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Li Y, Zhang F, Dou Z, Zheng W, Ai P, Bao M, Han C, Xiang K, Qin Q. Sexual behaviours and correlates of condom use among HIV-discordant couples from eastern China: a cross-sectional study. BMJ Open 2023; 13:e071195. [PMID: 37308275 DOI: 10.1136/bmjopen-2022-071195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/14/2023] Open
Abstract
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.
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Affiliation(s)
- Yi Li
- School of Public Health, Fudan University, Shanghai, China
| | - Fenglin Zhang
- Department of AIDS STD Disease Control and Prevention, Anqing Center for Disease Control and Prevention, Anqing, Anhui, China
| | - Zhengdong Dou
- Department of AIDS STD Disease Control and Prevention, Wuhu Center for Disease Control and Prevention, Wuhu, Anhui, China
| | - Wei Zheng
- Department of AIDS STD Disease Control and Prevention, Huangshan Center for Disease Control and Prevention, Huangshan, Anhui, China
| | - Ping Ai
- Department of AIDS STD Disease Control and Prevention, Xuancheng Center for Disease Control and Prevention, Xuancheng, Anhui, China
| | - Ming Bao
- Department of AIDS STD Disease Control and Prevention, Chizhou Center for Disease Control and Prevention, Chizhou, Anhui, China
| | - Congming Han
- Department of AIDS STD Disease Control and Prevention, Tongling Center for Disease Control and Prevention, Tongling, Anhui, China
| | - Kexia Xiang
- Department of AIDS STD Disease Control and Prevention, Ma'anshan Center for Disease Control and Prevention, Ma'anshan, Anhui, China
| | - Qirong Qin
- Department of AIDS STD Disease Control and Prevention, Ma'anshan Center for Disease Control and Prevention, Ma'anshan, Anhui, China
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Is There Risk Compensation among HIV Infected Youth and Adults 15 Years and Older on Antiretroviral Treatment in South Africa? Findings from the 2017 National HIV Prevalence, Incidence, Behaviour and Communication Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106156. [PMID: 35627693 PMCID: PMC9141949 DOI: 10.3390/ijerph19106156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 05/16/2022] [Accepted: 05/17/2022] [Indexed: 11/17/2022]
Abstract
In this paper, risk compensation among individuals on antiretroviral therapy (ART), using the 2017 South African national survey on HIV, is explored. A multi-stage stratified cluster random sampling approach was used to realize 11,130 participants 15 years and older. Logistic regression analysis assessed the association between multiple sexual partners, condom use at last sexual encounter, consistency of condom usage and potential explanatory variables using HIV status and ART exposure as a mediator variable. HIV positive participants who were aware and on ART were less likely to have multiple sexual partners, and less likely not to use a condom at last sex compared to HIV positive participants who were aware but not on ART. The odds of reporting multiple sexual partners were significantly lower among older age groups, females, non-Black Africans, and rural settings, and higher among those with tertiary level education, and risky alcohol users. The odds of no condom use at last sexual encounter were more likely among older age groups, females, other race groups, and less likely among those with secondary level education. The odds of inconsistent condom use were more likely among older age groups, females, and other race groups, and less likely among those with tertiary level education, high risk and hazardous alcohol users. Risk compensation is not apparent among HIV infected adults who are on ART. Risk groups that should receive tailored interventions to reduced risky sexual behaviours were identified.
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Guo Y, Hong YA, Cai W, Li L, Hao Y, Qiao J, Xu Z, Zhang H, Zeng C, Liu C, Li Y, Zhu M, Zeng Y, Penedo FJ. Effect of a WeChat-Based Intervention (Run4Love) on Depressive Symptoms Among People Living With HIV in China: A Randomized Controlled Trial. J Med Internet Res 2020; 22:e16715. [PMID: 32044751 PMCID: PMC7058168 DOI: 10.2196/16715] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 11/26/2019] [Accepted: 12/31/2019] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND People living with HIV (PLWH) have high rates of depressive symptoms. However, only a few effective mental health interventions exist for this vulnerable population. OBJECTIVE The aim of this study was to assess the efficacy of a WeChat-based intervention, Run4Love, with a randomized controlled trial among 300 people living with HIV and depression (PLWHD) in China. METHODS We recruited PLWH from the HIV outpatient clinic in South China. Participants were screened based on the Center for Epidemiologic Studies-Depression (CES-D) scale. Those who scored 16 or higher were eligible to participate. A total of 300 eligible patients were enrolled. After obtaining informed consent from the participants, completion of a baseline survey, and collection of participants' hair samples for measuring cortisol, the participants were randomly assigned to an intervention or a control group in a 1:1 ratio. The intervention group received the Run4Love program, delivered via the popular social media app WeChat. Cognitive behavioral stress management courses and weekly reminders of exercise were delivered in a multimedia format. Participants' progress was monitored with timely and tailored feedback. The control group received usual care and a brochure on nutrition for PLWH. Data were collected at 3, 6, and 9 months. The primary outcome was depression, which was measured by a validated instrument. RESULTS Participants in the intervention and control groups were comparable at baseline; about 91.3% (139/150), 88.3% (132/150), and 86.7% (130/150) participants completed the 3-, 6-, and 9-month follow-ups, respectively. At the 3-month follow-up, a significant reduction in CES-D score was observed in the intervention group (from 23.9 to 17.7 vs from 24.3 to 23.8; mean difference=-5.77, 95% CI -7.82 to -3.71; P<.001; standard effect size d=0.66). The mean changes in CES-D score from baseline to the 6- and 9-month follow-ups between the two groups remained statistically significant. No adverse events were reported. CONCLUSIONS The WeChat-based mobile health (mHealth) intervention Run4Love significantly reduced depressive symptoms among PLWHD, and the effect was sustained. An app-based mHealth intervention could provide a feasible therapeutic option for many PLWHD in resource-limited settings. Further research is needed to assess generalizability and cost-effectiveness of this intervention. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR-IPR-17012606; http://www.chictr.org.cn/showproj.aspx?proj=21019 (Archived by WebCite at https://www.webcitation.org/78Bw2vouF).
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Affiliation(s)
- Yan Guo
- Department of Epidemiology and Biostatistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Sun Yat-sen Center for Migrant Health Policy, Guangzhou, China
- Sun Yat-sen Center for Global Health, Guangzhou, China
| | - Y Alicia Hong
- Department of Health Administration and Policy, College of Health and Human Services, George Mason University, Fairfax, VA, United States
| | - Weiping Cai
- Department of Infectious Diseases, Guangzhou Number Eight People's Hospital, Guangzhou, China
| | - Linghua Li
- Department of Infectious Diseases, Guangzhou Number Eight People's Hospital, Guangzhou, China
| | - Yuantao Hao
- Department of Epidemiology and Biostatistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Sun Yat-sen Center for Global Health, Guangzhou, China
| | - Jiaying Qiao
- Department of Epidemiology and Biostatistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Zhimeng Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Hanxi Zhang
- National Center of AIDS/STD Control and Prevention, Beijing, China
| | - Chengbo Zeng
- South Carolina SmartState Center of Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Cong Liu
- Department of Infectious Diseases, Guangzhou Number Eight People's Hospital, Guangzhou, China
| | - Yiran Li
- Department of Epidemiology and Biostatistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Mengting Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yu Zeng
- Department of Epidemiology and Biostatistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Frank J Penedo
- Department of Psychology, University of Miami, Coral Gables, FL, United States
- Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL, United States
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