Factors Related To The Adoption Of Risk Reducing Behavior For Hiv In Women

Author : Ellen W. MacLachlan
Publisher :
ISBN 13 :
Total Pages : 318 pages
Book Rating : 4.:/5 (191 download)

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Download or read book Factors that Influence Risk Behavior in HIV Infected Women Receiving Antiretroviral Therapy in Kampala and Masaka, Uganda written by Ellen W. MacLachlan and published by . This book was released on 2008 with total page 318 pages. Available in PDF, EPUB and Kindle. Book excerpt: Women living in sub-Saharan Africa are more affected by HIV/AIDS than any other population in the world. Two-thirds of all new HIV infections worldwide occur in sub-Saharan Africa and over 60% of these infections are in women. Indeed, 70% of all women globally who are infected with HIV reside in this region (UNAIDS, 2006). If women are already infected with HIV, unprotected sex puts them at risk of transmitting the virus to a partner or to an unborn child. It also puts them at risk of becoming superinfected with different HIV strains, including HIV strains that are already resistant to HIV drugs (Little et al., 1999; Hecht et al., 1998; Flaks, Burman, Gourley, Rietmeijer, Cohn, 2003; Kozal et al., 2006). HIV infected women also need to be concerned with adherence to their antiretroviral therapy (ART) regimen. Lack of adherence to drug regimens puts women at risk of poor HIV treatment outcomes such as drug resistance (Chesney, 2003). When used consistently and correctly, male condoms are the most effective method of protection against HIV for sexually active persons (Stone, Timyan, Thomas,1999). Women, however, may be unable to negotiate the use of a male condom because strong gender-based power differentials and conservative social and cultural norms often make this decision completely up to a man (Gupta, 2002; Cohen, 2004). The constraints on a woman's ability to reduce her risk have led to concerns about the use of individual based models for HIV/AIDS behavior in women. These models often fail to acknowledge the relationship factors and the social, cultural and economic contexts that influence women's behavior. These concerns with inadequate models of HIV risk reduction for women have resulted in the publication of numerous articles proposing social-structural, also referred to as structural and environmental, models of HIV/AIDS risk reduction for women (Parker et al., 2002; O'Leary & Martins, 2000; Parker et al., 2000; Sumartojo,2000; Sweat & Denison, 1995; Decosas, 1996; Farmer, 2003; Turshen, 1998; Tawil et al., 1995; Lurie et al., 2004). This study, therefore, sought to use social-structural variables in exploring women's HIV-related risk behaviors in a sub-Saharan Africa setting, Uganda, in East Africa. Although much is known about structural and environmental approaches to HIV prevention among HIV negative women, little is known about the potential application of this approach to studying sexual risk behaviors and adherence to ART among HIV infected women. The overall aim of the study was to examine associations between social-structural variables (e.g., poverty, gender power dynamics) and two outcome variables: history of unprotected sex and self-reported adherence to ART among HIV infected women enrolled in drug therapy programs. Data were collected using structured interviews with 377 HIV infected women in four different HIV/AIDS treatment programs in Kampala and Masaka, Uganda. A major finding of the study was that few women in the sample were sexually active(34%), partly due to the high proportion of non-sexually active widows (49%). The majority of sexually active women reported condom use at last sex act (75%) and disclosure of their HIV status to a main partner (78%). In multivariate analysis condom use at last sex act was strongly predicted by the need to borrow food to survive (OR=5.440, 95% CI 1.237, 23.923, p