Risky sexual practice and associated factors among HIV positive adults attending anti-retroviral treatment clinic at Gondar University Referral Hospital, Northwest Ethiopia

Risky sexual practice and associated factors among antiretroviral therapy attendees in public health facilities, Wolaita Zone, South Ethiopia: a multi-center cross-sectional study

Background

The majority of people living with Human Immunodeficiency Virus (HIV) are in low- and middle-income countries, particularly in sub-Saharan Africa. Increased risky sexual practice puts people living with the human immune virus at higher risk of acquiring sexually transmitted infections other than the human immune virus and unplanned pregnancies. Sexually transmitted infections, particularly viral hepatitis (B and C), significantly impair antiretroviral therapy and the clinical outcome of the co-infected individual, leading to increased morbidity and mortality. The purpose of this study was to investigate the prevalence of risky sexual practices among antiretroviral therapy (ART) attendees in public health facilities within the Wolaita Zone of South Ethiopia.

Methods

From September to October 2023, a facility-based cross-sectional study was conducted among adult people living with HIV on ART in the Wolaita zone. Data was collected through a pretested and structured questionnaire. Six diploma nurses were trained to collect data. Systematic sampling techniques were used to select a total of 398 ART patients. Data were collected by Open Data Kit (ODK) and analyzed with SPSS Version 25. Binary and multiple logistic regression analyses were used. All the variables with a P-value of 0.25 associated with risky sexual practices are considered candidate variables. Multicollinearity was checked. The fitness of the model was tested by the Hosmer-Lemshow goodness of fit test. Finally, statistical significance was declared at a p-value of 0.05.

Result

A total of 398 respondents took part in this study. The prevalence of risky sexual practices in the past six months was 174 (43.7%) at 95% of the CI (38.9-48.7). The result of multiple logistic regression analysis showed that not disclosing HIV status (AOR = 1.8, 95% CI: 1.1-3.31), alcohol drinking (AOR = 3.1, 95% CI: 1.66-0.023), and poor social support (AOR = 1.9, 95% CI: 1.75-3.9) were statistically significantly associated with risky sexual practices.

Conclusion

This study revealed that the risky sexual practice among ART clients was high and disclosure status, social support, and alcohol use were factors associated with risky sexual practice. The governmental and non-governmental bodies have to strengthen social support for ART clients, disclosure status for ART clients, and counseling to avoid alcohol.

Risky sexual behaviors and associated factors among adult patients on antiretroviral treatment at Mankweng Hospital in Limpopo Province, South Africa

Background

Worldwide, it is estimated that 38 million people are HIV-positive and that over 36 million people have died from the virus. In South Africa, the prevalence of HIV was reported to be 20.6% with Limpopo Province having 17% HIV. Given the high rate of new HIV infection in Limpopo, there is therefore a need to assess factors promoting risky sexual behavior among people living with HIV in order to help design and develop behavioral interventions aimed at reducing risky behaviors among people living with HIV.

Methods

This was a quantitative cross-sectional prospective study, conducted in Mankweng Hospital. The study consisted of 116 participants of which 40 were males and 76 were females aged 18 years and above. The participants were selected using purposive sampling. The data was analyzed using Statistical Package for Social Sciences version 27. A comparison of proportions was performed using Chi-Square. The association between risky sexual practice and sociodemographic factors was analyzed using multivariate logistic regression.

Results

The proportion of risky sexual practices in the total population was 48.3%. Participants who were married, those aged 35-44, and those with tertiary qualifications were more likely to engage in risky sexual practices. Multivariate logistic regression showed widowed participants were less likely to practice risky sexual practices.

Conclusion

The present study reported a high prevalence of risky sexual practices of 48.3%. Risky sexual behavior was determined by age, marital status, and level of education. The proportion of married participants was higher in risky sexual behavior. Based on the findings of the present study, it is recommended that targeted interventions and educational programs should be implemented to reduce risky sexual behavior among married individuals, individuals aged 35-44, and individuals with tertiary qualifications.

