Changes in Risk Behavior Among HIV-Positive Patients During Their First Year of Antiretroviral Therapy in Cape Town South Africa

Abstract
We explore changes in sexual risk behaviour over the first year of antiretroviral therapy (ART) among a cohort of patients in Cape Town South Africa initiating treatment in five public facilities in 2006 and again 1 year later (Time 1 and Time 2). Contemporaneous measures of unprotected sex were also obtained from 2 cross-sectional samples of HIV-positive patients waiting to start ART attending the same facilities. Unprotected sex at last sex among patients on ART decreased significantly from a baseline of 44.7–23.2% one year later, regardless of partner status. After controlling for confounding factors, the observed decrease in unprotected sex among the ART cohort was highly significant in relation to the 2 cross-sectional samples of patients at Time 1 and Time 2 waiting to initiate ART. Findings suggest it is critical to start positive prevention to decrease risky sexual behavior prior to the start of ART within this setting.