Antiretroviral therapy(ART) and sexual behaviour among people living with HIV: A case study of Lusaka

Abstract

Background: With thousands of the HIV infected Zambian population on ART, there are worries that people on ART may be engaging in high risk sexual behaviours thereby nullifying the impact of current HIV prevention efforts.Objectives: This study therefore investigated sexual behaviours among people on ART in Lusaka District. It was specifically aimed to assess the knowledge and attitudes regarding the HIV infectivity of people on ART, assess levels of condom use, investigate the number of sexual partners and types of partners people on ART have sex with. It further evaluated the associations between duration of being on ART, HIV status disclosure, exposure to positive living messages, attitudes on the HIV infectivity of people on ART and social, economic and demographic factors on having multiple sexual partnerships and consistent condom use.Methods: Three hundred and twenty men and women aged 15-49 participated in this study and they were interviewed based on a mixed methods, quantitative and qualitative, cross-sectional study methodology.Results: key findings of this study were that multiple sexual partners among people on ART were high (21percent), non-condom use at last sex was high (19 percent) and consistent condom use was very low (14 percent). Results further showed that longer duration on ART (p=0.03), and being exposed to positive living messages (p=0.04), were associated with having only on sexual partner (p=0.03). Exposure to positive living messages (p=0.05) was also associated with safer sex; consistent condom use. Male respondents (OR: 11, p=0.001), those with secondary education and higher (OR: 2.3, p=0.04), shorter duration on ART, and no exposure to positive living messages (OR: 2, p=0.04) were significantly and positively associated with having multiple sexual partners. Having secondary education and higher (OR: 2.6, p=0.001), and exposure to positive living messages were significantly and positively associated with consistent condom use.Conclusions: The findings of this study signal a picture of high-risk sexual behaviours among people on ART. This study thus recommends that focused interventions needs to be designed to primarily target people living with HIV to inspire behaviors that will result in the reduction of new HIV infections. Specifically, programs should promote condom use among married partners, couples HIV testing, HIV status disclosure and intensification of health communication targeting people on ART.