Mental health, substance use, and risky sexual behaviors among women living with HIV

INTRODUCTION

Risky sexual behavior has been explored in women living with HIV (WLHIV) internationally but is not well studied in WLHIV in the United States (U.S.). This merits further investigation due to the negative reproductive and HIV health outcomes associated with risky sexual behavior, such as the increased risk for HIV transmission and infertility from sexually transmitted infections (STIs). The aims of this study are to (1) describe sexual behaviors in a cohort of WLHIV in Florida, (2) determine whether demographic characteristics, substance use, and mental health symptoms are associated with risky sexual behavior in a cohort of WLHIV in Florida, and (3) explore whether the relationship between substance use and mental health symptoms and risky sexual behavior differs in reproductive-age (age 18-49), compared to non-reproductive-age WLHIV (age 50+).

DESIGN

This was a cross-sectional analysis of data from a multisite cohort study done in Florida.

METHODS

Data were collected from a sample of 304 participants who were recruited into the Florida Cohort Study from 9 clinical and community sites in Florida between 2014 to 2017. The predictor variables of interest were mental health symptoms, substance use, and demographic variables. The outcome variable of interest was risky sexual behavior which was defined as reporting ≥1 of the following: (1) at least one STI diagnosis in the past 12 months, (2) two or more sexual partners in the past 12 months, or (3) any inconsistent condom use in the past 12 months. Descriptive statistics, bivariate analysis, and logistic regression (p < 0.1) were conducted on the variables of interest.

RESULTS

The mean age of the sample was 47.8 years, and approximately half (51.6%) of the sample was of reproductive-age. Reporting ≥1 risky sexual behavior was reported in over half (51.6%) of the reproductive-age WLHIV in the sample and 32% of the non-reproductive-age WLHIV in the sample. Binge drinking, alcohol-related problems, marijuana use, and age were all significantly associated with self-reporting ≥1 risky sexual behaviors in all WLHIV. Self-reporting binge drinking, marijuana use, and a high alcohol-related problems score respectively were associated with increased odds of self-reporting ≥1 risky sexual behavior in all WLHIV. Neither mental health symptoms nor race/ethnicity or education were significantly associated with self-reporting ≥1 risky sexual behavior in all WLHIV. Self-reporting severe anxiety symptoms and high alcohol-related problems scores respectively were associated with increased odds of self-reporting ≥1 risky sexual behavior only in reproductive-age WLHIV from the sample.

CONCLUSION

Marijuana use, binge drinking, and alcohol-related problems appear to have a relationship with risky sexual behavior in WLHIV regardless of age. Reproductive-age also appears to influence risky sexual behavior in WLHIV, and specific reporting severe anxiety symptoms and high alcohol-related problems in reproductive-age WLHIV increases the odds of engaging in risky sexual behavior.

CLINICAL SIGNIFICANCE

This study holds clinical significance for nurses and other clinicians working in reproductive health settings and clinics with WLHIV. Results indicate that it could be beneficial to do more screening for mental health symptoms (particularly anxiety) and alcohol use in younger reproductive-age WLHIV.

Risky Sexual Behaviour among HIV-Infected Adults in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

Background

Risky sexual behaviour raises serious public health concerns. The pooled prevalence of risky sexual behaviours among adults living with HIV/AIDS in sub-Saharan Africa was unknown. This systematic review determined the pooled prevalence of risky sexual behaviours and associated factors among HIV-infected adults in sub-Saharan Africa.

Methods

International databases such as PubMed, CINAHL, Google Scholar, and African Journals OnLine were systematically searched to identify articles. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline was used to conduct the review. All necessary data were extracted independently. Heterogeneity and publication bias were assessed by I-squared statistics and Egger's test, respectively. The random-effects meta-analysis model was used to estimate the pooled prevalence. The association between predictors and dependent variable was determined by a pooled odds ratio (OR) with a 95% confidence interval (CI).

