Determinants of Inconsistent Condom Use among HIV Serodiscordant Couples in Cambodia

Sovannary Tuot^{1, 2,} , Khuondyla Pal¹, Kouland Thin¹, Pheak Chhoun¹, Chanrith Ngin¹, Mengieng Ung³, Kolab Chhim⁴, Chrysanta Patio⁵, Kelly Allbritton⁵, Christie Blondek⁵, Gitau Mburu^{6, 7} and Siyan Yi^{1, 5}

¹KHANA Center for Population Health Research, Cambodia

²Royal University of Phnom Penh, Cambodia

³Department of Geography, Western University, Canada

⁴HIV/AIDS Flagship Project, KHANA, Cambodia

⁵Center for Global Health Research, Touro University California, USA

⁶International HIV/AIDS Alliance, UK

⁷Division of Health Research, Lancaster University, UK

Cite this paper:
Sovannary Tuot, Khuondyla Pal, Kouland Thin, Pheak Chhoun, Chanrith Ngin, Mengieng Ung, Kolab Chhim, Chrysanta Patio, Kelly Allbritton, Christie Blondek, Gitau Mburu and Siyan Yi. Determinants of Inconsistent Condom Use among HIV Serodiscordant Couples in Cambodia. American Journal of Public Health Research. 2016; 4(2):69-74. doi: 10.12691/ajphr-4-2-5

Abstract

Background: Globally, heterosexual transmission within serodiscordant relationships is a significant source of new HIV infections. In 2012, there were an estimated 1,350 incident cases of HIV in Cambodia, of which 37% were between heterosexual couples and 30% among sex workers. In combination with antiretroviral therapy (ART), consistent condom use can significantly reduce HIV transmission risk among serodiscordant couples. This study explored determinants of inconsistent condom use among serodiscordant couples in Cambodia. Methods: A cross-sectional study was conducted in Battambang, Pursat and Takeo provinces in September 2013. A structured questionnaire was used to collect data on condom use and other HIV-related risk behaviors from HIV-positive partners of 262 serodiscordant couples. A two-stage cluster sampling method was used to randomly select participants from a list of serodiscordant couples who were receiving care and support services from community-based organizations in the selected sites. Multivariate logistic regression analysis was conducted to identify factors associated with inconsistent condom use. Results: In total, 239 respondents were included in the analysis with a mean age of 41.6 years [standard deviation (SD) = 6.7 years], of whom 60.2% were male and 80.3% were consistent condom users. The mean duration of living in the serodiscordant relationship was 13.4 years (SD = 7.8 years). After controlling for other covariates, inconsistent condom users were significantly more likely to be female (OR = 2.8; 95% CI = 1.261, 6.462), to have been living in a shorter HIV serodiscordant relationship (OR = 0.89; 95% CI = 0.902, 0.998), and to be frequent alcohol users (OR = 2.9; 95% CI = 1.323, 6.483). In addition, inconsistent condom users were significantly more likely to agree that ART prevents transmission of HIV (OR = 2.7; 95% CI = 1.344, 5.443). Conclusions: Gender-sensitive interventions to promote consistent condom use and to mitigate alcohol-associated risky sexual behaviors, especially unprotected sex, should form part of HIV prevention interventions for serodiscordant couples in addition to early ART initiation. Further research is required to explore the role of pre-exposure prophylaxis among this population.

Keywords:
HIV AIDS condom use determinants serodiscordant couples Cambodia

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