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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Unprotected sex following HIV testing among women in Uganda and Zimbabwe: Short- and long-term comparisons with pre-test behaviour
International Journal of Epidemiology, Volume 38, No. 4, Year 2009
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Description
Background: Despite widespread condom promotion for HIV prevention, prospective measurement of condom use before and after HIV testing is infrequent. Methods: We analysed data from a prospective study of hormonal contraception and HIV acquisition among Zimbabwean and Ugandan women (1999-2004), in which HIV testing and counselling were performed approximately every 3 months. We used zero-inflated negative binomial (ZINB) models to examine the number and proportion of unprotected sex acts, comparing behaviour reported 2-6 months before HIV testing with behaviour reported both 2-6 months (short-term analysis) and 12-16 months (long-term analysis) after HIV testing. Results: Short- and long-term analyses were similar, so we present only long-term findings from 151 HIV-infected and 650 uninfected participants. The proportion of HIV-infected women reporting any unprotected acts in a typical month declined from 74% (pre-infection behaviour) to 56% (12-16 months after HIV diagnosis). In multivariable models, HIV-infected women were twice as likely to report that all sex acts were protected by condoms after diagnosis compared with beforehand [adjusted odds ratio (aOR): 1.99, 95% confidence interval (CI): 1.12-3.53]; uninfected women were somewhat less likely to report that all acts were protected (aOR: 0.82, 95% CI: 0.64-1.04). HIV-infected women also reduced their number of unprotected acts by 38% (95% CI: -16 to -55%). However, their proportion of unprotected acts changed little (7% reduction, 95% CI: -18 to +6%). Uninfected women reported little change in number or proportion of unprotected acts over the same time period. Conclusions: HIV-infected women reduced the number, but not theproportion, of unprotected acts. HIV-negative women did not increase condom use after testing and counselling, but neither did they decrease condom use, suggesting that testing negative was not interpreted as endorsement of risky behaviour. Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2009; all rights reserved.
Authors & Co-Authors
Turner, Abigail Norris
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Miller, William C.
United States, Chapel Hill
The University of North Carolina at Chapel Hill
United States, Chapel Hill
University of California
Padian, Nancy S.
United States, San Francisco
University of California, San Francisco
United States, Research Triangle Park
Rti International
Kaufman, Jay Scott
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Canada, Montreal
Université Mcgill
Behets, Frieda M.T.F.
United States, Chapel Hill
The University of North Carolina at Chapel Hill
United States, Chapel Hill
University of California
Chipato, Tsungai
Zimbabwe, Harare
University of Zimbabwe
Mmiro, Francis A.
Uganda, Kampala
Makerere University
Salata, Robert A.
United States, Cleveland
Case Western Reserve University
Morrison, Charles S.
United States, Durham
Fhi 360
Statistics
Citations: 9
Authors: 9
Affiliations: 9
Identifiers
Doi:
10.1093/ije/dyp171
ISSN:
03005771
e-ISSN:
14643685
Research Areas
Infectious Diseases
Sexual And Reproductive Health
Study Design
Cohort Study
Case-Control Study
Study Locations
Uganda
Zimbabwe
Participants Gender
Female