Result

In this study, 3713 articles were retrieved from various databases, and 22 of them were included. The pooled prevalence of risky sexual behaviour in sub-Saharan Africa was 36.16% (95% CI: 28.36-44.34) with significant heterogeneity among studies (I2 = 98.86%, p < 0.001). Risky sexual behaviour was significantly associated with the nondisclosure of HIV status (AOR = 1.97, 95% CI: 1.18, 2.76) and alcohol consumption (AOR = 2.29, 95% CI: 1.21, 3.36).

Conclusion

A significant percentage of participants engaged in risky sexual behaviour. Risky sexual behaviour was associated with failure to disclose HIV status and alcohol consumption. Healthcare professionals should advise HIV-positive patients on risk reduction measures like disclosing their HIV status to their sexual partners and avoiding alcohol use in order to promote consistent condom use. PROSPERO Protocol Registration. The protocol for this systematic review and meta-analysis has been registered (record ID: CRD42020170967, 09/06/2022).

Risky sexual practice and associated factors among people living with HIV/AIDS receiving antiretroviral therapy in Ethiopia: Systematic review and meta-analysis

Background

The risky sexual behavior of people living with HIV/AIDS (PLWHA) may impose a risk of transmitting the disease to their partners and increase Human Immunodeficiency Virus (HIV) co-infection. This systematic review and meta-analysis aimed to determine the pooled prevalence of risky sexual behavior and associated factors among PLWHA receiving [Antiretroviral Therapy (ART)] in Ethiopia.

Methods

To identify both published and unpublished research articles, systematic searches were performed in PubMed, HINARI, Medline, Science Direct, and Google Scholar databases. The review was carried out following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guideline. Cross-sectional studies reporting the prevalence of risky sexual practice and its associated factors among PLWHA receiving ART in Ethiopia were included. Two authors independently extracted all necessary data using a standardized data extraction format prepared in Microsoft Excel and exported to STATA version 14 statistical software for further analyses. The Cochrane Q test statistics and I² test were used to assess the heterogeneity of the studies. Since the included studies exhibited considerable heterogeneity, the random-effects meta-analysis model was computed to estimate the pooled prevalence of risky sexual practice which was determined by dividing the total number of PLWHA with risky sexual practice practices by the total number of PLWHA on ART in the study and multiplied by 100. Furthermore, pooled odds ratio (OR) with 95% confidence interval (CI) was determined for the association between determinant factors and risky sexual practice.

Result

In this study, 2351 articles were identified from different databases, and fifteen articles were selected for final systematic review and meta-analysis. In Ethiopia, the pooled prevalence of risky sexual practices was 43.56% (95% confidence interval (CI):35.51, 51.62). Discussion about safe sex with sexual partner/s [AOR = 0.26, 95% CI: 0.08, 0.92] and having multiple sexual partners [AOR = 1.90, 95% CI: 0.53, 6.84] were factors significantly associated with risky sexual practice in Ethiopia.

Conclusion

A significant proportion of respondents engaged in risky sexual practices. Multiple sexual partners and a lack of discussion about safe sex are linked to a higher prevalence of the risky sexual practice in Ethiopia. It is critical to raise awareness about safe sexual practices during health education and counselling services and to encourage clients to freely discuss safer sex practices with their sexual partner/s at their antiretroviral therapy (ART) appointments as part of their follow-up care.

Protocol registration

The protocol for this systematic review and meta-analysis was registered at PROSPERO (record ID = CRD42021274600, 25 September 2021).

Factors Associated with Condom Use Among Out-of-School Young People on Anti-Retroviral Therapy in Central Uganda

Introduction

Methods

Results

Conclusion

Predictors of secondary HIV transmission risk in a cohort of adolescents living with HIV in South Africa

OBJECTIVE

Preventing secondary HIV transmission from adolescents and young people living with HIV (AYPLHIV) to their partners and children is critical to interrupting the HIV infection cycle in sub-Saharan Africa. We investigated predictors of secondary HIV transmission risk (past-year sexual risk combined with past-year viremia) among AYPLHIV in South Africa.

