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AIDS Care 20, 4 (2008) 413-8
Sexual prevention of HIV within the couple after prenatal HIV-testing in West Africa.
Hermann Brou ( ) 1, 2, Gérard Djohan 2, Renaud Becquet 3, 4, Gérard Allou 5, Didier K. Ekouevi 5, B. Zanou 2, Valériane Leroy 3, 4, Annabel Desgrees-Du-Loû 1
(04/2008)

The resumption of sexual activity after delivery is a key moment in the management of the risk of sexual HIV transmission within the couple for women who have been prenatally tested for HIV. In this study, we have investigated consistent condom use during the resumption of sexual activity and its evolution over time among women tested for HIV infection during pregnancy. We tested for HIV during pregnancy 546 HIV-infected and 393 HIV-negative women within the Ditrame Plus ANRS project in Abidjan; these women were followed-up for two years after delivery. Most HIV-negative women (96.7%) disclosed their HIV-test result to their partners, whereas only 45.6% of HIV-infected women did so (p<0.001). Partners of HIV-infected women were more likely to be tested for HIV before resuming sexual activity than partners of HIV-negative women (11.7% vs. 7.4%, p=0.054). Less than one third of both HIV-infected and HIV-negative women reported having systematically used condoms during the resumption of sexual activity. The proportions of HIV-infected and HIV-negative women having consistently used condoms were respectively 26.2% and 19.8% (p=0.193) at 3 months post-partum, 12.1% and 15.9% (p=0.139) at 12 months post-partum, and 8.4% and 10.6% (p=0.302) at 18 months post-partum. In our study, although women had been prenatally tested for HIV and properly counselled on the sexual risk of HIV transmission, male partners were not tested for HIV before the resumption of sexual activity after delivery, very few couples were using condoms systematically and condom use was decreasing over time.
1 :  Laboratoire Population-Environnement-Développement (LPED)
Institut de recherche pour le développement [IRD] – Université de Provence - Aix-Marseille I
2 :  Projet Ditrame Plus
ANRS – ENSEA
3 :  Institut de Santé Publique, d'Epidémiologie et de Développement (ISPED)
Université Victor Segalen - Bordeaux II
4 :  Epidémiologie, santé publique et développement
INSERM : U593 – IFR99 – Université Victor Segalen - Bordeaux II – ISPED
5 :  Ditrame Plus, Programme PAC-CI (ANRS 1201/1202)
ANRS – CHU Treichville
Sciences du Vivant/Santé publique et épidémiologie
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