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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
HIV-1 acquisition and disease progression are associated with decreased high-risk sexual behaviour among Kenyan female sex workers
AIDS, Volume 20, No. 15, Year 2006
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Description
BACKGROUND: Changes in sexual risk behaviour may occur following HIV-1 infection. OBJECTIVE: To test the hypothesis that HIV-1 seroconversion and disease progression are associated with changes in risk behaviours, using data from a cohort of Kenyan female sex workers (FSWs). METHODS: HIV-1-seronegative FSWs were enrolled in a prospective cohort study of risk factors for HIV-1 acquisition. At monthly visits, standardized interviews were conducted to assess sexual risk behaviour and HIV-1 serologic testing was performed. Seroconverters were invited to continue with follow-up. Between 1993 and 2004 (when antiretroviral therapy was introduced in the cohort), 265 women seroconverted for HIV-1 (incidence 7.7/100 person-years) and were included in this analysis. RESULTS: Unprotected intercourse was reported at 546/2037 (27%) pre-seroconversion visits versus 557/3732 (15%) post-seroconversion visits (P < 0.001). These findings remained significant after adjustment for potential confounding factors [adjusted odds ratio (AOR) 0.69; 95% confidence interval (CI), 0.55-0.86]. Compared with HIV-1-seronegative women, there was a progressive stepwise decrease in unprotected intercourse among HIV-1-seropositive women with CD4 cell counts ≥ 500 (AOR, 0.93; 95% CI, 0.62-1.39), 200-499 (AOR, 0.58; 95% CI, 0.41-0.82) and < 200 cells/μl (AOR, 0.45; 95% CI, 0.25-0.82). Decreases in unprotected intercourse reflected increases in both abstinence and 100% condom use. Women also reported fewer partners and fewer episodes of intercourse after HIV-1 seroconversion. CONCLUSIONS: HIV-1 seroconversion and disease progression were associated with decreases in sexual risk behaviour among Kenyan FSWs. © 2006 Lippincott Williams & Wilkins.
Authors & Co-Authors
McClelland, Raymond Scott
United States, Seattle
University of Washington
Kenya, Nairobi
University of Nairobi
Hassan, Wisal M.
Kenya, Nairobi
University of Nairobi
Lavreys, Ludo
United States, Seattle
University of Washington
Kenya, Nairobi
University of Nairobi
Richardson, Barbra Ann
United States, Seattle
University of Washington
United States, Seattle
Fred Hutchinson Cancer Research Center
Mandaliya, Kishor N.
Kenya, Mombasa
Coast Provincial General Hospital, Kenya
Ndinya-Achola, Jeckoniah O.
Kenya, Nairobi
University of Nairobi
Jaoko, Walter G.
Kenya, Nairobi
University of Nairobi
Kurth, Ann Elizabeth
United States, Seattle
University of Washington
United States, Seattle
School of Nursing
Baeten, Jared M.
United States, Seattle
University of Washington
Statistics
Citations: 33
Authors: 9
Affiliations: 5
Identifiers
Doi:
10.1097/01.aids.0000247119.12327.e6
Research Areas
Infectious Diseases
Sexual And Reproductive Health
Study Design
Cohort Study
Case-Control Study
Study Approach
Quantitative
Participants Gender
Female