Despite the massive expansion of antiretroviral drugs in Africa, little is known about the resulting changes in sexual behavior or obstacles to antiretroviral therapy (ART) adherence. Our evaluation of Rwandan adults on ART found no increase in risky sexual behaviors, but an obstacle to ART initiation and adherence for 76% of patients was a fear of developing too much appetite without enough to eat. Access to adequate nutrition may be a major determinant for long-term adherence to ART.
aEmory University School of Medicine, Atlanta, Georgia, USA
bProjet San Francisco, Kigali, Rwanda
cEmory University Rollins School of Public Health, Atlanta, Georgia, USA.
Received 10 June, 2005
Accepted 26 June, 2006