Prevalence of and Factors Associated With Inconsistent Condom Use With HIV-Discordant Male Regular Sex Partners Among HIV-Infected Women in China

Sexual behaviours and correlates of condom use among HIV-discordant couples from eastern China: a cross-sectional study

OBJECTIVES

To investigate sexual behaviours among HIV-discordant heterosexual couples and assess the correlates of condom use at the couple level.

DESIGN

Cross-sectional study.

SETTING

Seven prefectures along the Yangtze River in the Anhui Province, China.

PARTICIPANTS

We included 412 participants aged 18 years or older (206 married HIV-discordant couples).

PRIMARY AND SECONDARY OUTCOME MEASURES

In this study, sexual behaviours included marital or extramarital sex in the past 6 months, as well as the frequency of marital sex and condom use (always, sometimes or never) if having marital sex in the past 6 months. We used stepwise ordinal logistic regression modelling to determine the correlates of condom use.

RESULTS

In total, 63.1% (130 of 206) of couples had marital sex in the past 6 months, of which 89.2% (116 of 130) used condoms consistently. Couples with more marital duration (OR=1.15; 95% CI: 1.03, 1.28) were more inclined to adhere to condom use, whereas those lacking support and care (OR=0.25; 95% CI: 0.07, 0.94) and being remarried (OR=0.08; 95% CI: 0.02, 0.43) were associated with less condom use. In addition, HIV-positive respondents were more likely to have extramarital sex than HIV-negative respondents (p=0.015).

CONCLUSIONS

The extramarital sex of HIV-positive spouses should be considered. Implementation of interventions, such as increasing support and care between spouses to promote marital intimacy and stability, could reduce unprotected sexual behaviour.

Important Roles of Health Professionals in Maternal HIV Disclosure Among HIV-Infected Women in China

Maternal HIV disclosure to children is beneficial for both mothers and children. A cross-sectional survey was conducted to investigate the prevalence of maternal HIV disclosure to at least one living child aged > 5 years among 292 HIV-infected mothers in Guangxi Province, China. Among all participants, 45.2% had self-disclosed their HIV positive sero-status to at least one living child aged > 5 years. After adjusting for the significant background variables, participants self-reported health professionals in governmental antenatal care clinics had discussed with them about maternal HIV disclosure (adjusted odds ratios, aOR: 5.85), had received counseling services (aOR: 7.84) or support (aOR: 8.75) from these health professionals when making decision on maternal HIV, and perceived higher empathy of these health professionals (aOR: 1.09) were more likely to have reported maternal HIV disclosure. Instrumental and affective interactions between health professionals and HIV-infected mothers were important facilitators of maternal HIV disclosure.