Sexual risk behavior among people living with HIV and AIDS on antiretroviral therapy at the regional hospital of Sokodé, Togo

BMC Public Health

Palokinam Pitche⁵  Bassan Lamboni⁷  Daoudou Idrissou²  Sékandé Senanou⁶  Makawa-Sy Makawa¹  P'Niwè Massoubayo Patchali⁶  Dadja Essoya Landoh³  Bayaki Saka⁴  Issifou Yaya⁸ 

[1] Ministère de la Santé, Direction Préfectorale de la Santé de Tône, Dapaong, Togo;Centre Hospitalier Régional (CHR) de Kara-Tomdè, Service de Médecine générale, Kara, Togo;Division de l’épidémiologie, Ministère de la santé, BP: 1396 Lomé, Togo;Service de dermatologie et IST, CHU Sylvanus Olympio, Université de Lomé, Lomé, Togo;Conseil National de Lutte contre les IST/VIH/Sida, Lomé, Togo;Centre Hospitalier Régional (CHR) de Sokodé, Service de dispensation d’antirétroviraux (ARV), Sokodé, Togo;Programme National de lutte contre les maladies non transmissibles, Ministère de la Santé, Lomé, Togo;Laboratoire de Santé Publique (EA 3279), Aix-Marseille Université, Marseille, France

关键词: Togo;    People living with HIV and AIDS;    Antiretroviral therapy;    Sexual risk behavior;   

Others  :  1129153
DOI  :  10.1186/1471-2458-14-636

 received in 2014-02-21, accepted in 2014-06-19,  发布年份 2014

【 摘 要 】

Background

Several studies on the sexual risk behaviors in sub-Saharan Africa have reported that the initiation of antiretroviral therapy leads to safer sexual behaviors. There is however a persistence of risky sexual behavior which is evidenced by a high prevalence of sexually transmitted infections among people living with HIV and AIDS (PLWHA). We sought to determine the factors associated with risky sex among PLWHA on antiretroviral therapy in Togo.

Methods

An analytical cross-sectional survey was conducted from May to July 2013 at regional hospital of Sokodé, Togo, and targeted 291 PLWHA on antiretroviral therapy for at least three months.

Results

From May to July 2013, 291 PLWHA on antiretroviral treatment were surveyed. The mean age of PLWHA was 37.3 years and the sex ratio (male/female) was 0.4. Overall, 217 (74.6%) PLWHA were sexually active since initiation of antiretroviral treatment, of which, 74 (34.6%) had risky sexual relations. In multivariate analysis, the factors associated with risky sex were: the duration of antiretroviral treatment (1 to 3 years: aOR = 27.08; p = 0.003; more than 3 years: aOR = 10.87; p = 0.028), adherence of antiretroviral therapy (aOR = 2.56; p = 0.014), alcohol consumption before sex (aOR = 3.59; p = 0.013) and level of education (primary school: aOR = 0.34 p = 0.011; secondary school: aOR = 0.23 p = 0.003; high school: aOR = 0.10; p = 0.006).

Conclusion

There was a high prevalence of unsafe sex among PLWHA receiving ART at the hospital of Sokodé. Factors associated with sexual risk behaviors were: low education level, non-adherence to ART, alcohol consumption before sex and the duration of ART. It is important to strengthen the implementation of secondary prevention strategies among this population group.

