Introduction: The South African public health system plays an important role in the delivery of HIV testing and treatment\nservices. The health system is also an important conduit for targeted behaviour change communication with\nthe expectation that clients who undergo counselling from health personnel, adopt safer sexual practices. Literature\nremains mixed on the impact these HIV services have on risky sexual behaviour. This analysis examines the sexual\nbehaviour of clients following the utilisation of HIV testing and treatment services in Kwazulu-Natal, South Africa.\nMethods: Data were used from two consecutive cross-sectional household surveys undertaken from June 2014 to\nJune 2015 (2014/2015 survey) and from July 2015 to June 2016 (2015/2016 survey) in the uMgungundlovu District\nof KwaZulu-Natal, South Africa. Collectively, 20,048 randomly selected individuals aged 15 to 49 years old were\ninterviewed across the two surveys. Utilisation of HIV testing and treatment services were used as independent\nvariables and three sexual risk behaviours were used as dependent variables. Multiple regression models assessed\nthe impact HIV testing and treatment services had on sexual risk behaviour while controlling for socio-demographic\ncharacteristics.\nResults: Having tested for HIV had no association with any of the three sexual risk behaviours. However, receiving\nan HIV positive diagnosis reduced the likelihood of using condoms inconsistently with the respondentsâ?? most recent\npartner (AOR: 0.64; 95% CI 0.54-0.77). Antiretroviral use was negatively associated with inconsistent condom use\n(AOR: 0.45; 95% CI 0.35-0.58) and number of sexual partners in the previous year (AOR: 0.61; 95% CI 0.46-0.81).\nConclusions: Results indicate that HIV testing and treatment services and the assumed exposure of clients to behaviour\nchange communication, had a limited effect in reducing risky sexual behaviour. Data suggests that the engagement\nbetween health personnel and individuals accessing HIV testing and treatment services does not necessarily\ntranslate into the adoption of safer sexual practices, with the exception of individuals testing positive for HIV and\nthose on ARV treatment, who had adopted safer sexual practices.
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