Sexual risk after HIV diagnosis: a comparison of pre-ART individuals with CD4>500 cells/ul and ART-eligible individuals in a HIV treatment and care programme in rural KwaZulu-Natal, South Africa

Little is known about people diagnosed as HIV-positive who access HIV care early in their disease. This cross-sectional study compared individuals presenting for HIV care. Baseline characteristics were contrasted between the two groups and logistic regression models used to explore group differences in: (a) being sexually active in the last month; (b) disclosure of HIV status to current partner; (c) knowing the HIV status of one's current partner; and (d) condom use at last sex. Reported sexual risk behaviours by pre-ART individuals suggest a continued risk of onward HIV transmission. There is a need for positive prevention efforts to target this group given that current treatment guidelines do not provide them with ART. Strengthening support regarding disclosure, partner HIV testing and consistent condom use, and further promotion of HIV testing in the community to assist earlier diagnosis are urgently required.