Disclosure, Multiple Sex Partners, and Consistent Condom Use among HIV Positive Adults on Antiretroviral Therapy in Johannesburg, South Africa

Abstract

Inconsistent condom use among persons on antiretroviral treatment (ART) is a major public health concern because of the risk of HIV transmission. This study examined the association between socio-demographic variables and knowing partners’ HIV status, multiple sex partners, and consistent condom use among 400 HIV-infected adults who had received ART for at least six months in Johannesburg, South Africa. The study used a cross-sectional survey and a structured interviewer administered questionnaire. Over half (n = 225, 56.3%) of participants were on ART for more than two years. Two thirds (n = 234, 63.2%) were aware of partner’s HIV status. Over a third (n = 136, 34.0%) reported having more than one sex partners. Three quarters (n = 279, 75.8%) reported consistent condom use with regular partner. Discussing HIV testing (aOR = 2.28, CI: 1.31 -3.95), awareness of partner’s HIV status (aOR = 2.59, CI: 1.50 -4.46), level of education (aOR = 0.64, CI: 0.42 -0.98), and duration on ART (aOR = 0.71, CI: 1.31 -3.95) were predictors for consistent condom use. Awareness of partner’s HIV status was associated with multiple partnership (aOR = 0.38, CI: 0.21 -0.66), living with partner (aOR = 4.75, CI: 2.86 -7.91), discussing HIV testing (aOR = 2.43, CI: 1.48 -3.99), and duration on ART (aOR = 2.04, CI: 1.43 -2.92). While gender (aOR = 5.68, CI: 3.46 -9.34), marital status (aOR = 0.44, CI: 0.25 -0.77), and awareness of partner’s HIV status (aOR = 0.52, CI: 0.30 -0.89) were associated with multiple partnerships. Risky sexual behaviours occurred in all types of partners and knowing partner’s HIV status was a predictor for consistent condom use with all types of partners. It is essential that HIV prevention strategies create an enabling environment for disclosure and reductions of risky sexual behaviours by HIV-infected persons on ART.