Syphilis seroprevalence and seroconversion among people newly diagnosed with HIV during the pre-antiretroviral therapy period in rural China

2020 ◽  
Vol 31 (9) ◽  
pp. 876-885
Author(s):  
Shifu Li ◽  
Wenbing Dong ◽  
Liang Chen ◽  
Shunxiang Li ◽  
Shu Su
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Condom Use ◽  
Consistent Condom ◽  
People Living With Hiv ◽  
Newly Diagnosed ◽  
Inconsistent Condom ◽  
Recent Hiv Infection ◽  
Inconsistent Condom Use

Syphilis has a high incidence among people living with HIV (PLHIV), which may be attributable to their similar sexual transmission route. A retrospective cohort study was conducted during the period 2009–2015 to investigate the syphilis seroprevalence and incidence of syphilis seroconversion among newly-diagnosed PLHIV in rural Yunnan, China. Recent HIV infection among PLHIV was identified by BED capture enzyme immunoassay. PLHIV were followed until they initiated antiretroviral therapy. Syphilis serology was conducted at baseline and each follow-up over the study period. Among 2162 participants, the syphilis seroprevalence at baseline was 2.7%, 95% confidence interval (CI) (2.4–3.1). Single and divorced (versus married) (aOR = 2.9, [1.1–7.4]; 5.9, [2.4–14.7], respectively), employed in the service industry (versus unemployed) (2.8, [1.4–5.6]), being diagnosed with HIV in hospitals (versus voluntary counselling and testing) (5.1, [2.0–12.9]), recent HIV infection (17.9, [8.5–37.9]) and inconsistent condom use in the previous three months (versus consistent condom use) (6.2, [2.8–13.4]) were associated with higher risk of syphilis infection at baseline. Participants contributed 1955.4 person-years (PYs) of follow-up, with a median follow-up period of 0.9 years (IQR: 0.5–1.9) and the incidence of syphilis seroconversion was 2.2 (95% CI 1.5–2.9) per 100 PYs. The syphilis seroprevalence at baseline (aHR 3.7, [1.8–7.9]), had a HIV-negative partner at baseline (3.9, [1.5–9.8]) and inconsistent condom use in the last three months at baseline (6.0, [1.4–25.4]) were associated with higher risk of syphilis seroconversion. Our findings indicate that the public health response should be escalated to minimise the spread of syphilis co-infection among PLHIV and reducing condomless sexual behaviours after HIV diagnosis.

scholarly journals Inconsistent Condom Use among Public Primary Care Patients with Tuberculosis in South Africa

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Gladys Matseke ◽  
Karl Peltzer ◽  
Julia Louw ◽  
Pamela Naidoo ◽  
Gugu Mchunu ◽  
...  
Keyword(s):  
South Africa ◽  
Primary Care ◽  
Condom Use ◽  
Multivariable Analysis ◽  
High Rate ◽  
Consistent Condom ◽  
Consistent Condom Use ◽  
Inconsistent Condom ◽  
The Past ◽  
Inconsistent Condom Use

The high rate of HIV infections among tuberculosis (TB) patients in South Africa calls for urgent HIV reduction interventions in this subpopulation. While correct and consistent condom use is one of the effective means of HIV prevention among sexually active people, there is insufficient research on condom use among TB patients in South Africa. The aim of this paper was to determine the prevalence of inconsistent condom use among public primary care TB patients and its associated factors using a sample of 4900 TB patients from a cross-sectional survey in three health districts in South Africa. Results indicated that when asked about their consistency of condom use in the past 3 months, 63.5% of the participants reported that they did not always use condoms. In the multivariable analysis, being married (OR=1.66; 95% CI 1.25–2.20) or cohabitating or separated, divorced, or widowed (OR=3.67; 1.85–7.29), lower educational level (OR=0.66; 0.46–0.94), greater poverty (OR=1.60; 1.25–2.20), not having HIV status disclosed (OR=0.34; 0.25–0.48), sexual partner on antiretroviral treatment (OR=0.38; 0.23–0.60), and partner alcohol use before sex (OR=1.56; 1.30–1.90) were significantly associated with inconsistent condom use in the past 3 months. The low proportion of consistent condom use among TB patients needs to be improved.

scholarly journals “I enjoy sex more without condoms": revisiting barriers and facilitators of consistent condom use among adolescents and young adults in South Africa

2021 ◽  
Author(s):  
Anthony Ajayi ◽  
Olumuyiwa Omonaiye ◽  
Charlotte Nwogwugwu
Keyword(s):  
South Africa ◽  
Young People ◽  
Condom Use ◽  
Financial Support ◽  
Consistent Condom ◽  
Sexually Active ◽  
Partner Communication ◽  
Consistent Condom Use ◽  
Inconsistent Condom ◽  
Inconsistent Condom Use

