Navigation Links
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 did not seem to operate that way in South Africa. For example, among HIV-positive people who said their closest partner's status was either HIV-negative or unknown, 18 percent had unprotected sex with them in the last six months, compared to only 14 percent who knew their partner was already infected.

Risks such as having frequent sex (two sex acts in the last two weeks) and going to a partner outside the primary relationship were somewhat lower with HIV-negative or unknown partners than with HIV-positive partners, but not much more so.

"The difference for partners who were negative or status unknown versus those who were positive was not markedly different," Venkatesh said.

In all, about 40 percent of the people surveyed knew their partner was also HIV positive. The same proportion didn't know their partner's status and 20 percent knew their partners to be HIV-negative. There was no correlation between how long the couples were together (a median of 3.4 years) and whether a partner's status was known.

Couples counseling

The factor that did seem to be associated with decreased sexual risk-taking behavior was receiving antiretroviral (ART) medication. This finding in couples was consistent with those that Venkatesh, Lurie and others reported last year in the journal AIDS, where they saw less risky behavior among ART recipients in a larger sample in Africa spanning close to 10 years. Rather than people becoming emboldened by medication and improved health to take more risks a practice called behavioral disinhibition - people in several African countries have tended to become more careful with treatment.

"Why we're seeing this might be due to the fact that treatment is also accompanied by condoms and other prevention messages, so that when individuals are coming to get their treatment they are also getting sexual risk behavior prevention counseling," Venkatesh said.

Taken together, Venkatesh said, the prevalence of risk in South African couples and the likely role that counseling plays in curbing risk could add up to a significant potential benefit to increasing couples counseling about HIV. By bringing men and women into counseling together, such programs may help overcome power imbalances between men and women that exacerbate the lack of communication about HIV status in some relationships.

"HIV prevention and treatment programs need to be more couples-friendly or family-focused," Venkatesh said.


'/>"/>

Contact: David Orenstein
david_orenstein@brown.edu
401-863-1862
Brown University
Source:Eurekalert

Related medicine news :

1. 29 Clear Channel stations Nationwide Raise Nearly $2.8 Million to Help Save the Lives of Kids Fighting Cancer and Other Deadly Diseases
2. New Cancer-Fighting Strategy Focuses On Signaling Molecules
3. Families Fighting Flu Commends the CDCs Advisory Committee on Immunization Practices Recommendation for Universal Influenza Vaccination
4. New testing method hints at garlics cancer-fighting potential
5. Citizens Constitutional Congress Formed To Resist White House Takeover Of American Healthcare System 'Free Citizens Fighting To Keep America Free'
6. Honolulu, Hawaii Bariatric Surgery Practice Launches New Website to Reach Out to Patients Fighting Morbid Obesity
7. Childrens sense of threat from parental fighting determines trauma symptoms
8. Author Erin Morrow Still Releases "Fighting MS: Strength in Numbers"
9. Tapping into sorghums weed-fighting capabilities to give growers more options
10. Fighting Off the Freshman Fifteen
11. UCLA scientists create army of tumor-fighting immune cells and watch as they attack cancer
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/25/2016)... ... June 25, 2016 , ... First Choice Emergency Room , the ... Ogunleye, as the Medical Director of its new Mesquite-Samuell Farm facility. , “We ... new Mesquite location,” said Dr. James M. Muzzarelli, Executive Medical Director of First Choice ...
(Date:6/25/2016)... ... June 25, 2016 , ... Dr. Calvin ... injury. Recently, he has implemented orthobiologic procedures as a method for treating his ... of the first doctors to perform the treatment. Orthobiologics are substances that orthopaedic ...
(Date:6/25/2016)... ... June 25, 2016 , ... Conventional wisdom preaches the benefits of ... of the latter, setting the bar too high can result in disappointment, perhaps even ... progress toward their goal. , Research from PsychTests.com reveals that behind ...
(Date:6/24/2016)... ... June 24, 2016 , ... Those who have experienced ... feelings, many turn to unhealthy avenues, such as drug or alcohol abuse, as a ... has released tools for healthy coping following a traumatic event. , Trauma sufferers tend ...
(Date:6/24/2016)... ... June 24, 2016 , ... Marcy was in a crisis. Her son James, eight, ... at his family verbally and physically. , “When something upset him, he couldn’t control his ... it. He would throw rocks at my other children and say he was going to ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... 24, 2016  Arkis BioSciences, a leading innovator ... more durable cerebrospinal fluid treatments, today announced it ... funding is led by Innova Memphis, followed by ... private investors.  Arkis, new financing will accelerate the ... market release of its in-licensed Endexo® technology. ...
(Date:6/23/2016)... 23, 2016 Any dentist who has made an ... current process. Many of them do not even offer this ... and high laboratory costs involved. And those who ARE able ... such a high cost that the majority of today,s patients ... Parsa Zadeh , founder of Dental Evolutions Inc. and ...
(Date:6/23/2016)... , June 23, 2016 Roche (SIX: RO, ... clearance for its Elecsys BRAHMS PCT (procalcitonin) assay as ... or septic shock. With this clearance, Roche is the ... fully integrated solution for sepsis risk assessment and management. ... bacterial infection and PCT levels in blood can aid ...
Breaking Medicine Technology: