Discount Factors that influence risk behavior in HIV infected women receiving antiretroviral therapy in Kampala and Masaka, Uganda.

Factors that influence risk behavior in HIV infected women receiving antiretroviral therapy in Kampala and Masaka, Uganda.

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This study 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<.05), possibly indicating that women engaging in sexual exchange for food are more likely to use condoms. Forced, coercive or survival sex was significantly associated with the number of meals missed per week due to lack of food (OR=1.130, 95% CI 1.125, 1.526, p<.005). In addition, married women compared to unmarried women were three times more likely to have experienced forced, coercive or survival sex (OR=2.911, 95% CI 1.234, 6.87, p<.05).;Because married women are considered to be relatively more economically stable, the findings that missing meals due to lack of food and married marital status are both associated with forced, coercive or survival sex, when adjusted for other

Factors that influence risk behavior in HIV infected women receiving antiretroviral therapy in Kampala and Masaka, Uganda.