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ART-treated patients less susceptible to HIV transmission
Cohen J. # MOAC0203.
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Despite a decrease in condom use, the proportion of antiretroviral therapy-treated patients susceptible to transmitting HIV decreased and remains low, according to Bruno Spire, MD, PhD.
“Therefore, fear of behavioral disinhibition should not be a barrier to universal access to treatment,” Spire, from the Stratall ANRS 12110/ESTHER study group, told Infectious Disease News. “Our data suggest that the strong potential of the ‘test and treat’ strategy cannot be overruled by the fear of changes in sexual behaviors. Furthermore, health care providers can influence sexual behaviors by providing adequate counseling and by reinforcing their skills for positive prevention.”
In the randomized, open-label trial, 459 HIV-infected adults from hospitals in Cameroon, Africa, were enrolled. The researchers investigated sexual risk for HIV transmission during the first 24 months of treatment in naive HIV-infected adults, as well as the characteristics of viremic ART-treated adults living with HIV/AIDS who do not use condoms consistently.
Plasma viral load was measured during months 0, 6, 12, 18 and 24, and questionnaires were administered at months 0, 6, 12, 18 and 24 to collect data on sexual behaviors and health staff readiness to listen. The relationship between detectable viral load and inconsistent condom use with HIV-negative partners or unknown serostatus at least once in the 3 months before the visit was examined.
Among patients reporting sexual activity, inconsistent condom use significantly decreased between month 0 and 6 (64% to 40%; P=.001); however, a significant increase was observed from month 6 to 24 (40% to 54%; P=.017).
Patients with detectable viral loads reporting inconsistent condom use was 64% at month 0; 23% at month 6; 26% at month 12; and 22% at month 24.
After adjusting for time, sexual activity and the number of sexual partners, the researchers determined that limited health staff readiness to listen remained significantly associated with detectable viral loads and inconsistent condom use (OR=1.81; 95% CI, 1.00-3.27).
Disclosure: Dr. Spire reports no relevant financial disclosures.
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