining their prevention needs 英文参考文献.docVIP
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Sexual behavior of HIV-positive adults not accessing HIV treatment in Mombasa, Kenya Defining their prevention needs 英文参考文献
Sarnaetal.AIDSResearchandTherapy2012,9:9
/content/9/1/9
RESEARCH
OpenAccess
SexualbehaviorofHIV-positiveadultsnot
accessingHIVtreatmentinMombasa,Kenya:
Definingtheirpreventionneeds
AvinaSarna1*,StanleyLuchters2,MelissaPickett3,MatthewChersich2,4,JerryOkal5,ScottGeibel5,NziokiKingola6
andMarleenTemmerman2
Abstract
Background:HIVspreadcontinuesathighratesfrominfectedpersonstotheirsexualpartners.In2009,an
estimated2.6millionnewinfectionsoccurredglobally.PeoplelivingwithHIV(PLHIV)receivingtreatmentarein
contactwithhealthworkersandthereforeexposedtopreventionmessages.Bycontrast,PLHIVnotreceivingART
oftenfalloutsidetheambitofpreventionprograms.Thereislittleinformationontheirsexualriskbehaviors.This
studyinMombasaKenyathereforeexploredsexualbehaviorsofPLHIVnotreceivinganyHIVtreatment.
Results:Usingmodifiedtargetedsnowballsampling,698PLHIVwererecruitedthroughcommunityhealthworkers
andHIV-positivepeercounsellors.Ofthe59.2%sexually-activePLHIV,24.5%reportedmultiplesexualpartners.Ofall
sexualpartners,10.2%wereHIVnegative,while74.5%wereofunknownHIVstatus.Overall,unprotectedsex
occurredin52%ofsexualpartnerships;notablywith32%ofHIV-negativepartnersand54%ofpartnersof
unknownHIVstatusinthelast6months.Multivariateanalysis,controllingforintra-clientclustering,showednon-
disclosureofHIVstatus(AOR:2.38,95%CI:1.47-3.84,p0.001);experiencingmoderatelevelsofperceivedstigma
(AOR:2.94,95%CI:1.50-5.75,p=0.002);andbelievingcondomsreducesexualpleasure(AOR:2.81,95%CI:1.60-4.91,
p0.001)wereindependentlyassociatedwithunsafesex.Unsafesexwasalsohigherinthoseusingcontraceptive
methodsotherthancondoms(AOR:5.47,95%CI:2.57-11.65,p0.001);ornomethod(AOR:3.99,95%CI:2.06-7.75,
p0.001),comparedtocondomusers.
Conclusions:High-risksexualbehaviorsarecommonamongPLHIVnotaccessingtreatmentservices,raisingthe
riskofHIVtransmissiontodiscordantpartners.Thispopulationcanbeidentifiedandreachedinthecommunity.
Preventionprogramsneedtourgentlybringthispopulationintotheambitofpreventionandcareservices.
Moreover,beginning
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