Abstract Background Previous studies have examined consistent condom use correlates in South Africa, focusing on sociodemographic factors, HIV risk perceptions, relationship conflict, multiple sexual partners, and masculinity. However, the effect of family financial support, HIV testing, partner communication and self-efficacy for HIV prevention is less studied. We drew from a cross-sectional survey to address this gap and highlight the key barriers and facilitators of consistent condom use among young people. Methods We analysed data obtained from 631 unmarried sexually active male and females students selected using stratified sampling from a university in Eastern Cape Province of South Africa. Consistent condom use was defined as regular use of condoms in all sexual encounters in the past year. We used an open-ended question to probe the reasons for inconsistent condom use. Adjusted and unadjusted regression analysis were fitted to examine factors associated with consistent condom use. Results The prevalence of consistent condom use was 39.3% (CI: 35.5%-43.2%), with no significant gender and age differences. After adjusting for relevant covariates, living with foster parents (AOR; 1.80 95% CI; 1.09-2.97), adequate family financial support (AOR; 2.49 95% CI; 1.71-3.62), partner knew status (AOR; 1.91 95% CI; 1.09-3.37) and feeling confident in one's ability to prevent HIV (AOR; 1.77 95% CI; 1.09-2.86) were associated with increased odds of consistent condom use. However, self-report of low condom self-efficacy (AOR; 0.58 95% CI; 0.40-0.85) and alcohol use (AOR; 0.83 95% CI; 0.58-1.19) were associated with lower odds of consistent condom use. Young people who inconsistently used condoms reiterated that sex is often unplanned and condoms are not always available. The desire for maximum pleasure, partner's objection, trust, and use of hormonal contraceptives were further reasons others inconsistently use condoms. Conclusions Inconsistent condom use remains a challenge among unmarried sexually active young people in South Africa. Education of young people on the need for partner communication about HIV, HIV testing uptake, and condom use should happen more rigorously in school and through the media to improve their consistent use of condoms.

scholarly journals Effects of HIV-Related Discrimination on Psychosocial Syndemics and Sexual Risk Behavior among People Living with HIV

2020 ◽  
Vol 17 (6) ◽  
pp. 1924
Author(s):  
Randolph C. H. Chan ◽  
Don Operario ◽  
Winnie W. S. Mak
Keyword(s):  
Hong Kong ◽  
Condom Use ◽  
Structural Equation ◽  
Poor Mental Health ◽  
Self Report ◽  
Equation Modeling ◽  
People Living With Hiv ◽  
Inconsistent Condom ◽  
Living With Hiv ◽  
Inconsistent Condom Use

In the context of HIV-related stigma and discrimination, people living with HIV (PLHIV) might be vulnerable to a ‘syndemic’ of co-occurring psychosocial challenges that can affect sexual behavior. The present study examined how HIV-related discrimination contributes to co-occurring psychosocial syndemic problems and results in inconsistent condom use among PLHIV in Hong Kong. Two-hundred and ninety-one PLHIV were recruited to complete a self-report questionnaire. More than one-quarter of the sample experienced two or more psychosocial syndemic problems, and 74.1% of the participants who had sex with steady partners reported inconsistent condom use over the past three months. The results indicated that HIV-related discrimination was positively predictive of the number of psychosocial syndemic problems. HIV-related discrimination and psychosocial syndemics were associated with increased odds of inconsistent condom use with steady partners (AOR = 5.40 and AOR = 3.09 respectively). Findings from structural equation modeling showed that psychosocial syndemics mediated the effect of HIV-related discrimination on condom use consistency with steady partners. PLHIV in Hong Kong suffered from the syndemic effects of stigma, social isolation, and poor mental health, which rendered them vulnerable to condomless sex. In order to curb the rapidly increasing incidence of HIV, multi-level strategies should be adopted to concurrently address the structural inequities and psychosocial syndemics faced by PLHIV.

scholarly journals Inconsistent condom use between serodifferent sexual partnerships to the human immunodeficiency virus

2019 ◽  
Vol 27 ◽  
Author(s):  
Renata Karina Reis ◽  
Elizabete Santos Melo ◽  
Nilo Martinez Fernandes ◽  
Marcela Antonini ◽  
Lis Aparecida de Souza Neves ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Condom Use ◽  
Consistent Condom ◽  
Bivariate Analysis ◽  
Treatment As Prevention ◽  
Sexual Partnership ◽  
Inconsistent Condom ◽  
Cross Sectional ◽  
Immunodeficiency Virus ◽  
Inconsistent Condom Use

