Open AccessPsychosocial Factors, Condomless Sex, and Detectable Viral Load in HIV-Positive Women in Serodiscordant Couples in Nairobi, Kenya
Author(s) -
Michela Blain,
Barbra A. Richardson,
John Kinuthia,
Danielle Poole,
Walter Jaoko,
Kate Wilson,
Anne Kaggiah,
Jane M. Simoni,
Carey Farquhar,
R. Scott McClelland
Publication year - 2020
Publication title -
aids and behavior
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.994
H-Index - 106
eISSN - 1573-3254
pISSN - 1090-7165
DOI - 10.1007/s10461-020-02907-0
Subject(s) - serodiscordant , medicine , health psychology , psychosocial , viral load , domestic violence , men who have sex with men , public health , demography , human immunodeficiency virus (hiv) , psychiatry , poison control , suicide prevention , immunology , environmental health , syphilis , nursing , sociology , antiretroviral therapy
This prospective study of HIV-positive Kenyan women in serodiscordant couples examined relationships between psychosocial factors, viral suppression, and condomless sex. Participants were screened for alcohol use disorders and intimate partner violence (IPV) annually and depressive symptoms every 6 months. Prostate specific antigen (PSA) detection was used as a marker for condomless sex. A total of 151 participants contributed 349 person-years of follow-up. Hazardous/harmful alcohol use was associated with increased risk of detecting PSA in vaginal secretions (aRR 1.99, 95%CI 1.08-3.66, χ 2 = 4.85 (1)), while IPV and depression were not. Events representing HIV transmission potential, where there was biological evidence of condomless sex at a visit with a detectable plasma viral load, were observed at 2% of visits. The high prevalence of IPV and association between alcohol use and sexual risk suggest the need for monitoring and support for these conditions as part of comprehensive HIV care for women.