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HIV Transmission Risk Behavior Among HIV-Positive Patients Receiving Antiretroviral Therapy in KwaZulu-Natal, South Africa

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Abstract

The aim of this investigation was to identify factors associated with HIV transmission risk behavior among HIV-positive women and men receiving antiretroviral therapy (ART) in KwaZulu-Natal, South Africa. Across 16 clinics, 1,890 HIV+ patients on ART completed a risk-focused audio computer-assisted self-interview upon enrolling in a prevention-with-positives intervention trial. Results demonstrated that 62 % of HIV-positive patients’ recent unprotected sexual acts involved HIV-negative or HIV status unknown partners. For HIV-positive women, multivariable correlates of unprotected sex with HIV-negative or HIV status unknown partners were indicative of poor HIV prevention-related information and of sexual partnership-associated behavioral skills barriers. For HIV-positive men, multivariable correlates represented motivational barriers, characterized by negative condom attitudes and the experience of depressive symptomatology, as well as possible underlying information deficits. Findings suggest that interventions addressing gender-specific and culturally-relevant information, motivation, and behavioral skills barriers could help reduce HIV transmission risk behavior among HIV-positive South Africans.

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Acknowledgements:

Funding for this work was provided by the National Institutes of Mental Health (NIMH) (5R01 MH077524 05). We would like to thank the KwaZulu-Natal (KZN) Department of Health (DOH) and uMgungundlovu (DC 22) and uMkhanyakude (DC 27) Districts for their collaboration and support. We would also like to thank Izindlela Zokuphila/Options for Health research team members, clinic staff at participating research sites, and most importantly, all patients who took part in this research.

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Authors and Affiliations

  1. Social and Epidemiological Research Department, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, M5S 2S1, Canada

    Paul A. Shuper

  2. Department of Psychology, University of Toronto, Toronto, Canada

    Paul A. Shuper

  3. Center for Health, Intervention, and Prevention, University of Connecticut, Storrs, USA

    Paul A. Shuper, Sarah Christie, Deborah H. Cornman & Jeffrey D. Fisher

  4. School of Medicine, University of Connecticut Health Center, Farmington, USA

    Susan M. Kiene

  5. Zimnandi Zonke, Pietermaritzburg, South Africa

    Gethwana Mahlase

  6. Enhancing Care Initiative (ECI), Nelson Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa

    Susan MacDonald, Umesh G. Lalloo & Sandy Pillay

  7. Departments of Psychology and Obstetrics and Gynaecology, University of Western Ontario, London, Canada

    William A. Fisher

  8. Maternal, Adolescent and Child Health (MatCH), Department of Obstetrics and Gynaecology, University of Witwatersrand, Johannesburg, South Africa

    Ross Greener

  9. Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa

    Francois van Loggerenberg

  10. The Global Health Network, Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK

    Francois van Loggerenberg

  11. Department of Psychology, University of Connecticut, Storrs, USA

    Jeffrey D. Fisher

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  1. Paul A. Shuper
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  2. Susan M. Kiene
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  9. Umesh G. Lalloo
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Correspondence to Paul A. Shuper.

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Shuper, P.A., Kiene, S.M., Mahlase, G. et al. HIV Transmission Risk Behavior Among HIV-Positive Patients Receiving Antiretroviral Therapy in KwaZulu-Natal, South Africa. AIDS Behav 18, 1532–1540 (2014). https://doi.org/10.1007/s10461-013-0647-1

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