Condom use consistency among South African HIV serodiscordant couples following an HIV risk-reduction intervention

Abstract

Background: Although there are several ways to transmit HIV, condomless sex remains the primary mode in sub-Saharan Africa, including South Africa, with KwaZulu-Natal Province being one of the epicentres of HIV infection. This study explored the use of condoms in serodiscordant couples who were exposed to an HIV-risk reduction intervention that aimed to improve condom use and reduce the spread of HIV. Methods: A Total of 30 couples completed a paper-based questionnaire on their demographics and general health at baseline and 3 months, plus a semi-structured questionnaire with four domains. An analysis of HIV knowledge, condom use, condom use attitudes and protection perceptions about how other serodiscordant couples behave was conducted following a 12-week HIV risk reduction intervention. Participants were randomised 2:1 into intervention and control groups. Results: Condom use increased from 55% at baseline to 73.7% ( p = .0047) at 3 months for the intervention group and condom use in the last 7 days increased from 53% to 86% ( p = .0117). For the control group, condom use remained low at the 3 months follow up period ( p = .625). HIV knowledge improved significantly from baseline to 3 months for the intervention group ( p < .0001), as well as the control group ( p = .0005). Negative HIV condom use attitude scores in both groups decreased significantly from baseline to 3 months; intervention group ( p = .0059) and control group ( p = .0007). Conclusion: HIV knowledge and condom use improved significantly, while negative condom use attitudes and HIV protection perceptions decreased significantly following exposure to a risk-reduction intervention, suggesting that HIV preventive interventions should focus on partnership interventions.