Master of Sciences, Case Western Reserve University, 2009, Epidemiology and Biostatistics

Understanding sexual behaviors of persons on Antiretroviral therapy(ART) is critical designing and implementation of positive prevention programs. 559 HIV infected adults were enrolled in clinic based prospective observational study and sexual behaviors ascertained at ART initiation and semi-annually thereafter. Using Logistic regression with generalized estimating equations, factors associated with sexual activity and unprotected sex were examined. Over the first three years of ART, the proportion sexually active did not change at ~52% (χ2 Trend, p=0.94) while the proportion reporting unprotected sex decreased (χ2 Trend, p<0.0001). Men reported unprotected sex less often than women (p<0.0001). In all analyses, having no children and female gender (controlling for any other factors) was associated with the practice of unprotected sex. The interventional effect of comprehensive HIV care resulted in marked reductions in unprotected sex particularly among men. Strengthening of positive prevention interventions, especially among females are needed in ART programs in this setting.

Committee: Ajay Sethi Phd,MHS (Committee Chair); Christopher Whalen MD, MS (Committee Member); Jeffrey Albert Phd (Committee Member) Subjects: Biostatistics; Epidemiology; Health; Health Care; Virology