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Decrease in sexual risk behaviours after early initiation of antiretroviral therapy: a 24-month prospective study in
Kévin Jean1, Delphine Gabillard2, Raoul Moh2
1Epidemiology of Occupational and Social Determinants of Health - Center for Research in Epidemiology and Population Health, INSERM U1018, Villejuif, France; UMRS 1018, Université Versailles Saint-Quentin, Villejuif, France; kevin.jean@inserm.fr.
Journal of the International AIDS Society
|July 3, 2014
Summary
Entering HIV care, not starting antiretroviral therapy (ART) early, reduced sexual activity and risky behaviors in adults with high CD4 counts. Early ART initiation did not lead to increased risk compensation.
Area of Science:
- Public Health
- Infectious Diseases
- Behavioral Science
Background:
- The impact of early antiretroviral therapy (ART) initiation on sexual risk behaviors in HIV-positive individuals with high CD4 counts is not well-documented.
- This study investigates changes in sexual behaviors following early versus standard ART initiation.
Purpose of the Study:
- To compare sexual risk behaviors between early ART initiation and standard ART initiation groups over 24 months.
- To determine if early ART initiation influences sexual risk behaviors in HIV-positive adults.
Main Methods:
- Prospective behavioral study nested within a randomized controlled trial (Temprano-ANRS12136).
- Generalized Estimating Equations models used to compare time trends in sexual activity, multiple partnership, unprotected sex, and risky sex between early and standard ART groups at 12 and 24 months.
- Data collected from 1952 HIV-positive adults with high baseline CD4 counts.
Main Results:
- Significant decreases in sexual activity, multiple partnership, unprotected sex, and risky sex were observed between baseline and 24 months in the early ART group.
- Similar trends in sexual behaviors were noted in the standard ART group, with decreases occurring before ART initiation.
- Decreases in unprotected and risky sex were more pronounced in participants whose last sexual partner was non-cohabiting.
Conclusions:
- Entry into HIV care, irrespective of immediate ART initiation, led to reduced sexual activity and risky behaviors in sub-Saharan adults with high CD4 counts.
- No evidence of risk compensation was found with early ART initiation.
- Early entry into care demonstrates a potential behavioral preventive effect, complementing early ART initiation.