Living serodiscordantly in Papua New Guinea: sexual practices of HIV-positive people on ART by serostatus of regular heterosexual partner

Abstract

This paper examines condom use in intimate relationships amongst Papua New Guineans on antiretroviral therapy (ART). These findings are from a mixed-method study in six provinces throughout Papua New Guinea (PNG). A total of 374 HIV-positive adult Papua New Guineans, over the age of 16 and on ART for more than two weeks were recruited using a non-probability, convenience sampling methodology. Participants were recruited through ART prescribing sites, People Living with HIV/AIDS (PLWHA) drop-in clinics and support groups. A small number (36) also participated in in-depth interviews.

Of the sample 226 (60.4%) were women and 148 (39.6%) were men. The majority of the sample was aged below 40 years, with a median age of 30 years. Of the sample who were in a regular relationship 64.7% identified themselves as being in a relationship where both they and their partner were HIV-positive (seroconcordant). Smaller proportions (21.0%) reported being in a relationship with a HIV-negative partner (serodiscordant), or in a relationship where they were not aware of their partner's HIV status (14.3%). The majority of participants who reported having a regular partner also reported having disclosed their HIV serostatus to their partner (91.8%). A significantly greater proportion of participants who reported being in relationships where they did not know the status of their partner, also reported living in the Southern Region of PNG (52.9%), while the majority of those in seroconcordant relationships lived in the Highlands Region (71.2%). There did not appear to be any differences in sexual practice of using condoms between the three groups. Knowledge of serostatus is important for “positive prevention”.

Keywords:

• HIV
• Papua New Guinea
• serostatus
• heterosexual
• sexual relationships

Acknowledgements

We would like to thank the National AIDS Council of PNG who with the financial support of the Government of Australia funded this study. To the participants and health care workers who participated and helped with recruitment thank you for your time and energy.

Notes

1. All people in this study self-identified that they were HIV-positive and on ART. No medical records were cross-checked but all people were recruited through HIV-related sites and networks.

2. Although the HIV status of a person's partner here is self-reported and may not be clinically accurate what is important is what the person already diagnosed with HIV thinks they know of their partner's status and how this does or does not affect sexual practice.