Changes in sexual behaviour after ART, Kenya.
Article Type: Brief article
Subject: Sex (Demographic aspects)
Sex (Research)
Risk-taking (Psychology) (Demographic aspects)
Risk-taking (Psychology) (Research)
Antiviral agents (Dosage and administration)
Pub Date: 05/01/2010
Publication: Name: Reproductive Health Matters Publisher: Reproductive Health Matters Audience: General Format: Magazine/Journal Subject: Family and marriage; Health; Women's issues/gender studies Copyright: COPYRIGHT 2010 Reproductive Health Matters ISSN: 0968-8080
Issue: Date: May, 2010 Source Volume: 18 Source Issue: 35
Topic: Event Code: 310 Science & research Canadian Subject Form: Sexual behaviour; Sexual behaviour
Geographic: Geographic Scope: Kenya Geographic Code: 6KENY Kenya
Accession Number: 236247775
Full Text: There is concern that sexual risk taking may increase with antiretroviral therapy (ART) initiation, especially in the long run once health improves and people increase sexual activity. In-depth interviews were conducted with 23 sexually-active adults receiving ART in Mombasa, Kenya--11 women and 12 men selected using stratified purposeful sampling--to understand changes in sexual behaviour after treatment initiation and factors influencing condom use. Advanced HIV disease had previously led to marked decreases in sexual desire and function, especially among men, which was somewhat reversed as health improved with ART. After HIV testing, numbers of partners reduced and monogamous relationships began to predominate. Receipt of ART strengthened these changes, while improving sexual health. However, concurrent sexual partnerships continued within polygamous marriage and unprotected sex occurred with regular partners, even those who were HIV-negative. Those who used condoms inconsistently prior to ART often remained inconsistent users thereafter. While disclosure of HIV status appeared to increase condom use, this did not always predict protected sex. In addition to classic perceptions about the effect of condoms on intimacy and trust, traditional gender roles, misconceptions about potential harm from condoms and fertility desires hindered condom use. Both HIV testing and receipt of ART appear to be key life stages, when respondents review and change behaviour. Individualised risk-reduction interventions at these times should be ensured. (1)

(1.) Sarna A, Chersich M, Okal J, et al. Changes in sexual risk taking with antiretroviral treatment: influence of context and gender norms in Mombasa, Kenya. Culture, Health and Sexuality 2009;11(8):783-97.
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