Indian J Sex Transm Dis Indian J Sex Transm Dis
Official Publication of the Indian Association for the Study of Sexually Transmitted Diseases
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  Table of Contents  
Year : 2022  |  Volume : 43  |  Issue : 2  |  Page : 223-224

High-risk behavioral tendencies in human immunodeficiency virus-positive patients on antiretroviral therapy: A 5-year retrospective study from a tertiary care center

Department of Dermatology and Venereology, Government Medical College, Trivandrum, Kerala, India

Date of Submission24-Jun-2022
Date of Decision13-Jul-2022
Date of Acceptance30-Jul-2022
Date of Web Publication17-Nov-2022

Correspondence Address:
Dr. S Pradeep Nair
Department of Dermatology and Venereology, Government Medical College, Trivandrum -695 011, Kerala
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijstd.ijstd_63_22

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How to cite this article:
Nair S P. High-risk behavioral tendencies in human immunodeficiency virus-positive patients on antiretroviral therapy: A 5-year retrospective study from a tertiary care center. Indian J Sex Transm Dis 2022;43:223-4

How to cite this URL:
Nair S P. High-risk behavioral tendencies in human immunodeficiency virus-positive patients on antiretroviral therapy: A 5-year retrospective study from a tertiary care center. Indian J Sex Transm Dis [serial online] 2022 [cited 2023 Nov 30];43:223-4. Available from:


Human immunodeficiency virus (HIV) infection is now considered a chronic manageable disease due to the availability of antiretroviral therapy (ART), and these patients have now almost a normal life span like the general population, thus encouraging some of them to indulge in high-risk behavior.[1]

This is a 5-year retrospective, descriptive study done in a tertiary care center. We analyzed all the HIV-positive cases in the study period with special reference to their high-risk behavior after starting ART. The data were analyzed by descriptive statistics with ethical considerations. There were a total of 21 cases currently on ART (n = 21). There were 19 males (90.47%) and 2 females (9.53%). The mean age was 26.78 years. The most common age group was 21–30 years (13, 61.90%). Eight cases (38.09%) were married, and in five cases (23.81%), the spouse was also HIV positive. 12 cases (57.14%, n = 12) were males and had unprotected multiple contacts while on ART, while 9 cases (42.86%) denied any contact other than marital contact [Figure 1]. 4 (19.04%) had Men Sex Men (MSM) contact with known partners; they were the active partners and had both anal and oral contacts. 4 (19.04%) had contact with sex workers and had vaginal, anal, and oral contacts. 7 cases (58.33%) who had high-risk contacts had sexually transmitted infections (STIs) also, the pattern of which is given in [Figure 1]. All the 12 cases who indulged in high-risk contacts were counseled previously regarding the practice of safe sex and usage of condoms.
Figure 1: Source and types of contact and pattern of sexually transmitted infections. MSM: Mene sex Menale, Others includes marital and known partners (n = 12)

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The habit of high-risk behavior while on ART recently being encountered is a very disturbing and dangerous trend.[2] This trend had also been encountered during the COVID pandemic in western countries where high-risk unprotected contacts were seen in the MSM population where the excuse was the unavailability of pre- and post-exposure prophylaxis drugs due to the closure of these clinics due to the pandemic.[3],[4] In the present study, the cohort who indulged in high-risk contacts even after counseling shows the absolute no care attitude or even ineffective counseling. They should also be informed that unprotected contacts while on ART can also enhance transmission of drug-resistant viral strains. These group of people also may require psychiatric counseling as some of them may deliberately indulging in high-risk behavior for the sole purpose of infecting others.[5] This study may be only the tip of the iceberg. HIV-positive patients on ART indulging in high-risk behavior form a major stumbling block for the national control programs. Counseling must be more vigorous and thorough for these exclusive groups of people, and the process of counseling must be restructured for them. This present study is only a preliminary observation and a small study. However, this study has been an an eye-opener where, in a cohort of HIV cases, many of themwere still indulging in high risk contacts while on ART therapy The main objective of this small study is to encourage venereologists to conduct similar studies in STI clinics all over India so that the true pattern of HIV patients who indulge in high-risk contacts while still on ART can be ascertained and whether it forms a hurdle to national HIV control programs.

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There are no conflicts of interest.

   References Top

Patel VV, Mayer KH, Makadon HJ. Men who have sex with men in India: A diverse population in need of medical attention. Indian J Med Res 2012;136:563-70.  Back to cited text no. 1
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Choudhry S, Ramachandran VG, Das S, Bhattacharya SN, Mogha NS. Characterization of patients with multiple sexually transmitted infections: A hospital-based survey. Indian J Sex Transm Dis AIDS 2010;31:87-91.  Back to cited text no. 2
Sherafat A, Ashraf MA, Vosough K, Cruickshank T, Shirani K. TB and HIV surveillance amid COVID-19 pandemic. Indian J Sex Transm Dis AIDS 2022;43:85-6.  Back to cited text no. 3
Keane A, Regan SO, Quinn L, Murphy D, Kelly BO, Lynam A, et al. Evaluation of the impact of human immunodeficiency virus pre-exposure prophylaxis on new human immunodeficiency virus diagnoses during the COVID-19 pandemic. Int J STD AIDS 2022;33:99-102.  Back to cited text no. 4
Singh S, Singh SK. Psychological health and well-being in patients with sexually transmitted infections: A prospective cross-sectional study. Indian J Sex Transm Dis AIDS 2021;42:125-31.  Back to cited text no. 5


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