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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Association of attitudes and beliefs towards antiretroviral therapy with HIV-seroprevalence in the general population of Kisumu, Kenya
PLoS ONE, Volume 4, No. 3, Article e4573, Year 2009
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Description
Background: Since antiretroviral therapy (ART) became available in the developed world, the prevalence of unprotected sex and the incidence of sexually transmitted infections (STIs) and HIV have increased. We hypothesized that a similar phenomenon may be occurring in sub-Saharan Africa concomitant with the scale-up of HIV treatment. Methods: We conducted a general population-based survey in Kisumu, Kenya. Participants completed an interview that included demographics as well as ART-related attitudes and beliefs (AB) and then underwent HIV serological testing. Exploratory and confirmatory factor analyses of AB about ART indicated two factors: 1) ART-related risk compensation (increased sexual risk taking now that ART is available); and 2) a perception that HIV is more controllable now that ART is available. Logistic regression was used to determine associations of these factors with HIV-seroprevalence after controlling for age. Findings: 1,655 (90%) of 1,844 people aged 15-49 contacted, including 749 men and 906 women, consented to participate in the study. Most participants (n = 1164; 71%) had heard of ART. Of those who had heard of ART, 23% believed ART was a cure for HIV. ART-related risk compensation (Adjusted (A)OR = 1.45, 95% CI 1.16-1.81), and a belief that ART cures HIV (AOR = 2.14, 95% CI 1.22-3.76) were associated with an increased HIV seroprevalence in men but not women after controlling for age. In particular, ART-related risk compensation was associated with an increased HIV-seroprevalence in young (aged 15-24 years) men (OR = 1.56; 95% CI 1.12-2.19). Conclusions: ART-related risk compensation and a belief that ART cures HIV were associated with an increased HIV seroprevalence among men but not women. HIV prevention programs in sub-Saharan Africa that target the general population should include educational messages about ART and address the changing beliefs about HIV in the era of greater ART availability. © 2009 Cohen et al.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC2649531/bin/pone.0004573.s001.doc
https://efashare.b-cdn.net/share/pmc/articles/PMC2649531/bin/pone.0004573.s002.doc
Authors & Co-Authors
Cohen, Craig R.
United States, San Francisco
University of California, San Francisco
Montandon, Michele
United States, San Francisco
University of California, San Francisco
Carrico, Adam W.
United States, San Francisco
Ucsf Center for Aids Prevention Studies
Shiboski, Stephen C.
United States, San Francisco
University of California, San Francisco
Bostrom, Alan G.
United States, San Francisco
University of California, San Francisco
Obure, Alfredo
Kenya, Nairobi
Kenya Medical Research Institute
Kwena, Zachary Arochi
Kenya, Nairobi
Kenya Medical Research Institute
Bailey, Robert C.
United States, Chicago
University of Illinois at Chicago
Nguti, Rosemary
Kenya, Nairobi
University of Nairobi
Bukusi, Elizabeth Anne
United States, San Francisco
University of California, San Francisco
Kenya, Nairobi
Kenya Medical Research Institute
Statistics
Citations: 54
Authors: 10
Affiliations: 5
Identifiers
Doi:
10.1371/journal.pone.0004573
e-ISSN:
19326203
Research Areas
Infectious Diseases
Sexual And Reproductive Health
Study Design
Cross Sectional Study
Cohort Study
Exploratory Study
Study Approach
Quantitative
Study Locations
Kenya
Participants Gender
Male
Female