Official websites use. Share sensitive information only on official, secure websites. Address for correspondence and reprint requests: R. The objective of this study was to test the hypothesis that sexual risk behaviour would increase following initiation of antiretroviral therapy ART in Kenyan female sex workers FSWs. Participants received sexual risk reduction education and free condoms at every visit.
Outcomes were evaluated at monthly follow-up visits using a one week recall interval. There was a non-significant decrease in abstinence AOR 0. Numbers of sex partners and frequency of sex were similar before versus after starting ART. A trend for decreased sexually transmitted infections following ART initiation provides additional support for the validity of the self-reported behavioural outcomes AOR 0. In the setting of ongoing risk reduction education and provision of free condoms, initiation of ART was not associated with increased sexual risk behaviour in this cohort of Kenyan FSWs.
Keywords: Antiretroviral therapy, sexual risk behaviour, human immunodeficiency virus type 1, sexually transmitted infection, Africa. Increased access to antiretroviral therapy ART in resource limited settings has improved the health and survival of millions of people [ 1 ].
Because individuals with low plasma viral load may be less infectious [ 2 ], widespread use of ART might also influence the course of the global HIV-1 epidemic [ 3 ]. However, the net effect of the ART rollout on global HIV-1 epidemiology will also depend on long-term effects of treatment on sexual risk behaviour [ 4 ].
Ninety percent of people infected with HIV-1 live in developing countries [ 1 ], but few studies have examined sexual risk behaviour after ART initiation in these settings. A key finding of a systematic review was the lack of data on this topic [ 5 ]; only three studies were identified. Few prospective studies have been published since the review. In Kenyan and South African adults, unprotected intercourse was less frequently reported one year after ART initiation compared to baseline [ 9 , 10 ].
