Sexual behaviour and HIV sero-discordance among HIV patients receiving HAART in rural Uganda.

Globally, HIV sero-discordance is a major public health problem, due to increased risk of HIV transmission to HIV-negative partners. From January to August 2009, we assessed the sexual behaviour of HIV-infected patients attending an HIV treatment centre in Uganda and analysed characteristics associated with HIV sero-discordance. Of the 278 respondents, 256 (92.1%) were female, 218 (78.1%) were on antiretroviral drugs and 107 (38.7%) belonged to a sero-discordant couple. In the prior 3 months, 238 (88.5%) had more than one sexual partner and 98 (35.8%) had acquired new sexual partners. Only 171 (61.5%) had ever disclosed sero-status to main sexual partners. Participants who had changed sexual partners in the previous 3 months were more likely to be sero-discordant (OR 1.87, 95% CI 1.13, 3.11). Respondents who used condoms during their last sexual intercourse and those currently on ARVs were significantly less likely to be sero-discordant (OR 0.52 95% CI 0.28, 0.96 and OR 0.52 95% CI 0.30, 0.94, respectively). Only disclosure of sero-status was independently though inversely associated with discordance (adjusted OR 0.41, 95% CI 0.20, 0.64). Our findings indicate that HIV patients continue exhibiting high risk behaviour characterised by changing sexual partners, having multiple sexual partners and non-use of condoms.

Reasons, methods used and decision-making for pregnancy termination among adolescents and older women in Mulago Hospital, Uganda.

OBJECTIVE: To explore the methods, reasons and decision-making process for termination of pregnancy among adolescents and older women, in Mulago hospital, Kampala, Uganda. DESIGN: Comparative study. SUBJECTS: Nine hundred and forty two women seeking postabortion care, of which 333 had induced abortion (of whom 115 were adolescents). SETTING: The emergency gynaecological ward of Mulago Hospital, Kampala, Uganda from September 2003 through June 2004. RESULTS: Women with induced abortion were single, in polygamous marital relationships and of lower parity (p<0.001); had lower education and number of living children (p<0.05), reported more (p<0.001) mistimed, unplanned or unwanted pregnancies, and were 13 times more likely to have recent history of domestic violence. Relationship issues were the most common reason for pregnancy termination for both categories. Decision-making for induced abortion was influenced by socio-economic, educational and personal considerations. Instrumentation and use of local herbs in the genitalia were the most common methods for pregnancy termination. Neither methods used for pregnancy termination nor reasons differed when adolescents were compared with older women. CONCLUSION: Relationship issues influence the decision-making process for pregnancy termination. Neither methods used for pregnancy termination nor reasons for pregnancy termination differ when adolescents are compared with older women.