scholarly journals A strategy for selecting sexual partners believed to pose little/no risks for HIV: serosorting and its implications for HIV transmission

AIDS Care ◽  
2009 ◽  
Vol 21 (10) ◽  
pp. 1279-1288 ◽  
Author(s):  
Lisa A. Eaton ◽  
Seth C. Kalichman ◽  
Daniel A. O'Connell ◽  
William D. Karchner
2010 ◽  
Vol 2 (2) ◽  
pp. 13 ◽  
Author(s):  
John Rubaihayo ◽  
Akib Surat ◽  
Mughusu Ezekiel ◽  
Abaasa Andrew

In Uganda, previous studies have shown a tremendous decline in HIV prevalence over the past two decades due to changes in sexual behavior with a greater awareness of the risks involved. However, studies in Fort-Portal municipality, a rural town in Western Uganda, continued to show a persistent high HIV prevalence despite the various interventions in place. We conducted a study to establish the current magnitude of HIV prevalence and the factors associated with HIV prevalence in this community. This cross-sectional study was conducted between July and November 2008. Participants were residents of Fort-Portal municipality aged 15-49 years. A population-based HIV sero-survey and a clinical review of prevention of mother to child HIV transmission (PMTCT) and voluntary counseling and HIV Testing (VCT) records were used to collect quantitative data. An inteviewer administered structured questionnaire was used to collect qualitative data on social deographics, risk behaviour and community perceptions. Focus group discussions (FGDs) and in-depth interviews provided supplementary data on community perceptions. Logistic regression was used in the analysis. The overall HIV prevalence in the general population was 16.1% [95% CI; 12.5-20.6]. Prevalence was lower among women (14.5%; 95% CI; 10.0-19.7) but not significantly different from that among men (18.7%; 95% CI; 12.5-26.3) (c2=0.76, P=0.38). Having more than 2 sexual partners increased the odds of HIV by almost 2.5 times. None or low education and age over 35 years were independently associated with HIV prevalence (P<0.05). Most participants attributed the high HIV prevalence to promiscuity/multiple sexual partners (32.5%), followed by prostitution (13.6%), alcoholism (10.1%), carelessness (10.1%), poverty (9.7%), ignorance (9.5%)), rape (4.7%), drug abuse (3.6%) and others (malice/malevolence, laziness, etc.) (6.2%). Although there was a slight decline compared to previous reports, the results from this study confirm that HIV prevalence is still high in this community. In order to prevent new infections, the factors mentioned above need to be addressed, and we recommend that education aimed at changing individual behavior should be intensified in this community.


Healthcare ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 253 ◽  
Author(s):  
Khensane Mengwai ◽  
Sphiwe Madiba ◽  
Perpetua Modjadji

The study investigated the motivation to disclose or the decision to withhold one’s HIV serostatus to one’s partners and assessed the implications of non-disclosure on young peoples’ sexual behaviour and access to treatment. This was a cross-sectional survey conducted with 253 youth aged 18–25 years receiving antiretroviral therapy in a health district in North West Province, South Africa. The majority were female (75%), the mean time since the HIV diagnosis was 22 months, 40% did not know their partner’s HIV status, 32% had more than two sexual partners, and 63% had not used a condom during the last sexual act. The prevalence of disclosure was 40%, 36% delayed disclosure for over a year, and most disclosed to protect the partner from HIV transmission, to receive support, and to be honest and truthful. The prevalence of non-disclosure was high, as 60% withheld disclosure due to fear of abandonment, stigma and discrimination, accusations of unfaithfulness, and partner violence. Over half (55%) had no intentions to disclose at all. The lower disclosure rates imply that HIV transmission continues to persist among sexual partners in these settings. The findings suggest that high levels of perceived stigma impact on disclosure and HIV treatment, which increases the risk of on-going HIV transmission among youth receiving long-term antiretroviral therapy (ART) in South Africa.


2016 ◽  
Vol 2 (1) ◽  
pp. 18-24
Author(s):  
Gampo Dorji ◽  
Chukwuemeka Umeh ◽  
B.M. Ramesh ◽  
Shajy Isac ◽  
Robert Lorway ◽  
...  

Introduction: Multiple sexual partnering is a known predictor for risk of STI and HIV transmission. This study explored the multiple sexual partnering and its predictors among people who visited public social venues (bars, restaurants, hotels, lodges, cafes, karaokes and discos) in Bhutan’s two largest townships of Thimphu and Phuntsholing. Methods: We interviewed 755 sexually active venue patrons from 102 randomly selected venues (56 in Thimphu, 46 in Phuntsholing) from a list of all venues identified as having sex workers or patrons seeking sexual partners. Both bivariate and multivariate analyses were carried out to characterize the predictors of multiple sexual partnering among 755 respondents who had previously had sex. Results: Of the 755 patrons, 46.09% had one sexual partner while the remaining 54.91% had multiple sex partners (greater than or equal to 2 sexual partners) in the 12 months preceding the study. Overall, 6.23% of respondents had received payment from someone at least once for sex; 34.61% of male respondents had paid someone at least once for sex. Nearly all patrons (97.72%) had heard about HIV/ AIDS. About one quarter (24.20%) felt that they were at risk of being infected with HIV, while 37.28% had taken an HIV test in the 12 months preceding the study. In multivariate analysis, males had higher odds of multiple sexual partners compared to females (OR =3.19, 95% CI 1.90-5.20). The odds of having multiple sexual partners was 2.24 (95% CI 1.30-3.90) times higher in those never married compared to those who were married/divorced or separated; multiple partnering increased with increasing age (OR = 1.07 per year, 95% CI 1.02-1.13). Between the townships of Phuentsholing and Thimphu, the odds of multiple sexual partnering did not vary. Conclusions: Venue patrons had a high prevalence of multiple sexual partnering and have the potential for creating sexual networks that could propagate wider transmission of infection, including to their monogamous partner. Targeting HIV prevention program to these groups of people in urban locations presents an opportunity to make a great impact in maintaining Bhutan’s current low HIV epidemic level.


