Predictors of Sexual Behavior and Risk Practices of HIV-Positive Rwandan Women Survivors of Genocidal and Non-Genocidal Rape

Adebola Adedimeji, Albert Einstein College of Medicine

The sexual behavior of HIV-infected women especially unprotected sex carries the risk of new infections with potentially drug-resistant strains of HIV and huge implications for quality of life. We describe sexual practices of HIV-positive women survivors of genocidal and non-genocidal rape using longitudinal data from Rwandan Women Inter-association Study and Assessment. Univariate and multivariate logistic regression models were fit to describe sexual practices and demographic and clinical characteristics influencing risk behaviors. Previous experience of genocidal sexual violence was associated with high-risk sexual behaviors. Rape survivors were twice as likely to engage in transactional sex and report prior infection with a non-HIV STI. Younger women living with a husband or partner were more sexually active, while viral load was the strongest predictor of condom use. HIV-positive women with a history of sexual violence in the contexts of war and conflict may be susceptible to high-risk sexual behaviors that deserve attention.