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Sexual risk behaviour, marriage and ART: a study of HIV-positive people in Papua New Guinea

Wing Young Nicola Man12, Angela Kelly13*, Heather Worth1, Andrew Frankland1, Patti Shih1, Martha Kupul3, Thiri Lwin1, Agnes Mek3, Barbara Kepa3, Rebecca Emori3, Frances Akuani3, Brenda Cangah3, Lucy Walizopa3, Lawrencia Pirpir3, Somu Nosi3 and Peter M Siba3

Author Affiliations

1 School of Public Health and Community Medicine, UNSW Medicine, University of New South Wales, Sydney, Australia

2 Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia

3 Sexual & Reproductive Health Unit, Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea

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AIDS Research and Therapy 2013, 10:17  doi:10.1186/1742-6405-10-17

Published: 27 June 2013



The prevention of intimate partner transmission of HIV remains an important component of comprehensive HIV prevention strategies. In this paper we examine the sexual practices of people living with HIV on antiretroviral therapy (ART) in Papua New Guinea (PNG).


In 2008, a total of 374 HIV-positive people over the age of 16 and on ART for more than two weeks were recruited using a non-probability, convenience sampling methodology. This accounted for around 18% of adults on ART at the time. A further 36 people participated in semi-structured interviews. All interviews were thematically analysed using NVivo qualitative data analysis software.


Less than forty per cent (38%) of participants reported having had sexual intercourse in the six months prior to the survey. Marital status was by far the most important factor in determining sexual activity, but consistent condom use during vaginal intercourse with a regular partner was low. Only 46% reported consistent condom use during vaginal intercourse with a regular partner in the last six months, despite 77% of all participants reporting that consistent condom use can prevent HIV transmission. Consistent condom use was lowest amongst married couples and those in seroconcordant relationships. The vast majority (91.8%) of all participants with a regular heterosexual partner had disclosed their status to their partner. Qualitative data reinforced low rates of sexual activity and provided important insights into sexual abstinence and condom use.


Considering the importance of intimate partner transmission of HIV, these results on the sexual practices of people with HIV on ART in PNG suggest that one-dimensional HIV prevention messages focussing solely on condom use fail to account for the current practices and needs of HIV-positive people, especially those who are married and know their partners’ HIV status.

HIV; Papua New Guinea; Sexual Behaviour; Antiretroviral Therapy