DESIGN

A prospective cohort of AYLPHIV in South Africa recruited n = 1046 participants in 2014-2015, 93.6% of whom were followed up in 2016-2017 (1.5% mortality). Questionnaires used validated scales where available and biomarkers were extracted from n = 67 health facilities.

METHODS

Multivariate logistic regressions tested baseline factors associated with secondary HIV transmission risk, controlling for covariates, with marginal effect modelling combinations.

RESULTS

About 14.2% of AYPLHIV reported high secondary HIV transmission risk. High-risk AYPLHIV were more likely to be sexually infected [adjusted odds ratio (aOR) 2.79, 95% confidence interval (95% CI) 1.66-4.68, P < 0.001], and report hunger (aOR 1.93, 95% CI 1.18-3.14, P = 0.008) and substance use (aOR 2.19, 95% CI 1.19-4.02, P = 0.012). They were more likely to be in power-inequitable relationships (aOR 1.77, 95% CI 1.08-2.92, P = 0.025) and be parents (aOR 4.30, 95% CI 2.16-8.57, P < 0.001). Adolescents reporting none of these factors had a 4% probability of secondary transmission risk, rising to 89% probability with all five identified factors. Older age and early sexual debut were also strongly associated with a higher risk of secondary HIV transmission.

CONCLUSION

It is essential to identify and support AYPLHIV at a high risk of secondary transmission. Screening for factors such as mode of infection and parenthood during routine healthcare visits could help identify and provide resources to the most at-risk adolescents.

Factors Contributing to High HIV Prevalence in Majang Zone, Southwest Ethiopia: What Lies Beneath the Tip of the Iceberg?

BACKGROUND

Despite the tremendous efforts made, HIV epidemic has been continuing to be a public health threat and one of the leading causes of death in sub-Saharan African countries. Gambella region is a high prevalence region persistently exhibiting the highest share of HIV cases in Ethiopia. Thus, the objective of this study was to explore factors contributing to high HIV prevalence in the Majang zone of Gambella region, Southwest Ethiopia.

METHODS

A descriptive qualitative study was conducted in the Majang zone of Gambella region, Southwest Ethiopia from March to May 2019. A heterogeneous purposive sampling technique was employed to recruit key informants and focused group discussion participants. Eighteen key informant interviews and 9 focused group discussions were conducted (N = 90) with health professionals, youth, mothers, and community elders. An interview guide developed through an extensive literature review was used to elicit information from the study participants, and data were collected by the investigators themselves with the help of local guides. Data were audio recorded, transcribed, translated, coded, and analyzed thematically, assisted by Atlas.ti 7.5.16 software. Trustworthiness of the data was ensured through data triangulation, prolonged engagement, member checking, and inquiry audit in which findings were audited and verified by qualitative research experts. Ethical clearance was obtained from the Institutional Review Board of Mizan Tepi University, and written signed informed consent was obtained from all the participants prior to conducting the interviews.

RESULTS

A total of 90 individuals have participated in this study. Several factors appear to underlie the sustained high prevalence of HIV in the study area and were organized into five major themes: 1) government-related factors, 2) community perception towards HIV, 3) substance use, 4) socio-cultural factors, and 5) movement of people.

CONCLUSION

Low government attention towards HIV prevention and control activities, low perceived severity of HIV, substance use, socio-cultural factors, and high movement of people appear to inform the understanding of factors contributing to HIV risk in Majang zone. The sociocultural factors include the use of "Tifo Bet" and social support for polygamy. These findings loudly call for the governmental, non-governmental, and private sectors to reconsider and strengthen strategies for the prevention and control of HIV in the study area.

Serodiscordance predictors among couples in the HIV context: implications for health care

Background

After HIV diagnosis, people maintain, reestablish their sexual lives, or build new relationships, often with HIV seronegative partners. Therefore, understanding the factors concerning couple-vulnerability is essential in order to design effective HIV preventive strategies. We examined HIV serodiscordant couples prevalence and their associated factors from a Brazilian city.

Methods

This is a cross-sectional analytical study carried out with people living with HIV (PLHIV) who had an active sex life and were engagement in HIV health care follow-up. Data were collected using a semi-structured questionnaire during individual interviews. We analyzed data using bivariate and multiple logistic regression analyses.

