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Behaviour
Original article
Condom use behaviour among people living with HIV: a seven-country community-based participatory research in the Asia-Pacific region
  1. Keshab Deuba1,
  2. Verena Kohlbrenner2,
  3. Sushil Koirala3,
  4. Anna Mia Ekström1,4
  5. for the CAT-S group
  1. 1 Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
  2. 2 Programme to Foster Innovation, Learning and Evidence in HIV and Health Programmes of German Development Cooperation, GIZ, Bonn, Germany
  3. 3 Asia Pacific Network of People Living with HIV/AIDS, Bangkok, Thailand
  4. 4 Department of Infectious Diseases, Huddinge, Karolinska University Hospital, Stockholm, Sweden
  1. Correspondence to Keshab Deuba, Department of Public Health Sciences, Widerströmska Huset, Stockholm S-171 77, Sweden; keshab.deuba{at}ki.se

Abstract

Objectives We examined the prevalence of inconsistent condom use and its correlates among people living with HIV (PLHIV) in the Asia-Pacific region.

Methods Between 1 October 2012 and 31 May 2013, a total of 7843 PLHIV aged 18–50 years were recruited using targeted and venue-based sampling in Bangladesh, Indonesia, Lao People’s Democratic Republic (PDR), Nepal, Pakistan, Philippines and Vietnam. Logistic regression was used to explore the association between condom use behaviour and demographics, social support, stigma and discrimination and various health-related variables.

Results Overall, 43% of 3827 PLHIV practised inconsistent condom use at sexual intercourse with their regular partner. An even higher proportion, 46% of 2044 PLHIV admitted that they practised unprotected sex with a casual partner. Participants from Lao PDR reported the lowest prevalence of inconsistent condom use for both regular and casual partners, while participants from the Philippines had the highest risk behaviour. Inconsistent condom use was significantly associated with belonging to a key population (drug user, sex worker or refugee subpopulation), not knowing that condoms are still needed if both partners are HIV positive, having a regular partner whose HIV status was either positive or unknown, having experienced physical assault and not receiving antiretroviral treatment.

Conclusions This large seven-country study highlights a high prevalence of inconsistent condom use among PLHIV in the Asia-Pacific region. In addition to knowledge-imparting interventions, the adoption and expansion of the ‘Test and Treat’ strategy could help to maximise the prevention benefits of antiretroviral treatment.

  • HIV infections/prevention and control
  • risk/taking

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

https://doi.org/10.1136/sextrans-2017-053263

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    Footnotes

    • Handling editor Sevgi O Aral

    • Contributors KD, VK, SK and AME conceived and designed the study. KD contributed to the management of the data for this study. KD and VK performed the statistical analyses and wrote the first draft of the article. All authors discussed the results, revised and commented on the article and agreed to it being submitted for publication.

    • Funding This study was funded by The Global Fund to Fight AIDS, Tuberculosis and Malaria round 10 regional grant. The funders had no role in study design or protocol development, data collection or analysis, report writing or the decision to publish this research data in a peer-reviewed article.

    • Competing interests None declared.

    • Ethics approval The study protocol was approved by the responsible research council of each country (Bangladesh Medical Research Council, Number: BMRC/NREC/2010-2013/1016; Indonesia: Atmajaya University, Number: 949/III/LPPM-PM.10.01/11/2012; Lao PDR: National Ethics Committee for Health Research at the Department of Hygiene and Diseases Control, Ministry of Health, Number: 63NECHR; Nepal Health Research Council, Number: 478; Pakistan: National Institution Bridge Consultants Foundation; Philippines: Department of Health Research Ethics Committee (DREC), Number: DREC201207; Vietnam: Ha Noi School of Public Health, Number: 128/2012/YTCC-HD3).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement The data underlying this study are third party data. Data are available from the Asia Pacific Network of People Living with HIV/AIDS for researchers who meet the criteria for access to confidential data. Data are from the CAT-S study. The authors do not have any special access privileges to these data. All the data and the translated tools will be available from the following address: Monitoring Access to Treatment in Asia, Website: http://www.apnmata.org. Sushil Koirala, Project Manager, Email: sushilkoirala@gmail.com, Tel: +662-2597488, Ocean Tower II, Unit 75-12, FL.15, Sukhumvit Road, Soi 21, Khlong Toei Nua, Watthana Bangkok, 10110 Thailand.

    • Collaborators CAT-S group: Asghar Satti, Association of People Living with HIV Pakistan; Basanta Chettri, National Association of PHILV Nepal; Jun Orena (Noel), Pinoy Plus Association Philippines; Khamla Thidavanh, Association of People Living with HIV/AIDS Lao People’s Democratic Republic; Laura Milette, Jaringan Gaya Warna Lentera (Jaringan GWL-INA), Indonesia; Mohammed Sharif, Ashar Alo Society Bangladesh; and Nguyen Hien, Vietnam Network of People Living with HIV.