Paper # 136
Knowledge of Partner HIV Status and Consistent Condom Use among HIV+ Individuals Attending Clinical Care in Tanzania, Kenya, and Namibia
Pamela Bachanas*1, A Medley1, D Kidder1, S Flores1, J Zhang1, M Sheriff2, N Deluca3, G Antelman4, O Muhenje5, A Wadud6, and PwP Study Team
1CDC, Atlanta, GA, US; 2Intl Ctr for AIDS Care and Treatment Prgms, Nairobi, Kenya; 3CDC, Windhoek, Namibia; 4Intl Ctr for AIDS Care and Treatment Prgms, Dar es Salaam, Tanzania; 5CDC, Nairobi, Kenya; and 6CDC, Dar es Salaam, Tanzania
Background: HIV discordance within couples or partners
in Sub-Saharan Africa is common but condom use is low. This places the negative
partner at high risk for HIV. We describe whether knowledge of partner’s status
is associated with consistent condom use among people living with HIV (PLWH)
and assess differences by gender.
Methods: In a group randomized control trial, we
randomly assigned to intervention or control arms 18 care and treatment clinics
in Kenya, Namibia, and Tanzania (6 per country). At baseline, approximately 200
sexually active HIV+ patients from each clinic were administered a
structured questionnaire. A multi-variable logistic regression model adjusted
for age, gender, partner type, and country was used to examine predictors of
consistent condom use.
Results: A total of 3546 HIV+
patients (42% male, 61% on treatment) were enrolled. Overall, 70% of patients
reported their partner had been tested for HIV. Most (96%) whose partner had
been tested knew the partner’s HIV status. Of those who did, 72% reported their
partner was HIV+. Women were less likely to report having a positive
partner (AOR: 0.46, 95%C 0.38 to 0.55). In the past 90 days, 77% of
participants reported consistent condom use: 85% with HIV–
partners, 80% with HIV+ partners, and 66% with partners of unknown
status. Participants were more likely to report consistent condom use with an
HIV– partner than an HIV+ partner (AOR 1.88, 95%CI 1.40
to 2.54) or partner of unknown status (AOR 4.18, 95%CI 3.06 to 5.75). Men whose
partner was HIV– were significantly more likely to report consistent
condom use than women (AOR 2.72, 95%CI 1.58 to 4.65).
Conclusions: Although the majority of
participants reported their partner had been HIV tested, 30% still did not know
their partner’s status and 28% reported being in a relationship with an HIV–
partner. Consistent condom use was more likely when PLWHIV knew their partners
were HIV–. Of concern is the low frequency of condom use reported
with partners of unknown status. These findings highlight the need to integrate
partner/couples HIV testing and counseling services into routine care offered
to PLWHIV. This is especially important for women as they are more likely to
report having a partner of negative or unknown HIV status and less likely to report
consistent condom use regardless of the HIV status of their partner.
|
