Combination Antiretroviral Therapy for HIV in Rwandan Adults: Clinical Outcomes and Impact on Reproductive Health up to 24 Months

Table 4

Behavioral and clinical changes over time by study group.

	Women pre-cART		Women cART		Men cART
	Baseline	M12	Baseline	M12	Baseline	M12
Living with spouse (%)	58.0	55.0	46.9	39.8	62.6	70.0
Number of sex partners at the last 6 months (median, range)	1 (0–9)	1 (0–2)	1 (0-1)	0 (0-1)	1 (0–20)	1 (0–3)
Currently sexually active (%)	64.0	56.7	50.9	43.6	66.7	71.0
Desire to get pregnant (%)	11.1	11.3	13.2	8.0	NA	NA
Currently trying to get pregnant (%)	9.5	9.7	10.8	5.0	NA	NA
Currently using family planning (%)^1,2	65.5	49.3	48.6	36.8	NA	NA
Frequent vaginal sex in last month (median, range)^1,2	2 (0–7)	2 (0–4)	1 (0–5)	1 (0–6)	2 (0–12)	3 (0–18)
Used a condom during last sex act (%)	40.6	44.4	43.1	41.8	61.2	76.5
Frequent washing in vagina last week (median, range)^1	7 (0–28)	7 (0–30)	7 (0–35)	7 (0–21)	NA	NA
Feeling depressed in the last 4 weeks (%)^1
Never/almost never	46.5	55.1	34.8	53.7	56.6	80.0
Sometimes	28.3	30.4	29.5	26.8	31.3	11.4
Often	25.2	14.5	35.7	19.5	12.1	8.6
Sexual desire in the last 4 weeks (%)^1
A lot less desire	41.1	37.7	41.1	41.5	24.2	11.4
A little less desire	24.4	13.0	19.6	9.8	27.3	21.4
The same or increased desire	34.5	49.3	39.3	48.7	48.5	67.2
Any genital symptoms in the last 6 months (%)^1,3,4	43.2	27.5	51.3	28.4	34.0	12.9
Sought STI treatment in the last 6 months (%)^1	25.4	10.3	29.8	15.2	13.1	8.6
Any abnormal pelvic exam finding (%)^1,5	53.6	28.3	60.9	39.7	NA	NA
Abnormal bimanual exam (%)	7.4	13.3	7.9	19.4	NA	NA
Clinical diagnosis made after pelvic/bimanual exam (%)^6	28.6	18.6	27.3	29.2	NA	NA

Difference between baseline and month 12 shown in bold is statistically significant at .
²Including the family planning methods listed in Table 1. The proportion of women using specific methods over time did not change, but women pre-cART were statistically significantly more likely to use hormonal methods of contraception than women on cART, whereas women on cART were statistically significantly more likely to use condoms.
³For women, these included (all participant-reported, from most frequently reported to less frequently reported) vaginal itching, vaginal burning, unusual vaginal discharge, abdominal pain, discomfort when urinating, rash external genitalia, unusual vaginal odor, vaginal pain, pain during sex, ulcers, abnormal menstrual bleeding, and other. The symptoms indicated with were statistically significantly less prevalent at M12 than baseline in both study groups, in the pre-cART group only, and in the cART group only.
⁴For men, these included (all participant-reported, from most frequently reported to less frequently reported): genital itching, genital rash, penile pain, genital ulcers, discomfort when urinating, genital burning, pain during sex, and other. The symptoms indicated with were statistically significantly less prevalent at M12 than baseline.
⁵These included (all clinician-observed) palpable inguinal lymph nodes, lesions on the external, vaginal or cervical epithelia, unusual vaginal discharge, or abundant cervical mucus.
⁶Including (in decreasing frequency) vaginal discharge syndrome, cervicitis, pelvic inflammatory disease, genital warts, genital herpes, and other.