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首页> 外文期刊>AIDS care. >Changes in sexual activity and risk behaviors among PLWHA initiating ART in rural district hospitals in Cameroon - Data from the STRATALL ANRS 12110/ESTHER trial
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Changes in sexual activity and risk behaviors among PLWHA initiating ART in rural district hospitals in Cameroon - Data from the STRATALL ANRS 12110/ESTHER trial

机译：喀麦隆农村地区医院中感染艾滋病病毒的艾滋病毒/艾滋病患者中性行为和危险行为的变化-来自STRATALL ANRS 12110 / ESTHER试验的数据

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The continued scaling-up of antiretroviral therapy (ART) in Sub-Saharan Africa provides an opportunity to further study its impact on sexual behaviors among people living with HIV/AIDS (PLWHA). We explored time trend and correlates of sexual activity among PLWHA initiating ART in Cameroon and compared sexual risk behaviors between patients sexually active before and after initiating ART and those resuming sexual activity after ART initiation. Analyses were based on longitudinal data collected within the randomized trial (n = 459) conducted in nine rural district hospitals in Cameroon. Sexual activity was defined as reporting at least one sexual partner during the previous 3 months. Inconsistent condom use (ICU) was defined as reporting to have "never," "sometimes," or "nearly always" used condoms at least once with a partner(s) either HIV-negative or of unknown HIV status during the same period. Mc Nemar tests were used to assess time trend, while mixed-effect logistic regressions were conducted to analyze the effect of time since ART initiation on sexual activity. The proportion of sexually active patients significantly increased over time: from 31.8% at baseline to 40.2 and 47.1% after 6 and 12 months of ART, respectively (p=0.001), to 55.9% after 24 months (p=0.02). After adjustment for behavioral and psychosocial factors, time since ART initiation was independently associated with reporting sexual activity (AOR [95% CI] = 1.30 [1.17-1.46] per 6-month increase, p=0.001). ICU was more frequent among patients sexually active both before and after ART initiation than among those who resumed sexual activity after ART initiation (82 vs. 59%, p<0.001). To conclude, while ART initiation fosters resumption of sexual activity in patients who are inactive before starting treatment; unsafe sexual behaviors remain less frequent in this population than in patients who are already sexually active before starting ART. Risk reduction programs should be reinforced among PLWHA in the context of ART scaling-up. ? 2013
机译：撒哈拉以南非洲地区继续扩大抗逆转录病毒疗法（ART），这为进一步研究其对艾滋病毒/艾滋病患者（PLWHA）性行为的影响提供了机会。我们探讨了在喀麦隆发起PLWHA的ART患者中性活动的时间趋势和相关性，并比较了在开展ART之前和之后进行性活动的患者与在ART发起后恢复性活动的患者之间的性风险行为。分析是基于在喀麦隆的9个农村地区医院进行的随机试验（n = 459）中收集的纵向数据。性活动定义为在过去3个月内报告至少一个性伴侣。不一致的避孕套使用（ICU）的定义是报告在同一时期内，与一个或多个HIV阴性或艾滋病毒状况未知的伴侣​​“从未”，“有时”或“几乎总是”使用过避孕套。 Mc Nemar检验用于评估时间趋势，而混合效应Logistic回归分析自ART开始以来的时间对性活动的影响。随着时间的流逝，性活跃患者的比例显着增加：从基线时的31.8％分别增加到ART的6和12个月后的40.2和47.1％（p = 0.001），再到24个月后的55.9％（p = 0.02）。在对行为和社会心理因素进行调整后，自开始抗逆转录病毒治疗以来的时间与报告的性活动独立相关（每6个月增加AOR [95％CI] = 1.30 [1.17-1.46]，p = 0.001）。与开始ART后恢复性活动的患者相比，在ART开始前后有性活动的患者中ICU的发生率更高（82比59％，p <0.001）。总而言之，尽管抗病毒治疗可以促进在开始治疗前处于非活动状态的患者恢复性活动。与开始接受抗逆转录病毒治疗前已经发生性行为的患者相比，该人群中不安全的性行为仍然较少发生。在扩大抗逆转录病毒治疗的范围内，应当加强艾滋病毒/艾滋病感染者的降低风险计划。 ？ 2013年

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