Sexual Risk Behavior in HIV-Uninfected Pregnant Women in Western Uganda

Abstract

Our aim was to identify sexual risk behavior among HIV-negative pregnant women in Kabarole District, Uganda, by conducting a cross-sectional study among 1610 women within three healthcare settings. One in six women engaged in HIV-specific risk behaviors including multiple sexual partners or alcohol abuse; 80% of the pregnant women reported to generally abstain from using condoms. In multivariate analysis, predictors of sexual risk behavior included being a client of the public health facilities as compared to the private facility (AOR 3.6 and 4.8, p < 0.001), being single, widowed or divorced or not cohabiting with the partner (AOR 4.7 and 2.3, p < 0.001), as well as higher household wealth (AOR 1.8, p < 0.001) and lack of partner status knowledge (AOR 1.6, p = 0.008). Self-estimated risk perception was linked with engagement in HIV-related risk behaviors except for alcohol abuse. Our findings indicate that reducing risky behaviors in pregnancy in order to prevent HIV should be a high-priority public health concern.

Preventing HIV Infection in Pregnant Women in Western Uganda Through a Comprehensive Antenatal Care-Based Intervention: An Implementation Study

“…The self-assessed individual risk of pregnant women largely matched the HIV risk determined by our tool, showing that women had a realistic perception of their behavior. This confirmed previous studies from Uganda, where women were aware of the risks their behavior evoked (González et al, 2019 ; Theuring et al, 2021 ). Practicing risky behaviors despite being fully aware of it may indicate a general lack of knowledge regarding the consequences of maternal HIV infection for the unborn child, pointing to a need for specific education in this context (Homsy et al, 2019 ; Schumann et al, 2020 ; UNAIDS, 2021 ; WHO, 2017 ).…”

“…The socioeconomic status (SES) was measured by a score from zero to nine as used in other thematically related publications (Schnack et al, 2016 ; Schumann et al, 2020 ; Theuring et al, 2021 ) depending on nine common potential properties, uniformly dichotomized and categorized in “lower” scoring zero to four, or “higher” scoring five to nine.…”

Recent Alcohol Use Is Associated With Increased Pre-exposure Prophylaxis (PrEP) Continuation and Adherence Among Pregnant and Postpartum Women in South Africa

“…In this study, sexual risk behaviors were prevalent among pregnant women, which is consistent with our previous work in South Africa 44 and the larger evidence base examining sexual risk behaviors among pregnant and postpartum women in sub-Saharan Africa. [45][46][47][48][49] Of note, the relationship between alcohol use and knowledge of partner HIV serostatus was not explored here, and it is unclear how this factor may influence the relationship between alcohol use and PrEP use. However, our recently published study using baseline data from the same study found that pregnant women reporting any alcohol use in the year before pregnancy had greater odds of being at high risk of HIV (aOR 1.33, 95% CI: 1.05-1.68), using a proxy measure that consisted of several sexual HIV risk factors, which included awareness of partner HIV status (as well as presence of an STI, multiple sexual partners, and condom use).…”

High incidence of asymptomatic genital tract infections in pregnancy in adolescent girls and young women: need for repeat aetiological screening

“…[5][6][7][8][9][10][11][12] While a high prevalence of asymptomatic STIs and bacterial vaginosis (BV) in adult pregnancies (>19 years of age) is well documented, [13][14][15] the prevalence and clinical presentation of STIs in adolescent pregnancies are understudied. [16][17][18] Frequent condomless sex during pregnancy has been reported since 2013 in several studies in South Africa and other sub-Saharan countries [19][20][21] and reasons for limited condom use during pregnancy include low perception of risk, cultural myths and gender-power imbalance in relationships. 22 Given the above evidence of continued risk during pregnancy, studies reporting HIV incidence in pregnancy have provided the basis for the need for repeat testing in pregnancy with an intention to initiate antiretroviral treatment and prevent mother-to-child transmission and adverse pregnancy outcomes.…”

“…Frequent condomless sex during pregnancy has been reported since 2013 in several studies in South Africa and other sub-Saharan countries 19–21 and reasons for limited condom use during pregnancy include low perception of risk, cultural myths and gender–power imbalance in relationships. 22 Given the above evidence of continued risk during pregnancy, studies reporting HIV incidence in pregnancy have provided the basis for the need for repeat testing in pregnancy with an intention to initiate antiretroviral treatment and prevent mother-to-child transmission and adverse pregnancy outcomes.…”