Diclemente R, Funkhouser E, Wingood GM, Fawal H, Vermund S; International Conference on AIDS.

Int Conf AIDS. 1998; 12: 211 (abstract no. 14143).

UAB School of Public Health, Birmingham AL, USA.

OBJECTIVES: To determine whether treatment with protease inhibitors is associated with an increase in unprotected sexual behavior among persons living with HIV. DESIGN: A cross-sectional study. METHODS: Persons living with HIV, 13 years of age and older, attending one of six public clinics that treat persons with HIV and reside in non-urban communities were recruited during routine clinic visits. Interviews were sought from all persons attending the clinics. Interviews were conducted in a private area and took approximately one hour. Information was elicited on demographics, opinions concerning acquisition of HIV, effect of HIV infection on life style, current treatment, and current and past sexual practices. RESULTS: Of the 190 sexually active persons completing interviews, 15.8% were currently being treated with protease inhibitors. Patients treated with protease inhibitors were 2.6 times more likely to report infrequent condom use in the 30 days prior to the interview (condoms used < 50% of sexual episodes), relative to persons not being treated with protease inhibitors (p = 0.018; 90% CI 1.3-5.1). Even after adjusting for observed and hypothesized correlates of high-risk sexual behavior (i.e., education, past history of condom use, number of sex partners), patients treated with protease inhibitors were still 2.5 times more likely to report infrequent condom use in past 30 days (p = .026; 90% CI 1.3-5.5). Analyses, stratified by patient's sexual orientation, indicates that men-have-sex-with-men (MSM) are disproportionately more likely to report high-risk sexual behavior relative to men-have-sex-with-women or women. Among MSM (n = 89), those undergoing treatment with protease inhibitors were 4.1 times more likely to report infrequent condom use in the 30 days prior to the interview, relative to persons not being treated with protease inhibitors (p = 0.024; 90% CI 1.5-11.4). CONCLUSIONS: For many people living with HIV, protease inhibitors have resulted in enhanced quality of life. However, an unanticipated consequence of treatment efficacy may be that individuals are less concerned about safer sex practices and, thus, less likely to use condoms. This risk behavior increases the potential for HIV transmission to uninfected sex partners as well as persons living with HIV themselves being exposed to STDs and more virulent HIV strains. Risk-reduction counseling is urgently needed for persons living with HIV.

Publication Types:

• Meeting Abstracts

Keywords:

• Acquired Immunodeficiency Syndrome
• Condoms
• Counseling
• Cross-Sectional Studies
• Female
• Gambling
• HIV Infections
• HIV Seropositivity
• Humans
• Interviews as Topic
• Male
• Protease Inhibitors
• Risk-Taking
• Safe Sex
• Sexual Behavior
• Sexual Partners
• Sexually Transmitted Diseases
• Unsafe Sex

Other ID:

• 98391886

UI: 102228013

From Meeting Abstracts