Objective: to analyze predictors of inconsistent condom use among HIV-positive people with sexual immunodeficiency virus serodifferent sexual partnership. Method: cross-sectional, analytical study with a consecutive non-probabilistic sample consisting of people living with the human immunodeficiency virus with serodifferent sexual partnership and who were in outpatient clinical follow-up. Data were collected through individual interviews guided by a semi-structured questionnaire and subsequently analyzed with bivariate analysis and logistic regression. Results: Seven variables were independently associated with inconsistent condom use. Schooling less than 11 years of schooling (4.9 [2.4-10.1]), having multiple partnerships (5.0 [1.3-19.6]), using alcohol (2.1 [1.1 -4.4]) or other drugs (2.8 [1.2-6.3]), do not receive advice from a healthcare professional (2.0 [1.1-3.9]), have no knowledge of treatment as prevention (3.0 [1,2-6,9]) and not knowing that undetectable viral load reduces the risk of human immunodeficiency virus transmission (3.8 [1,1-13,7]) were predictors for inconsistent condom use. Conclusion: The study showed that psychosocial factors interfere with consistent condom use between serodifferent partnerships. Thus, it is highlighted that there is a need for comprehensive interventions that include the integration of clinical and psychosocial care.

scholarly journals 1282. A Major Hurdle for HIV Elimination: How Do We Promote Pre-Exposure Prophylaxis Persistence among Men Who Have Sex with Men in the Deep South?

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S461-S462
Author(s):  
Ronnie M Gravett ◽  
Andrew O Westfall ◽  
Kachina Kudroff ◽  
Edgar T Overton ◽  
Jeanne Marrazzo
Keyword(s):  
Condom Use ◽  
Deep South ◽  
Initial Visit ◽  
Inconsistent Condom ◽  
Patient Reported ◽  
Sex With Men ◽  
Hiv Acquisition ◽  
Exposure Prophylaxis ◽  
Inconsistent Condom Use

Abstract Background Pre-Exposure Prophylaxis (PrEP) effectively prevents HIV acquisition in men who have sex with men (MSM), if taken appropriately. Effective PrEP requires persistence in PrEP care. We defined the PrEP care continuum in a Deep South PrEP clinic and examined factors related to persistence in care among MSM. Methods We reviewed data for MSM at a university-affiliated PrEP clinic in Birmingham, AL from 2014–2018 to define the PrEP continuum at five major steps: screening, initial visit, follow-up visit, current persistence, and self-reported adherence. We defined persistence as attending a PrEP clinic visit in the last 6 months and nonpersistence as prior attendance without a visit in the last 6 months. We compared demographics, insurance status, and patient-reported behaviors from initial and most recent visits between those who persisted (“persisters”) and did not (“non-persisters”) using Wilcoxon rank sum, chi-square, or Fisher’s exact test. Results 226 (100%) MSM were screened, 141 (62%) MSM attended an initial visit, 116 (51%) MSM attended follow-up, 43 (19.0%) persisted in PrEP care, and 29 (13%) MSM self-reported good adherence (figure). Among 139 MSM (46 persisters, 93 nonpersisters), persisters were older than nonpersisters (33 vs. 32 yr, P = 0.03), and were less likely to report inconsistent condom use at their initial visit (48% vs. 73%; P = 0.01) as compared with their last visit (69% vs. 63%, P = 0.13). 23% of persisters and 29% of nonpersisters were black (P = 0.39), and 98% of persisters and 90% of nonpersisters were insured (P = 0.50). 60% of persisters and 74% of nonpersisters had multiple sex partners at initial visit (P = 0.19) as compared with 56% and 60% at their last visit, respectively (P = 0.83). Conclusion At a Deep South PrEP clinic, persistence overall was poor for MSM. More nonpersisters had inconsistent condom use, indicating higher risk despite nonpersistence. Although not statistically significant, nonpersisters were more likely to be black, uninsured, and have multiple sexual partners when compared with persisters. Disparities seen nationally in new HIV diagnoses are reflected in nonpersisters. Nonpersisters may not realize the extent of their risk of HIV acquisition and warrant intensive engagement interventions. Disclosures All authors: No reported disclosures.

scholarly journals Cross-sectional comparative study of risky sexual behaviours among HIV-infected persons initiated and waiting to start antiretroviral therapy in rural Rakai, Uganda

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e016954 ◽  
Author(s):  
Lydia Jacenta Nakiganda ◽  
Gertrude Nakigozi ◽  
Joseph Kagaayi ◽  
Fred Nalugoda ◽  
David Serwadda ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Condom Use ◽  
Hiv Positive ◽  
Sexual Encounter ◽  
Inconsistent Condom ◽  
Cross Sectional ◽  
Sexual Behaviours ◽  
Rakai District ◽  
Risky Sexual Behaviours ◽  
Inconsistent Condom Use

