Open AccessAdherence as a Predictor of Sexual Behaviors in People Living with HIV/AIDS during the First Year of Antiretroviral Therapy in Rural Cameroon: Data from Stratall ANRS 12110/ESTHER Trial
Author(s) -
Gilbert Ndziessi,
Sylvie Boyer,
Charles Kouanfack,
Julien Cohen,
Fabienne Marcellin,
JeanPaul Moatti,
Eric Delaporte,
Bruno Spire,
Christian Laurent,
Patrizia Carrieri
Publication year - 2012
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0036118
Subject(s) - medicine , logistic regression , condom , antiretroviral therapy , casual , demography , human immunodeficiency virus (hiv) , sexual intercourse , longitudinal study , viral load , antiretroviral treatment , pediatrics , population , family medicine , environmental health , materials science , syphilis , pathology , sociology , composite material
Objective This study aims to investigate the time pattern of inconsistence condom use (ICU) during the first year of antiretroviral therapy (ART) and its relationship with treatment adherence in naïve HIV-infected adult patients. Methods Data collection was nested within a longitudinal trial on HIV treatment. ICU was defined as reporting to have “never”, “sometimes” or “nearly always” used condoms with one’s main or casual partner(s) - either HIV-negative or of unknown HIV status in the three previous months. Adherence was defined as taking 100% of their ART prescribed doses in the 4 days before the visit and “not having interrupted treatment”, even once, for more than two consecutive days during the 4 previous weeks. Mixed logistic regression was used to study the relationship between adherence and ICU. Results Among the 459 patients enrolled, 212 (46%) during 334 visits reported to have had sexual intercourse at least once with their partner(s) – either HIV-negative or of unknown HIV status- during the first 12 months of ART. The proportion of ICU was 76%, 50% and 59% at month 0 (M0), month 6 (M6) and month 12 (M12), while 60% and 66% of patients were ART-adherent at M6 and M12, respectively. After adjustment for the frequency of sexual activity, type of sexual partner(s), perceived social class and desire for a child, patients adherent to ART were less likely to report ICU when compared with baseline (AOR [95% CI]: 0.38 [0.19–0.76]; P = 0.006). Conclusions Adherence to ART is associated with a lower risk of ICU but this result needs to be interpreted carefully. As adherence behaviors are not only determined by problems with the healthcare systems but also by social barriers encountered by patients in their daily life, counseling should not only be ART adherence-centered but also patient-centered, including sexual risk minimization and psychosocial support.