Does antiretroviral therapy initiation increase sexual risk taking in Kenyan female sex workers? A retrospective case-control study.

Mawji, Elysha; McKinnon, Lyle; Wachihi, Charles; Chege, Duncan; Thottingal, Paul; Kariri, Anthony; Plummer, Francis; Ball, T Blake et al. · BMJ Open · 2012

case_control · Level III

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Abstract

Although antiretroviral therapy (ART) prolongs life and reduces infectiousness, in some contexts, it has been associated with increased sexual risk taking. Retrospective case-control study. Nairobi-based dedicated female sex worker (FSW) clinic. HIV-infected FSWs before and after ART initiation (n=62); HIV-infected and -uninfected control FSWs not starting ART during the same follow-up period (n=40). Initiation of ART. Self-reported condom use, client numbers and sexually transmitted infection incidence over the study period (before and after ART initiation in cases). Sexual risk-taking behaviour with casual clients did not increase after ART initiation; condom use increased and sexually transmitted infection incidence decreased in both cases and controls, likely due to successful cohort-wide HIV prevention efforts. ART provision was not associated with increases in unsafe sex in this FSW population.