Risk behaviour of HIV positive individuals who are aware of their serostatus: evidence from the 2012 HIV Population-based Household Survey in South Africa

HIV positive people are the main source of new infections, which occur mainly through risk behaviours with a high-risk partner. Awareness of HIV status has been proposed as a key factor underlying sexual and HIV risk behaviour. This study sought to determine whether awareness of one's HIV positive status translates to reduced sexual risk behaviour among HIV positive individuals. The analysis was based on the 2012 South African National HIV Prevalence, Incidence and Behaviour Survey, which included socio-demographic characteristics, age at sexual debut, age disparate partnerships, multiple sexual partners, condom use at last sex, self-perceived risk of HIV infection and alcohol use. Bivariate and multivariate logistic regression was used to assess sexual and HIV risk behavioural factors associated with awareness of HIV status. Of 2565 HIV positive individuals, 48.3% reported that they were aware of their HIV status while the remainder indicated they were aware not aware of their HIV status. HIV positive females were more likely to report that they knew their status than their male counterparts [OR=1.6 (95% CI: 1.0-2.7), p=0.049]. Knowing that one was HIV positive was associated with increased likelihood of condom at last sex [OR=1.5 (95% CI: 1.1-2.0), p=0.010], low risk perception of HIV infection ([OR=0.7 (95% CI: 0.5-0.9), p=0.011], and reduced likelihood of risky/hazardous drinking of alcohol among males [OR=0.3 (95% CI: 0.2-0.6), p<0.001]. The current findings confirm that gaining knowledge of one's own HIV status is key to adopting HIV prevention behaviours. Given the large number of people living with HIV/AIDS in South Africa more efforts should be made to promote positive prevention programmes.