Psychosocial correlates of inconsistent condom use among HIVinfected patients enrolled in a structured ART interruptions trial in Coˆ te d’Ivoire: results from the TRIVACAN trial (ANRS 1269)

International audienceobjective To investigate the relationship between unsafe sexual behaviours and poor self-perceivedhealth among people living with HIV and AIDS (PLWHA) in western Africa.methods In March 2006, a survey was conducted among patients continuing their participation in theTRIVACAN trial (ANRS 1269) in Coˆ te d’Ivoire, in which patients had been randomized to eithercontinuous or interrupted antiretroviral therapy (ART) (2-months-off ⁄ 4-months-on cycles [2 ⁄ 4-ART])after 6–18 months of continuous ART (C-ART). Socio-demographic and psychosocial information,including data on sexual behaviours during the previous 6 months, was collected using face-to-faceinterviews. Sexually active patients with either a steady partner (serodiscordant or of unknown HIVstatus) or casual partners were considered to have unsafe sexual behaviours if they reported inconsistentcondom use (ICU).results Seventy-seven of the 192 patients reported ICU. In multivariate logistic regression, men weresignificantly less likely to report ICU than women (OR [95% CI] = 0.45 [0.20–0.98]). After adjustment foreducational level and reduced sexual activity since ART initiation, concealment of HIV status (2.08 [1.02–4.25]) and poor self-perceived health (2.32 [0.97–5.52]) were independently associated with ICU.conclusion HIV prevention strategies in resource-limited settings should take into account self-perceivedhealth and difficulties to disclose HIV status. Counselling interventions need to be developed tohelp PLWHA to adopt or negotiate safe behaviours respecting their individual cultures