Results

There was 72.0% of HIV serodiscordant partnerships. Those who inconsistently used condoms (aOR: 0.3[0.13–0.7]) and/or had HIV detectable viral load (aOR: 0.29 [0.12–0.7]) were less likely to have an HIV serodiscordant sexual partner. On other hand, the lack of HIV transmission counseling by the health service (aOR: 5.08 [2.02–12.76]), or those who had a casual partner (aOR: 8.12 [1.7–38.8]) or a steady and casual one concomitantly (aOR: 24.82 [1.46–420.83]), were more likely to indicate an HIV serodiscordant partnership.

Conclusion

The findings showed a high prevalence of serodiscordant partnerships in PLHIV. Greater visibility among couples in the health services is needed as well as a reassessment in order to provide PLHIV and their sexual partners with care strategies, by the health professionals.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-11835-0.

Risky Sexual Behavior and Associated Factors among Street Youth in Dilla Town, Gedeo Zone, South Ethiopia, 2018

BACKGROUND

Street youth are exposed to situations that make them vulnerable to sexual and reproductive health problems. The majority of street youth are living in conditions of severe deprivation, which place them at all kinds of health risks. Street youth have risky sexual behaviors that increase the likelihood of adverse sexual and reproductive health consequences. Therefore, this study aimed to identify the prevalence and associated factors of risky sexual behavior among street youth in Dilla town, Gedeo zone, South Ethiopia, 2018.

METHODS

A cross-sectional study was conducted among 279randomly selected street youth after locating and identifying them through census using a structured pre-tested questionnaire. Descriptive and binary logistic regression analyses were used. Statistically significant was declared at alpha<0.05.

RESULTS

The prevalence of risky sexual behavior among street youth in Dilla town was53.9% (95% CI -(48, 60.2)). Female sex (AOR=9.57, 95% CI- (1.76, 52.07)), age (AOR=1.23, 95% CI-(1.08, 1.39)), educational level (AOR=3.00, 95% CI- (1.08, 8.33)) and alcohol intake (AOR=2.27, 95% CI - (1.11, 4.68)) were statistically significant with risky sexual behavior.

CONCLUSION

A substantial number of street youths were engagedin risky sexual behavior, while female sex, increase in age, educational level, and alcohol intake of street youth were found to contribute to aggravate the problem. This calls formobilizing interventions considering the above factors to bring behavioral change in reducing risky sexual practices.

High level risky sexual behavior among persons living with HIV in the urban setting of the highest HIV prevalent areas in Ethiopia: Implications for interventions

INTRODUCTION

Data on the sexual behavior among people living with human immunodeficiency virus (PLHIV) dwelling at HIV prevalent setting located at the periphery of Ethiopia is lacking. Therefore, this study was designed to investigate sexual practice of patients following their antiretroviral therapy (ART) service and factors affecting their behavior.

MATERIALS AND METHODS

A facility based cross-sectional study design was employed to assess risky sexual practice and associated factors among HIV positive adults attending ART clinics in Gambella town, Southwest Ethiopia. Risky sexual practice is defined as a custom of getting in at least one of the following practices such as condom-unprotected sex with any partner, having two or more sexual partners and practicing casual sex in the last three months. A total of 352 randomly selected clients were interviewed by using a structured questionnaire. The multivariable logistic regression model was used to examine the association between covariates and the outcome variable.

RESULTS

Majority of the study participants were engaged at least in one of the risky sexual practices (79.8% confidence interval (CI): 75.3% - 83.9%). The multivariable analysis found that the odds of risky sexual practice were higher among individuals who use substances ('khat' users (AOR: 3.82, 95%CI:1.30-11.22), smoke cigarette (AOR:4.90, 95%CI:1.19-12.60), consume alcohol (AOR: 2.59, 95%CI:1.28-5.21)); those who never discuss about safe sex with their partner/s (AOR: 2.21, 95%CI:1.16-4.21); those who have been in attachment for longer duration (more than four years) with their partner (AOR: 3.56, 95%CI: 1.32-9.62); and groups who desire to bear children in their future life (AOR: 3.15, 95%CI:1.40-7.04) as compared to their respective comparison groups.