2017 ◽  
Vol 29 (2) ◽  
pp. 164-171 ◽  
Author(s):  
Maureen Chisembele ◽  
Violeta J Rodriguez ◽  
Megan R Brown ◽  
Deborah L Jones ◽  
Maria L Alcaide

Intravaginal practices (IVP) are linked to bacterial vaginosis (BV), obstetric/gynecological complications, and HIV. Late adolescent and young adult (LAYA) women in Zambia have high rates of HIV. Adult and mature (AM) HIV-infected women in Zambia engage in IVP for hygiene, health, and sexuality reasons; however, to our knowledge, IVP use among LAYA women has not been examined. This study compares IVP use between LAYA and AM women to identify age-specific factors to target when developing IVP reduction interventions for LAYA women. LAYA (≤25 years; n = 24) and AM (>25 years; n=124) HIV-infected women completed self-administered demographic, HIV history, sexual risk factor, and IVP measures. LAYA and AM women were then compared. Number of sexual partners, sexual activity, or condom use did not differ between groups. Rates of IVP in the prior month with different products were similar, though LAYA women used soap more frequently (96% versus 74.2%, p = 0.034). LAYA women were more likely to use products for hygiene reasons (soap 83% versus 43%; cloth, paper, or wipes 50% versus 17%, p < 0.05); and AM women to use products to please sexual partners (cloth 20% versus 56%, p = 0.074). Interventions tailored to LAYA women may be needed to reduce IVP and subsequent BV as LAYA women may have different reasons for engaging in IVP, in comparison with AM women. Reduced IVP among LAYA women may decrease the risk for HIV transmission to sexual partners and newborns and is urgently needed in settings with high prevalence of IVP, BV, and HIV infections, such as Zambia.


2016 ◽  
Vol 18 (1) ◽  
pp. 10-16 ◽  
Author(s):  
Bronwen Lichtenstein ◽  
Cynthia Rodgers ◽  
Lauren EB Marefka ◽  
Marla D Hinson ◽  
Dayna Cook-Heard ◽  
...  

HIV-positive adolescents are required by law to notify sexual partners, but can find it difficult to achieve this goal. This article offers practice guidance for counselling HIV-positive adolescents about sexual disclosure in clinical settings and for building confidence in managing sexual lives with HIV. We use two vignettes to illustrate key differences between perinatally and sexually infected adolescents in terms of readiness to disclose, and include a set of strategies for both groups that can be tailored to individual circumstances and contexts. The toolbox of strategies we describe include pre-counselling, focused counselling, social support groups and technical support. Pre-counselling helps to identify barriers and motivations to sexual disclosure and is followed by counselling sessions in which the focus is on role playing and sexual scripts for disclosure. Peer-led support groups are designed to boost adolescent confidence, and pre-paid cell phones, text messaging, ready-dial phone numbers and a private Facebook page provide back-up support and out-of-hours contact. Since sexual disclosure can be a risky proposition, safety plans, such as having an emergency contact person, should always be in place. These strategies are designed to empower vulnerable adolescents, foster trust between patient and provider, and reduce HIV transmission to sexual partners.


Author(s):  
Eric P. F. Chow ◽  
Jason J. Ong ◽  
Basil Donovan ◽  
Rosalind Foster ◽  
Tiffany R. Phillips ◽  
...  

Australia introduced a national lockdown on 22 March 2020 in response to the COVID-19 pandemic. Melbourne, but not Sydney, had a second COVID-19 lockdown between July and October 2020. We compared the number of HIV post-exposure prophylaxis (PEP) prescriptions, HIV tests, and new HIV diagnoses during these lockdown periods. The three outcomes in 2020 were compared to 2019 using incidence rate ratio. There was a 37% and 46% reduction in PEP prescriptions in Melbourne and Sydney, respectively, with a larger reduction during lockdown (68% and 57% reductions in Melbourne’s first and second lockdown, 60% reduction in Sydney’s lockdown). There was a 41% and 32% reduction in HIV tests in Melbourne and Sydney, respectively, with a larger reduction during lockdown (57% and 61% reductions in Melbourne’s first and second lockdowns, 58% reduction in Sydney’s lockdown). There was a 44% and 47% reduction in new HIV diagnoses in Melbourne and Sydney, respectively, but no significant reductions during lockdown. The reduction in PEP prescriptions, HIV tests, and new HIV diagnoses during the lockdown periods could be due to the reduction in the number of sexual partners during that period. It could also result in more HIV transmission due to substantial reductions in HIV prevention measures during COVID-19 lockdowns.


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