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dc.contributor.authorKembabazi, Anneten_US
dc.contributor.authorBajunirwe, Francisen_US
dc.contributor.authorHunt, Peter W.en_US
dc.contributor.authorMartin, Jeffrey N.en_US
dc.contributor.authorMuzoora, Conraden_US
dc.contributor.authorHaberer, Jessica E.en_US
dc.contributor.authorBangsberg, David R.en_US
dc.contributor.authorSiedner, Mark J.en_US
dc.date.accessioned2014-02-18T18:10:46Z
dc.date.issued2013en_US
dc.identifier.citationKembabazi, Annet, Francis Bajunirwe, Peter W. Hunt, Jeffrey N. Martin, Conrad Muzoora, Jessica E. Haberer, David R. Bangsberg, and Mark J. Siedner. 2013. “Disinhibition in Risky Sexual Behavior in Men, but Not Women, during Four Years of Antiretroviral Therapy in Rural, Southwestern Uganda.” PLoS ONE 8 (7): e69634. doi:10.1371/journal.pone.0069634. http://dx.doi.org/10.1371/journal.pone.0069634.en
dc.identifier.issn1932-6203en
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:11717514
dc.description.abstractBackground: In resource-rich areas, risky sexual behavior (RSB) largely diminishes after initiation of anti-retroviral therapy, with notable exceptions among some populations who perceive a protected benefit from anti-retroviral therapy (ART). Yet, there is limited data about long-term trends in risky sexual behavior among HIV-infected people in sub-Saharan Africa after initiation of anti-retroviral therapy. Methods: We administered questionnaires every three months to collect sexual behavior data among patients taking ART in southwestern Uganda over four years of follow-up time. We defined RSB as having unprotected sex with an HIV-negative or unknown status partner, or unprotected sex with a casual partner. We fit logistic regression models to estimate changes in RSB by time on ART, with and without adjustment for calendar year and CD4 count. Results: 506 participants were enrolled between 2005 and 2011 and contributed a median of 13 visits and 3.5 years of observation time. The majority were female (70%) and median age was 34 years (interquartile range 29–39). There was a decrease in the proportion of men reporting RSB from the pre-ART visit to the first post-ART visit (16.2 to 4.3%, p<0.01) but not women (14.1 to 13.3%, p = 0.80). With each year of ART, women reported decreasing RSB (OR 0.85 per year, 95%CI 0.74–0.98, p = 0.03). In contrast, men had increasing odds of reporting RSB with each year of ART to near pre-treatment rates (OR 1.41, 95%CI 1.14–1.74, p = 0.001), which was partially confounded by changes in calendar time and CD4 count (AOR = 1.24, 95%CI 0.92–1.67, p = 0.16). Conclusions: Men in southwestern Uganda reported increasing RSB over four years on ART, to levels approaching pre-treatment rates. Strategies to promote long-term safe sex practices targeted to HIV-infected men on ART might have a significant impact on preventing HIV transmission in this setting.en
dc.language.isoen_USen
dc.publisherPublic Library of Scienceen
dc.relation.isversionofdoi:10.1371/journal.pone.0069634en
dc.relation.hasversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC3716596/pdf/en
dash.licenseLAAen_US
dc.subjectBiologyen
dc.subjectPopulation Biologyen
dc.subjectEpidemiologyen
dc.subjectInfectious Disease Epidemiologyen
dc.subjectMedicineen
dc.subjectGlobal Healthen
dc.subjectInfectious Diseasesen
dc.subjectSexually Transmitted Diseasesen
dc.subjectAIDSen
dc.subjectViral Diseasesen
dc.subjectHIVen
dc.subjectHIV epidemiologyen
dc.subjectHIV preventionen
dc.subjectInfectious Disease Controlen
dc.subjectPublic Healthen
dc.subjectBehavioral and Social Aspects of Healthen
dc.subjectSocial and Behavioral Sciencesen
dc.subjectSociologyen
dc.subjectSexual and Gender Issuesen
dc.subjectVeterinary Scienceen
dc.subjectAnimal Managementen
dc.subjectAnimal Behavioren
dc.subjectSexual Behavioren
dc.titleDisinhibition in Risky Sexual Behavior in Men, but Not Women, during Four Years of Antiretroviral Therapy in Rural, Southwestern Ugandaen
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden
dc.relation.journalPLoS ONEen
dash.depositing.authorBangsberg, David R.en_US
dc.date.available2014-02-18T18:10:46Z
dc.identifier.doi10.1371/journal.pone.0069634*
dash.contributor.affiliatedSiedner, Mark
dash.contributor.affiliatedBangsberg, David R.


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