CONCLUSIONS

A significant number of participants were engaged at least in one of the risky sexual practices which potentially result in super infection by a new or/and drug resistant viral strain/s, and onward transmission of the virus. Thus, an HIV intervention program which focuses on the identified factors has to be implemented to mitigate risk of unsafe sexual behavior of this population group and move towards ending the HIV/Acquired Immunodeficiency Syndrome (AIDS) epidemic.

Risky Sexual Practice and Associated Factors Among Women Living with HIV/AIDS Receiving Antiretroviral Therapy at a PMTCT Clinic in Western Oromia, Ethiopia

BACKGROUND

Human immunodeficiency virus infection has been one of the top health-related challenges for the past four decades. Ethiopia is extremely infected by HIV pandemic every year, whereby 22,300 people were newly infected and 690,000 were living with HIV at the end of 2018. Sexual behavior of HIV positive individuals visiting treatment clinics is a neglected issue. Nonetheless, it has been a significant way of HIV transmission to serodiscordant partners.

METHODS

A facility-based cross-sectional study design was used on a sample of 432 women attending treatment clinics in west Oromia from February 26 to March 26, 2019. Systematic sampling was used to select the study participants. A pretested and structured interviewer-administered questionnaires were used to collect the data. The data were coded, entered, cleaned and exported to SPSS version 20.0 for analysis. Descriptive statistics were used to present frequency distributions. Variables with P-value <0.25 during bivariate analysis were entered into multiple logistic regression models to control for all possible confounders. Odds ratio along with 95% CI were estimated to measure the strength of the association. Level of statistical significance was declared at a p-value less than 0.05.

RESULTS

Out of total respondents, 240 (56.9%), 95% CI: (52.1-61.6%) were involved in risky sexual practices in the prior 12 months. Urban residence [AOR: 3.24, (95% CI: (1.52, 6.89)], those with no formal education [AOR: 2.77, (95% CI: (1.18, 6.54)], being on ART for >2years [AOR: 2.74, (95% CI: (1.13, 6.65)] and CD4 count ≥200 cells/mm3 [AOR: 3.20, (95% CI: (1.50, 6.82)] were factors significantly associated with risky sexual practice.

CONCLUSION

A considerable number of respondents were involved in risky sexual practices 240 (56.9%) due to being rural residence, not attending formal education, being on ART for >2 years and CD4 count ≥200 cells/mm3.

<p>Risky Sexual Practice, Sexually Transmitted Infection and Associated Factors Among Newly Diagnosed HIV-positive People in Northwest Ethiopia</p>

Purpose

Risky sexual practice expose for the acquisition of sexually transmitted infection (STI) including human immunodeficiency virus (HIV). This study was conducted to fill the knowledge gap on the prevalence of risky sexual practice, STIs and associated factors among newly diagnosed HIV-positive people in northwest Ethiopia.

Patients and Methods

This study was a cross-sectional study design which was conducted on 745 newly diagnosed HIV patients. An interviewer-administered questionnaire was used to interview patients within seven days of HIV diagnosis using client exit interview approach. Data were entered to EpiData and exported to SPSS version 24 for analysis. Binary logistic regression analysis was employed to select factors for multivariate logistic regression at p-value of less than 0.25. Two separate logistic regression models were used for risky sexual practice and STI as dependent variables. The strength of statistical association was quantified using an adjusted odds ratio (AOR) with a 95% confidence level.

Results

The prevalence of risky sexual practices and STIs among newly diagnosed HIV-positive people were 15.8% (95%CI: 13.1–18.4) and 6.6% (95%CI: 4.8–8.5), respectively. Although there were no statistically significant factors associated with STI, having two or more lifetime sexual partners (AOR=3.19; 95%CI: 1.57–6.49) and frequent use of alcohol (AOR=3.10; 95%CI: 1.34–7.19) were the factors associated with risky sexual practice.

