Reported sexual risky behaviours among people receiving antiretroviral treatment: the case study of Kigoma/Ujiji municipality

Background: A lot has been invested in HIV prevention programmes globally, yet HIV infection continues to spread, although more slowly than before. Antiretroviral treatment has led into declining of morbidity and mortality from HIV disease and to improved wellbeing. It is of concern to see people who are on ART, who have experienced the infection first hand to continue practicing risky sexual behaviors. It is important, to know the motivations and forces that govern the decision to practice these behaviors among people who are on ART, so that to design effective interventions to reduce HIV transmission. Objectives: The main objective of this study was to explore, sexual risky behaviors among persons receiving ARVs in Kigoma/Ujiji municipality. Materials and Methods: A descriptive exploratory study design that aimed at in-depth collection of information from sexually-active adults on ART, targeting those attending Kigoma regional Hospital CTC in Kigoma/Ujiji municipality was employed. The study was conducted from mid June to end of July 2012. A purposive sampling technique was used to select appropriate participants to meet the objectives of the study. In-depth interviews were held with 14 (8 females, 6 males) sexually-active adults receiving ART, to understand sexual risky behaviors after initiation of treatment. Results: While almost all respondents except two, reported have managed to reduce sexual partners to maintain single sexual partner, more than a half of all respondents reported that they do not use condoms consistently. For both male and female respondents, a transition from multiple partners to a single regular partner began at the time of HIV testing and the resolve to stay with one partner was further strengthened by initiation of ART. A need for Materials support and inability to break the long standing relationship as claimed by some respondents seem to be a factor contributing to continue having multiple partners. This shows an existence of a gap in life skills experienced by these participants which need to be addressed by psycho-social counselors. Conclusions: As reported by respondents, there is inconsistent condom use, especially in stable relationships, some of which contain HIV discordant couples. Religious and culturalbarriers to condom use, and misconceptions about the harmful effects of condoms hindered their use. Among those reported inconsistent non-condom use, a desire for children was an important reason for not using condoms. The study suggests that there is a reported significant reduction in multiple concurrent sexual partners among people on ARVs, to a small extent, an increase in condom use around the time of HIV diagnosis. While disclosure of HIV status appeared to support condom use, this does not always predict protected sex. Recommendations: The study recommends that in-depth psycho-social long term client-or couple focused counseling should be used to identify, explore and address deep rooted psycho-social barriers to sexual risky behavioral change