| Titre : | Unprotected sex following HIV testing among women in Uganda and Zimbabwe : short-and long-term comparisons with pre-test behaviour. (2009) |
| Auteurs : | Abigail-Norris TUMER ; Frieda-M BEHETS ; Tsungai CHIPATO ; Jay-S KAUFMAN ; William-C MILLER ; Francis-A MMIRO ; Charles-S MORRISON ; Nancy-S PADIAN ; Robert-A SALATA ; Department of Epidemiology. University of North Carolina.. Chapel Hill. NC. USA ; Departments of Epidemiology and Medicine. University of California.. Chapel Hill. NC. USA |
| Type de document : | Article |
| Dans : | International journal of epidemiology (vol. 38, n° 4, 2009) |
| Pagination : | 997-1007 |
| Langues: | Anglais |
| Mots-clés : | Sérologie ; Comportement sexuel ; Dépistage ; Sida ; VIH ; Femme ; Homme ; Ouganda ; Zimbabwe ; Court terme ; Long terme ; Etude comparée ; Prévention santé ; Virose ; Infection ; Rétrovirus ; Virus ; Afrique ; Immunopathologie ; Préservatif masculin |
| Résumé : | [BDSP. Notice produite par INIST-CNRS AJBR0xrA. Diffusion soumise à autorisation]. Background. Despite widespread condom promotion for HIV prevention, prospective measurement of condom use before and after HIV testing is infrequent. Methods. We analysed data from a prospective study of hormonal contraception and HIV acquisition among Zimbabwean and Ugandan women (1999-2004), in which HIV testing and counselling were performed approximately every 3 months. We used zero-inflated negative binomial (ZINB) models to examine the number and proportion of unprotected sex acts, comparing behaviour reported 2-6 months before HIV testing with behaviour reported both 2-6 months (short-term analysis) and 12-16 months (long-term analysis) after HIV testing. Results. Short-and long-term analyses were similar, so we present only long-term findings from 151 HIV-infected and 650 uninfected participants. The proportion of HIV-infected women reporting any unprotected acts in a typical month declined from 74% (pre-infection behaviour) to 56% (12-16 months after HIV diagnosis). In multivariable models, HIV-infected women were twice as likely to report that all sex acts were protected by condoms after diagnosis compared with beforehand [adjusted odds ratio (aOR) : 1.99,95% confidence interval (CI) : 1.12-3.53] ; uninfected women were somewhat less likely to report that all acts were protected (aOR : 0.82,95% CI : 0.64-1.04). HIV-infected women also reduced their number of unprotected acts by 38% (95% CI : - 16 to - 55%). However, their proportion of unprotected acts changed little (7% reduction, 95% CI : - 18 to+6%). Uninfected women reported little change in number or proportion of unprotected acts over the same time period. Conclusions. HIV-infected women reduced the number, but not the proportion, of unprotected acts. HIV-negative women did not increase condom use after testing and counselling, but neither did they decrease condom use, suggesting that testing negative was not interpreted as endorsement of risky behaviour. |
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