Rolland, M;
McGrath, N;
Tiendrebeogo, T;
Larmarange, J;
Pillay, D;
Dabis, F;
Orne-Gliemann, J;
(2019)
No effect of test and treat on sexual behaviours at population level in rural South Africa.
AIDS
, 33
(4)
pp. 709-722.
10.1097/QAD.0000000000002104.
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Abstract
CONTEXT: Within the community-randomised ANRS 12249 Treatment-as-Prevention (TasP) trial conducted in rural South Africa, we analysed sexual behaviours stratified by sex over time, comparing immediate ART irrespective of CD4 count vs CD4-guided ART (start at CD4>350 then >500) arms. METHODS: As part of the 6-monthly home-based trial rounds, a sexual behaviour questionnaire (IQ) was administered to all residents ≥16 years. We considered seven indicators: sexual intercourse in the past month; at least one regular sexual partner in the past six months; at least one casual sexual partner in the past six months and more than one sexual partner in the past six months; condom use at last sex (CLS) with regular partner, CLS with casual partner, and point prevalence estimate of concurrency. We conducted repeated cross-sectional analyses, stratified by sex. GEE models were used, including trial arm, trial time, calendar time and interaction between trial arm and trial time. RESULTS: CLS with regular partner varied between 29%-51% and 23%- 46% for men and women, respectively, with significantly lower odds among women in the control versus intervention arm by trial end (p < 0.001). CLS with casual partner among men showed a significant interaction between arm and trial round, with no consistent pattern. Women declared more than one partner in the past 6 months in less that 1% of IQs; among men, rates varied between 5%-12%, and odds significantly and continuously declined between calendar rounds 1 and 7 (OR = 4.2 [3.24-5.45]). CONCLUSION: Universal Test and Treat was not associated with increased sexual risk behaviours.
| Type: | Article |
|---|---|
| Title: | No effect of test and treat on sexual behaviours at population level in rural South Africa |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1097/QAD.0000000000002104 |
| Publisher version: | https://doi.org/10.1097/QAD.0000000000002104 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Africa, antiretroviral therapy, HIV, prevention, sexual behaviour |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Infection and Immunity |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10065906 |
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