Risk compensation: the Achilles' heel of innovations in HIV prevention?

Cassell, Michael M; Halperin, Daniel T.; Shelton, James D; Stanton, David

doi:10.1136/bmj.332.7541.605

Cited by 333 publications

(236 citation statements)

References 20 publications

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“…Furthermore, our study was not consistent with a review of studies conducted in Africa by Kennedy et al [30], where it was observed that a majority of HIV patients on ART abstained from sexual activity. This risky sexual behavioural tendency observed among our study participants may be due to the decreased perception of their risk of HIV infection as a result of their access to effective ART [31]; and this may also be contributing to the level of disclosure observed in this study.…”

Section: Discussionmentioning

confidence: 67%

Sexual Behaviour, Sero-Status Disclosure and Willingness to Disclose Status among HIV Positive Male Patients Receiving Care in Hospitals in Imo State, Nigeria

Iwu¹,

Duru²,

Diwe³

et al. 2017

J AIDS Clin Res

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Background: The non-disclosure of HIV positive status has most often been accompanied by risky sexual behaviours which is a complex relationship that facilitates the transmission of sexually transmitted diseases such as HIV.Objective: To determine sexual behaviour, levels of sero-status disclose and willingness to disclose; and the socio-demographic determinants of disclosure and willingness to disclose among HIV positive male patients receiving care in hospitals in Imo State, Nigeria. Methods:A cross sectional analytical design using a simple random sampling technique to select 422 HIV male patients attending the adult HIV clinics of two major hospitals. Data was collected using a pretested, semi structured questionnaire. Descriptive statistics were presented using frequencies and summary indices. Chi square statistics were computed to determine significant relationships and binary logistic regression was used to determine predictors of disclosure and willingness to disclose. A p-value of ≤ 0.05 was considered significant. Results:A majority of the respondents were either traders or artisans (54.6%) with a mean age of 32.0 ± 2.0 years. The results revealed that more than one third of the respondents had two or more sexual partners (35.5%), less than one quarter correctly and consistently use condoms (23.3%) and close to one third had not disclosed their HIV positive status (31.7%); of which, less than two fifths are now willing to disclose (37.8%). It was further revealed that married HIV positive male patients who are traders or artisans above the age of 30 years with monthly income levels less than N40,000 ($110) and living in an urban or semi urban area with family members or other people, were significantly more likely to have disclosed their HIV positive status. Similarly, HIV positive male patients who had not disclosed their status, but are artisans aged above 30 years, were significantly more likely to be willing now to disclose their HIV positive status.

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Section: Discussionmentioning

confidence: 67%

Sexual Behaviour, Sero-Status Disclosure and Willingness to Disclose Status among HIV Positive Male Patients Receiving Care in Hospitals in Imo State, Nigeria

Iwu¹,

Duru²,

Diwe³

et al. 2017

J AIDS Clin Res

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“…If risk compensation 44 occurs in the wake of the news that male circumcision is partially protective against HIV acquisition in men, women will not be protected, and the indirect benefits of male circumcision for women may not materialise. Already mathematical modelling suggests that in the medium term the proportion of people living with HIV in sub-Saharan Africa who are women may rise as male circumcision programmes are scaled up in high HIV prevalence settings, due to the lag time for indirect effects for women to be felt.…”

Section: Resultsmentioning

confidence: 99%

Male Circumcision: Implications for Women as Sexual Partners and Parents

Hankins¹

2007

Reproductive Health Matters

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“…Certainly, the potential for 'risk compensation,' or a potential increase in risky behavior subsequent to adopting a preventive measure such as MC (or a future vaccine), is an important concern to be closely monitored and addressed [23]. However, circumcision appears akin to a 'strong immunization', whose benefits would probably be extremely difficult to offset through such behavioral disinhibition (and a recent community-based study from rural Kenya suggests that within the context of adequate counseling, disinhibition from MC may be unlikely [24]).…”

mentioning

confidence: 99%

Is Male Circumcision as Good as the HIV Vaccine We‘Ve Been Waiting For?

Klausner¹,

Wamai

Bowa

et al. 2007

Future HIV Ther.

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What would the reaction of the international public health community have been if a year ago scientists had announced the discovery of a vaccine or chemical gel that, in three separate clinical trials, had reduced the risk of heterosexual HIV infection in men by at least 60%? Considering that even with increasing access to antiretroviral therapy AIDS continues to be a huge killer -every day over 2,000 men become infected with HIV in sub-Saharan Africa alone [1], which eventually also results in millions of new cases in their partners and children -would not such an announcement have surely sparked a massive surge of excitement and renewed investment in HIV prevention?In fact, in December 2006 officials from the US NIH did announce the discovery of an intervention at least as effective, for heterosexual transmission, as the long hoped for AIDS vaccine. However, unlike many previous breakthroughs in medicine, this time the intervention was not discovered by a team of scientists toiling in academic or government laboratories. Rather, some two decades ago anthropologists, demographers and epidemiologists initially

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Risk compensation: the Achilles' heel of innovations in HIV prevention?

Cited by 333 publications

References 20 publications

Sexual Behaviour, Sero-Status Disclosure and Willingness to Disclose Status among HIV Positive Male Patients Receiving Care in Hospitals in Imo State, Nigeria

Sexual Behaviour, Sero-Status Disclosure and Willingness to Disclose Status among HIV Positive Male Patients Receiving Care in Hospitals in Imo State, Nigeria

Male Circumcision: Implications for Women as Sexual Partners and Parents

Is Male Circumcision as Good as the HIV Vaccine We‘Ve Been Waiting For?

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