【 授权许可】

   
2014 Yaya et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]ONUSIDA: Rapport mondial: Rapport ONUSIDA sur l’épidémie mondiale de sida 2013. Genève: ONUSIDA; 2013.
• [2]Conseil National de Lutte contre le SIDA -Togo: Rapport de progrès sur la riposte au sida au Togo (GARP 2012); suivi de la déclaration de politique sur le VIH et le SIDA. Lomé: CNLS-Togo; 2012.
• [3]Pitche P, Gbetoglo K, Saka B, Akakpo S, Landoh DE, D'Almeida S, Banla AK, Sodji D, Deku K: HIV prevalence and behavioral studies in female sex workers in Togo: a decline in the prevalence between 2005 and 2011. Pan Afr Med J 2013, 15:62.
• [4]Peretti-Watel P, Spire B, Schiltz MA, Bouhnik AD, Heard I, Lert F, Obadia Y: Vulnerability, unsafe sex and non-adherence to HAART: evidence from a large sample of French HIV/AIDS outpatients. Soc Sci Med 2006, 62:2420-2433.
• [5]Eisele TP, Mathews C, Chopra M, Brown L, Silvestre E, Daries V, Kendall C: High levels of risk behavior among people living with HIV Initiating and waiting to start antiretroviral therapy in Cape Town South Africa. AIDS Behav 2008, 12:570-577.
• [6]Kiene SM, Christie S, Cornman DH, Fisher WA, Shuper PA, Pillay S, Friedland GH, Fisher JD: Sexual risk behaviour among HIV-positive individuals in clinical care in urban KwaZulu-Natal, South Africa. AIDS 2006, 20:1781-1784.
• [7]Luchters S, Sarna A, Geibel S, Chersich MF, Munyao P, Kaai S, Mandaliya KN, Shikely KS, Rutenberg N, Temmerman M: Safer sexual behaviors after 12 months of antiretroviral treatment in Mombasa, Kenya: a prospective cohort. AIDS Patient Care STDS 2008, 22:587-594.
• [8]Bajunirwe F, Bangsberg DR, Sethi AK: Alcohol use and HIV serostatus of partner predict high-risk sexual behavior among patients receiving antiretroviral therapy in South Western Uganda. BMC Public Health 2013, 13:430. BioMed Central Full Text
• [9]Diabate S, Alary M, Koffi CK: Short-term increase in unsafe sexual behaviour after initiation of HAART in Cote d'Ivoire. AIDS 2008, 22:154-156.
• [10]Ncube NM, Akunna J, Babatunde F, Nyarko A, Yatich NJ, Ellis W, Turpin A, Jolly PE: Sexual risk behaviour among HIV-positive persons in Kumasi, Ghana. Ghana Med J 2012, 46:27-33.
• [11]Berhan A, Berhan Y: Is the sexual behaviour of HIV patients on antiretroviral therapy safe or risky in sub-Saharan Africa? Meta-Analysis Meta-Regression AIDS Res Ther 2012, 9:14.
• [12]Osinde MO, Kakaire O, Kaye DK: Sexually transmitted infections in HIV-infected patients in Kabale Hospital, Uganda. J Infect Dev Ctries 2012, 6:276-282.
• [13]Ministère de la santé: Plan national de développement sanitaire 2012–2015. Lomé: Ministère de la Santé; 2012.
• [14]Programme National de Lutte contre le Sida et le IST au Togo: Rapport d'activité 2012. Lomé: PNLS - Togo; 2013.
• [15]Pearson CR, Cassels S, Kurth AE, Montoya P, Micek MA, Gloyd SS: Change in sexual activity 12 months after ART initiation among HIV-positive Mozambicans. AIDS Behav 2011, 15:778-787.
• [16]Ragnarsson A, Ekstrom AM, Carter J, Ilako F, Lukhwaro A, Marrone G, Thorson A: Sexual risk taking among patients on antiretroviral therapy in an urban informal settlement in Kenya: a cross-sectional survey. J Int AIDS Soc 2011, 14:20. BioMed Central Full Text
• [17]Olley B: Higher-risk sexual behavior among HIV patients receiving antiretroviral treatment in Ibadan. Nigeria Afr J AIDS Res 2008, 7:71-78.
• [18]Eisele TP, Mathews C, Chopra M, Lurie MN, Brown L, Dewing S, Kendall C: Changes in risk behavior among HIV-positive patients during their first year of antiretroviral therapy in Cape Town South Africa. AIDS Behav 2009, 13:1097-1105.
• [19]Moore AR, Oppong J: Sexual risk behavior among people living with HIV/AIDS in Togo. Soc Sci Med 2007, 64:1057-1066.
• [20]Wamoyi J, Mbonye M, Seeley J, Birungi J, Jaffar S: Changes in sexual desires and behaviours of people living with HIV after initiation of ART: implications for HIV prevention and health promotion. BMC Public Health 2011, 11:633. BioMed Central Full Text
• [21]Man WY, Kelly A, Worth H, Frankland A, Shih P, Kupul M, Lwin T, Mek A, Kepa B, Emori R, Akuani F, Cangah B, Walizopa L, Pirpir L, Nosi S, Siba PM: Sexual risk behaviour, marriage and ART: a study of HIV-positive people in Papua New Guinea. AIDS Res Ther 2013, 10:17. BioMed Central Full Text
• [22]Apondi R, Bunnell R, Ekwaru JP, Moore D, Bechange S, Khana K, King R, Campbell J, Tappero J, Mermin J: Sexual behavior and HIV transmission risk of Ugandan adults taking antiretroviral therapy: 3 year follow-up. AIDS 2011, 25:1317-1327.
• [23]Tumwesigye NM, Atuyambe L, Wanyenze RK, Kibira SP, Li Q, Wabwire-Mangen F, Wagner G: Alcohol consumption and risky sexual behaviour in the fishing communities: evidence from two fish landing sites on Lake Victoria in Uganda. BMC Public Health 2012, 12:1069. BioMed Central Full Text