ObjectivesTo compare risky sexual behaviours between HIV-positive persons initiated on antiretroviral therapy (ART) (ART-experienced) and persons waiting to start on ART (ART-naive) and assess predictors of risky sexual behaviours among HIV-infected patients in rural Rakai district, Uganda.Study designThis is a cross-sectional study that used data from the Rakai Community Cohort Study (RCCS) database between 2013 and 2014. A structured questionnaire was used for data collection. We used stepwise logistic regression as an index to estimate the adjusted ORs for the association between risky sexual behaviours and ART treatment status.Study settingThis study was conducted in Rakai district, located in south-western Uganda. The data for this study were extracted from the RCCS. RCCS is an open prospective cohort of approximately 15 000 consenting participants aged 15–49 years.ParticipantsHIV-positive participants aged 18–49 years who had sex at least once a month with any partner prior to the start of the study.Main outcome measuresInconsistent/no condom use in the last 12 months, alcohol use at last sexual encounter, and two or more sexual partners.ResultsART-naive participants were more likely to report inconsistent condom use (OR=1.74, 95% CI 1.11 to 2.73) and more likely to drink alcohol at last sexual encounter (OR=1.65, 95% CI 1.11 to 2.46), compared with ART-experienced patients. ART treatment status (p<0.001) was a significant predictor of risky sexual behaviours. Both marital status (p=0.016) and occupation level (p=0.009) were positively associated with inconsistent condom use, while sex (p<0.001) correlated with alcohol use at last sexual encounter.ConclusionART-naive participants were more likely to exhibit risky sexual behaviours than the ART-experienced participants. The intensity of risk reduction counselling should be increased for HIV-positive persons waiting to start ART but already in HIV care.

Psychosocial pathways to inconsistent condom use among male sex workers: personality, drug misuse and criminality

Sexual Health ◽  
2011 ◽  
Vol 8 (3) ◽  
pp. 390 ◽  
Author(s):  
Fernanda C. Prado Cortez ◽  
Douglas P. Boer ◽  
Danilo A. Baltieri
Keyword(s):  
Condom Use ◽  
Sex Workers ◽  
Self Report ◽  
Drug Misuse ◽  
Consistent Condom ◽  
Male Sex Workers ◽  
Related Factors ◽  
Inconsistent Condom ◽  
Male Sex ◽  
Inconsistent Condom Use

Background This research compared street male sex workers in Santo André, Brazil, that reported consistent condom use with those that revealed inconsistent condom use with their clients, concerning personality aspects, impulsiveness, alcohol and drug consumption, depressive symptoms, sociodemographic data and criminal involvement. Methods: Eighty-six male sex workers were evaluated in face-to-face interviews at their place of work. A ‘snowball’ sampling procedure was used to access this hard-to-reach population. Findings: Male sex workers with inconsistent condom use showed greater involvement with criminal activities, higher reward dependence level and more frequent self-report of being HIV-positive. Conclusions: Conceptualisation of male sex workers’ psychological characteristics may be required where HIV risk is not only attributed to sex work per se, but to other aspects such as personality-related factors and negative identity.

Gender-related correlates and predictors of consistent condom use among young adult African-American women: a prospective analysis

1998 ◽  
Vol 9 (3) ◽  
pp. 139-145 ◽  
Author(s):  
G M Wingood ◽  
R J Diclemente
Keyword(s):  
African American ◽  
Condom Use ◽  
African American Women ◽  
Consistent Condom ◽  
Consistent Condom Use ◽  
Inconsistent Condom ◽  
American Women ◽  
Prevention Programmes ◽  
The Stability

The present study examined the correlates of consistent condom use among African-American women and prospectively evaluated the stability of these significant variables to predict consistent condom use at 3-month follow-up. A sample of 128 African-American women, 18-29 years of age completed a baseline interview and 3 months later completed a similar follow-up interview ( n =100). Compared to women who were inconsistent condom users, women who were consistent condom users were more likely to: have high assertive communication skills (OR=13), desire not becoming pregnant (OR=8.6), have high sexual selfcontrol over condom use (OR=7.6), perceive having control over their partners' use of condoms (OR=6.6), be younger (OR=5.8), and report having a partner that was not committed to the relationship (OR=3.3). Prospective analyses identified baseline level of condom use as the best predictor of condom use at 3-month follow-up. Women who were consistent condom users at baseline were 6.3 times as likely to be consistent condom users at 3-month follow-up. In conclusion, HIV prevention programmes for women need to be gender specific and need to be implemented before high-risk behaviours are established and may be more difficult to modify.

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