@article{fdi:010059010,
  title = {{C}hanges in sexual activity and risk behaviors among {PLWHA} initiating {ART} in rural district hospitals in {C}ameroon data from the {STRATALL} {ANRS} 12110/{ESTHER} trial},
  author = {{N}dziessi, {G}. and {C}ohen, {J}. and {K}ouanfack, {C}. and {B}oyer, {S}. and {M}oatti, {J}ean-{P}aul and {M}arcellin, {F}. and {L}aurent, {C}hristian and {S}pire, {B}. and {D}elaporte, {E}ric and {C}arrieri, {M}.{P}.},
  editor = {},
  language = {{ENG}},
  abstract = {{T}he continued scaling-up of antiretroviral therapy ({ART}) in {S}ub-{S}aharan {A}frica provides an opportunity to further study its impact on sexual behaviors among people living with {HIV}/{AIDS} ({PLWHA}). {W}e explored time trend and correlates of sexual activity among {PLWHA} initiating {ART} in {C}ameroon and compared sexual risk behaviors between patients sexually active before and after initiating {ART} and those resuming sexual activity after {ART} initiation. {A}nalyses were based on longitudinal data collected within the randomized trial (n = 459) conducted in nine rural district hospitals in {C}ameroon. {S}exual activity was defined as reporting at least one sexual partner during the previous 3 months. {I}nconsistent condom use ({ICU}) was defined as reporting to have never, sometimes, or nearly always used condoms at least once with a partner(s) either {HIV}-negative or of unknown {HIV} status during the same period. {M}c {N}emar tests were used to assess time trend, while mixed-effect logistic regressions were conducted to analyze the effect of time since {ART} initiation on sexual activity. {T}he proportion of sexually active patients significantly increased over time: from 31.8% at baseline to 40.2 and 47.1% after 6 and 12 months of {ART}, respectively (p=0.001), to 55.9% after 24 months (p=0.02). {A}fter adjustment for behavioral and psychosocial factors, time since {ART} initiation was independently associated with reporting sexual activity ({AOR} [95% {CI}] = 1.30 [1.171.46] per 6-month increase, p=0.001). {ICU} was more frequent among patients sexually active both before and after {ART} initiation than among those who resumed sexual activity after {ART} initiation (82 vs. 59%, p<0.001). {T}o conclude, while {ART} initiation fosters resumption of sexual activity in patients who are inactive before starting treatment; unsafe sexual behaviors remain less frequent in this population than in patients who are already sexually active before starting {ART}. {R}isk reduction programs should be reinforced among {PLWHA} in the context of {ART} scaling-up.},
  keywords = {{HIV} ; {AIDS} ; antiretroviral therapy ; sexual activity ; sexual risk ; behaviors ; {S}ub-{S}aharan {A}frica ; {C}ameroon ; {CAMEROUN}},
  booktitle = {},
  journal = {{A}ids {C}are-{P}sychological and {S}ocio-{M}edical {A}spects of {A}ids/{H}iv},
  volume = {25},
  numero = {3},
  pages = {347--355},
  ISSN = {0954-0121},
  year = {2013},
  DOI = {10.1080/09540121.2012.701717},
  URL = {https://www.documentation.ird.fr/hor/fdi:010059010},
}