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Sexual behavior of HIV discordant couples after HIV counseling and testing.

Publication ,  Journal Article
Allen, S; Meinzen-Derr, J; Kautzman, M; Zulu, I; Trask, S; Fideli, U; Musonda, R; Kasolo, F; Gao, F; Haworth, A
Published in: AIDS
March 28, 2003

BACKGROUND AND OBJECTIVES: Sexual behavior following voluntary HIV counseling and testing (VCT) is described in 963 cohabiting heterosexual couples with one HIV positive and one HIV negative partner ('discordant couples'). Biological markers were used to assess the validity of self-report. METHODS: Couples were recruited from a same-day VCT center in Lusaka, Zambia. Sexual exposures with and without condoms were recorded at 3-monthly intervals. Sperm detected on vaginal smears, pregnancy, and sexually transmitted diseases (STD) including HIV, gonorrhea, syphilis, and Trichomonas vaginalis were assessed. RESULTS: Less than 3% of couples reported current condom use prior to VCT. In the year after VCT, > 80% of reported acts of intercourse in discordant couples included condom use. Reporting 100% condom use was associated with 39-70% reductions in biological markers; however most intervals with reported unprotected sex were negative for all biological markers. Under-reporting was common: 50% of sperm and 32% of pregnancies and HIV transmissions were detected when couples had reported always using condoms. Positive laboratory tests for STD and reported extramarital sex were relatively infrequent. DNA sequencing confirmed that 87% of new HIV infections were acquired from the spouse. CONCLUSIONS: Joint VCT prompted sustained but imperfect condom use in HIV discordant couples. Biological markers were insensitive but provided evidence for a significant under-reporting of unprotected sex. Strategies that encourage truthful reporting of sexual behavior and sensitive biological markers of exposure are urgently needed. The impact of prevention programs should be assessed with both behavioral and biological measures.

Duke Scholars

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Published In

AIDS

DOI

ISSN

0269-9370

Publication Date

March 28, 2003

Volume

17

Issue

5

Start / End Page

733 / 740

Location

England

Related Subject Headings

  • Zambia
  • Virology
  • Truth Disclosure
  • Sexually Transmitted Diseases
  • Sexual Partners
  • Sexual Behavior
  • Risk Factors
  • Prospective Studies
  • Patient Compliance
  • Middle Aged
 

Citation

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Allen, S., Meinzen-Derr, J., Kautzman, M., Zulu, I., Trask, S., Fideli, U., … Haworth, A. (2003). Sexual behavior of HIV discordant couples after HIV counseling and testing. AIDS, 17(5), 733–740. https://doi.org/10.1097/00002030-200303280-00012
Allen, Susan, Jareen Meinzen-Derr, Michele Kautzman, Isaac Zulu, Stanley Trask, Ulgen Fideli, Rosemary Musonda, Francis Kasolo, Feng Gao, and Alan Haworth. “Sexual behavior of HIV discordant couples after HIV counseling and testing.AIDS 17, no. 5 (March 28, 2003): 733–40. https://doi.org/10.1097/00002030-200303280-00012.
Allen S, Meinzen-Derr J, Kautzman M, Zulu I, Trask S, Fideli U, et al. Sexual behavior of HIV discordant couples after HIV counseling and testing. AIDS. 2003 Mar 28;17(5):733–40.
Allen, Susan, et al. “Sexual behavior of HIV discordant couples after HIV counseling and testing.AIDS, vol. 17, no. 5, Mar. 2003, pp. 733–40. Pubmed, doi:10.1097/00002030-200303280-00012.
Allen S, Meinzen-Derr J, Kautzman M, Zulu I, Trask S, Fideli U, Musonda R, Kasolo F, Gao F, Haworth A. Sexual behavior of HIV discordant couples after HIV counseling and testing. AIDS. 2003 Mar 28;17(5):733–740.

Published In

AIDS

DOI

ISSN

0269-9370

Publication Date

March 28, 2003

Volume

17

Issue

5

Start / End Page

733 / 740

Location

England

Related Subject Headings

  • Zambia
  • Virology
  • Truth Disclosure
  • Sexually Transmitted Diseases
  • Sexual Partners
  • Sexual Behavior
  • Risk Factors
  • Prospective Studies
  • Patient Compliance
  • Middle Aged