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Receiving ART lowered unprotected sex among people with HIV
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Data from a systematic review suggest that unprotected sex is reduced among people with HIV receiving treatment.
“Although it is plausible that HIV treatment and prevention messages could mutually reinforce risk reduction among HIV-positive individuals selected for ART, the observation that reductions in unprotected sex are associated with ART use must be interpreted cautiously: limited data are available to accurately assess a causal relationship,” researchers from the Centre for Population Health at the Burnet Institute in Melbourne, Australia, wrote in Clinical Infectious Diseases.
The systematic review and meta-analysis included 58 studies in which patients with HIV receiving ART were compared with patients with HIV not receiving ART in terms of unprotected sexual intercourse, diagnosis of sexually transmitted infections and unsafe injecting behavior. There were 56 studies that reported unprotected sex, 11 studies that reported STI diagnosis and four studies that reported unsafe injecting practices.
They found that unprotected sex was lower among patients receiving ART compared with those who were not (OR=0.73; 95% CI, 0.64-0.83). This was true in both high-income and low-/middle-income countries. The results also suggested that there were fewer STI diagnoses among people on ART (OR=0.58; 95% CI, 0.33-1.01). There was no difference in injection risk-taking behavior between the groups.
“The current practice of providing ART with counseling, education and ongoing clinical care probably offers an optimal strategy of ensuring that individuals on ART minimize risks associated with unsafe sex,” the researchers wrote. “These findings suggest that campaigns or treatment strategies that scale up use of treatment are unlikely to adversely increase compensatory risk-taking behavior.”
Disclosure: One researcher reports relationships with Gilead, Merck and Viiv.
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