Conclusion

Risky sexual practice and STI were found to be low among newly identified HIV patients. Factors associated with risky sexual practice failed to explain STI diagnosis using the syndromic approach. Therefore, revisiting the definition of risky sexual practice is necessary for the universal test and treat approach since sustained viral suppression may leave the need for consistent use of condoms among HIV patients who are on ART especially with regular sexual partners. Further study is also recommended to measure changes in sexual practice after initiating antiretroviral therapy.

Inconsistent condom use between serodifferent sexual partnerships to the human immunodeficiency virus

Objective:

to analyze predictors of inconsistent condom use among HIV-positive people with sexual immunodeficiency virus serodifferent sexual partnership.

Method:

cross-sectional, analytical study with a consecutive non-probabilistic sample consisting of people living with the human immunodeficiency virus with serodifferent sexual partnership and who were in outpatient clinical follow-up. Data were collected through individual interviews guided by a semi-structured questionnaire and subsequently analyzed with bivariate analysis and logistic regression.

Results:

Seven variables were independently associated with inconsistent condom use. Schooling less than 11 years of schooling (4.9 [2.4-10.1]), having multiple partnerships (5.0 [1.3-19.6]), using alcohol (2.1 [1.1 -4.4]) or other drugs (2.8 [1.2-6.3]), do not receive advice from a healthcare professional (2.0 [1.1-3.9]), have no knowledge of treatment as prevention (3.0 [1,2-6,9]) and not knowing that undetectable viral load reduces the risk of human immunodeficiency virus transmission (3.8 [1,1-13,7]) were predictors for inconsistent condom use.

Conclusion:

The study showed that psychosocial factors interfere with consistent condom use between serodifferent partnerships. Thus, it is highlighted that there is a need for comprehensive interventions that include the integration of clinical and psychosocial care.

Risky sexual practice and associated factors among HIV positive adults visiting ART clinics in public hospitals in Addis Ababa city, Ethiopia: a cross sectional study

Background

Sexual behavior of HIV positive individuals visiting anti- retroviral clinics is a neglected issue. With access to anti-retroviral treatment, HIV positive individuals experience improved health and are able to reintegrate into their social life and many of them engage in sexual activities. In the context of Ethiopia, safer sex practices among people living with HIV is critical in terms of preventing the acquisition of another strain of HIV and helping address the epidemic.

Method

An institution-based cross sectional study was conducted at Addis Ababa public hospitals from January to February 2017. A pretested structured questionnaire was used to collect the data. Using the systematic random sampling technique, a total of 562 respondents participated in the study. The data were entered into EPI info version 3.5.3 and transferred to SPSS version 20 for analysis. Descriptive statistics, bi-variate, and multi variable analyses were done. A p-value < 0.05 was considered to determine the statistical significance of the association between factors (independent variables) and risky sexual practice. The Odds ratio was also used to determine the presence and the degree of association between dependent and independent variables.

Results

A total of 562 respondents participated in the study which revealed that the prevalence of risky sexual practice was 39.1% (95% CI: 35.2, 43.8) three months prior to the data collection. Educational status of participants who were below grade eight (AOR = 2.27, 95% CI:1.01,5.10) and went to grades eight to twelve (AOR = 2.12, 95% CI:1.02,4.41), were married (AOR = 2.07, 95% CI:1.06,4.02), had no concern for safer sexual practice (AOR = 3.74, 95% CI:2.28, 6.13), had CD₄ count of ≥500cells/mm³(AOR = 1.66, 95% CI:1.04, 2.64), and used substance (AOR = 3.41, 95% CI:1.83, 6.35) were significantly associated with risky sexual practice.

Conclusion

The prevalence of risky sexual practice was markedly high in this study due to such contributory factors as low educational status, marriage, lack of concern for safer sexual practices, and substance use.

Electronic supplementary material

The online version of this article (10.1186/s12889-019-6438-5) contains supplementary material, which is available to authorized users.