Predictors of unsafe sexual behavior among people living with human immunodeficiency virus/AIDS attending antiretroviral therapy center in Western India

Abstract

Background:As more and more people with human immunodeficiency virus (HIV) live longer and healthier lives because of antiretroviral therapy (ART), an increasing number of sexual transmissions of HIV may arise from these people living with HIV/AIDS (PLWHA). Hence, this study is conducted to assess the predictors of unsafe sexual behavior among PLWHA on ART in Western India.Materials and Methods:The current cross-sectional study was carried out among 175 PLWHAs attending ART center of a Tertiary Care Hospital in Western India. Unsafe sex was defined as inconsistent and/or incorrect condom use. A total of 39 variables from four domains viz., sociodemographic, relationship-related, medical and psycho-social factors were studied for their relationship to unsafe sexual behavior. The variables found to be significantly associated with unsafe sex practices in bivariate analysis were explored by multivariate analysis using multiple logistic regression in SPSS 17.0 version.Results:Fifty-eight percentage of PLWHAs were practicing unsafe sex. 15 out of total 39 variables showed significant association in bivariate analysis. Finally, 11 of them showed significant association in multivariate analysis. Young age group, illiteracy, lack of counseling, misbeliefs about condom use, nondisclosure to spouse and lack of partner communication were the major factors found to be independently associated with unsafe sex in multivariate analysis.Conclusion:Appropriate interventions like need-based counseling are required to address risk factors associated with unsafe sex.

Risky sexual practice and associated factors among people living with HIV/AIDS receiving antiretroviral therapy in Ethiopia: Systematic review and meta-analysis

“…This finding was lower than a study conducted in the USA which reported 49.4% of PLWHA had unsafe sexual behavior, mainly inconsistent condom [ 38 ], in an India study in which Fifty-eight percentage of PLWHAs were practicing unsafe sex [ 11 ], a study conducted in Wakiso health center IV, Uganda (60.9%) [ 39 ] and a Nigerian study (56%) [ 40 ]. However, higher than study conducted in Jamaica, Brazil and Argentina, reported the prevalence of risky sexual practice or irregular condom use were 25%, 29% and 20%, respectively [ 41 – 43 ], and a study conducted in the United kingdom (UK) found that 12.8% of participants admitted to engaging in sexually risky behavior (unprotected sex in the previous 3 months with someone who was HIV-negative or of unknown HIV status) [ 44 ], and study in Togo (34.6%) [ 45 ], Nigeria (25.2%) [ 46 ], Uganda (25.9%) [ 47 ], and another a meta-analytic review conducted on Highly Active Antiretroviral Therapy and sexual risk behavior reported the median risky sexual practice among HAART attendees were 33% [ 48 ].…”

“…The prevalence of risky sexual practices varies by country, ranging from 23% to 58% [ 8 , 11 , 13 ]. In Ethiopia, the risky sexual practices among PLWHA receiving ART ranged from 22% to 79.8% [ 7 , 14 – 24 ], with the most prevalent factors associated with risk sexual practice being a lack of discussion about safe sex with their partner/s, an unknown partner’s serostatus, and having multiple sexual partners [ 16 – 18 , 22 , 24 , 25 ].…”

Risky sexual behavior and associated factors among antiretroviral therapy attendees in Nekemte Referral Hospital, Western Ethiopia: a cross-sectional study

“…Consistent with the current study, a similar study conducted in western India showed that those with sero-positive partners were 3 times more likely to engage in unsafe sex. 15 The possible explanation might be due to false belief that condom is not important if both of them are sero-positive. This might hasten HIV reinfection with different strains and may lead to drug resistance.…”

“…This is in line with studies from Addis Ababa and western India. 11 , 15 This might indicate that individuals who felt stigmatized were afraid to disclose their status to their partner.…”

“…This finding is consistent with studies from Uganda and Western India. 8 , 15 The reason might be due to the fact that progressive education and or counseling given on the importance of protecting oneself from strain could change their behavior to one of practicing safe sex.…”