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Fighting HIV in South Africa should focus on couples, study finds
Date:4/25/2011

PROVIDENCE, R.I. [Brown University] A new study of sexual risk behaviors within long-term couples in South Africa finds that HIV-positive people take almost as much risk in their sexual behavior when they know their partner is HIV-negative or don't know their status, as when they know their partner is already infected. At the same time, HIV-positive partners who are on antiretroviral therapy and in intensive counseling do engage in less risky behavior. The Brown University researchers who led the study say both findings suggest that more couples-based HIV counseling is needed in South Africa where about 18 percent of adults carry the virus.

"The concept of Positive Prevention the idea that one focus of prevention should be among people already infected with HIV since they are the only ones who could infect others was first floated by the CDC in 2003 but hasn't really taken hold in sub-Saharan Africa," said Mark Lurie, professor of community health and a senior author of the study published in advance online April 8 in AIDS and Behavior. "This paper clearly points to the urgent need to intervene among people already infected with HIV and especially those in 'discordant' relationships relationships in which their partner is not infected."

The study surveyed 1,163 sexually active HIV-positive men and women in a primary care program at Chris Hani Baragwanath Hospital in Soweto, near Johannesburg. Researchers led by Brown medical student and Ph.D. candidate Kartik Venkatesh asked whether they knew their closest sexual partner's HIV status, how often they have sex, how often it is unprotected, and how often they have sex outside that relationship.

Risky couples

Although in some places around the world, specific high-risk groups of HIV-positive people have restricted their riskier sexual activities to people also already infected (a practice called "sero-sorting"), Venkatesh's survey found that heterosexual couples
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Contact: David Orenstein
david_orenstein@brown.edu
401-863-1862
Brown University
Source:Eurekalert

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