Risky sexual practice and associated factors among HIV positive adults attending anti-retroviral treatment clinic at Gondar University Referral Hospital, Northwest Ethiopia

Abstract

IntroductionRisky sexual practice among people living with HIV/AIDS is a public health concern because of the risk of transmission of the virus to sero-discordant partner/s. There is also the risk of re-infection with new, drug resistant viral strains between sero-concordant partners. However, there is lack of information on risky sexual practices among HIV positive adults. Therefore, this study aimed to assess risky sexual practice and associated factors among adult HIV positive clients at Gondar University Referral Hospital, Northwest Ethiopia, 2015.MethodsAn institution based cross sectional study was conducted at Gondar University Referral Hospital from May to June 2015. A pretested structured questionnaire was used to collect the data. Using systematic random sampling technique, a total of 513 respondents were participated in this study. The data were entered into EPI info version 3.5.3 and transferred to SPSS version 20 for analysis. Descriptive, bivariate and multivariate analyses were done. A P-value <0.05 was considered to determine the statistical significance of the association between factors (independent variables) and risky sexual practice. The Odds ratio was also used to determine the presence and the degree of association between the dependent and independent variables.ResultsA total of 513 respondents were participated in this study. The prevalence of risky sexual practices in the past three months was 38% (95% CI: 33.3%, 42.3%). Being in the age range of 18–29 years (AOR = 2.63, 95% CI: 1.55, 4.47) and 30–39 years (AOR = 2.29, 95% CI: 1.48, 3.53), being single (AOR = 6.32, 95%CI: 2.43, 16.44),being married (AOR = 6.06, 95% CI: 2.81, 13.07), having no child (AOR = 2.58, 95% CI: 1.17, 5.72), and a CD4 count of greater than 500/mm3 were factors significantly associated with risky sexual practices.ConclusionsA considerable number of HIV positive clients had risky sexual practices. It is strongly recommended that the Regional Health Bureau and health service providers working at Gondar University Hospital especially in the ART Clinic need to work hard on behavioral change communication.

<p>Risky Sexual Practice and Associated Factors Among Women Living with HIV/AIDS Receiving Antiretroviral Therapy at a PMTCT Clinic in Western Oromia, Ethiopia</p>

“…5,12,13 Sexual behavior of HIV positive individuals visiting ART and PMTCT clinics is a neglected issue. [14][15][16] Evidence show 20-80% of people living with HIV/AIDS continue to engage in risky sexual behaviors in sub-Saharan countries. [16][17][18][19] However, there are controverting ideas on the risk of sexual practices of HIV positive individuals who are on ART.…”

“…[14][15][16] Evidence show 20-80% of people living with HIV/AIDS continue to engage in risky sexual behaviors in sub-Saharan countries. [16][17][18][19] However, there are controverting ideas on the risk of sexual practices of HIV positive individuals who are on ART. Some studies suggest risky sexual practices declined among individuals on HIV treatment because of the detailed counseling they were getting during their ART follow-ups; others claimed that it revealed increases after the initiation of ART because of the physical well-being that followed ART initiation; still, others concluded ART has no effect on it.…”

<p>Risky Sexual Practice, Sexually Transmitted Infection and Associated Factors Among Newly Diagnosed HIV-positive People in Northwest Ethiopia</p>

“…37 – 39 Similarly, risky sexual practices among HIV-positive people who are on ART were documented to be high in Ethiopia and elsewhere in Africa. 10 , 19 Such cases include study reports from Nekemte Referral Hospital in western Ethiopia 32.9%, 31 Gondar University Referral Hospital in northwest Ethiopia 38%, 19 Nairobi in Kenya 44.4%, 10 Dar Es Salaam, in Tanzania 40%, 8 Cape Town in South Africa 44–46% 25 , 32 and the Regional Hospital of Sokodé, in Togo 34.6%. 7 The discrepancies between the current findings and the previous studies could be different definitions of risky sexual practices which ranges from having a large number of sexual partners, having unprotected sex, starting sex in earlier age, to sexual intercourse under the influence of substances such as alcohol or cocaine.…”

“…13 – 16 Many previous studies defined risky sexual practice when one or more of the following happen: having multiple sexual partners (more than one sexual partner), early initiation of sex (sexual debut at the age <18 years old), inconsistent use of condoms (inconsistent/failure to use condoms at least once during sexual intercourse) and sex with commercial sex workers. 7 , 14 , 17 – 19 In this study, we adopted the definitions of risky sexual practice as having unprotected sexual intercourse as the most recent sexual activity among those who had sex with a nonregular sexual partner. 20 This would avoid overestimation of risky sexual practice in line with the study population.…”

“…Factors associated with risky sexual practice in various studies include being educated, being wealthy and young, 27 substance abuse, peer pressure, and watching pornography. 16 , 17 , 28 – 30 Other factors are living in urban areas, 27 being single and married compared to widowed, 19 having HIV-positive sexual partner, nondisclosure of HIV-positive status, having experienced HIV-related stigma, 31 history of suicide attempt and sexual assault. 29…”