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Sexual behaviour among people with HIV according to self-reported antiretroviral treatment and viral load status

Lampe, FC; (2016) Sexual behaviour among people with HIV according to self-reported antiretroviral treatment and viral load status. AIDS , 30 (11) pp. 1745-1759. 10.1097/QAD.0000000000001104. Green open access

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Abstract

OBJECTIVE: To assess, among people with HIV, the association of self-reported antiretroviral treatment (ART) and viral load status with condomless sex with an HIV-serodifferent partner (CLS-D). DESIGN: Cross-sectional study of 3258 HIV-diagnosed adults in the United Kingdom, 2011–2012. METHODS: CLS-D in the past 3 months and self-reported ART/viral load were ascertained by questionnaire. Clinic-recorded viral load was documented. HIV-transmission risk sex (CLS-D-HIV-risk) was defined as CLS-D together with either not on ART or clinic-recorded viral load more than 50 copies/ml. RESULTS: Of 3178 participants diagnosed more than 3 months ago, 2746 (87.9%) were on ART, of whom self-reported viral load was ‘50 copies/ml/ or less/undetectable’ for 78.4%; ‘more than 50 copies/ml/detectable’ for 8.3%; ‘do not know/missing’ for 13.3%. CLS-D prevalence was 14.9% (326/2189), 6.4% (23/360) and 10.7% (67/629) among men who have sex with men, heterosexual men and women, respectively. Among men who have sex with men, CLS-D prevalence was 18.8% among those not on ART; 15.2% among those on ART with undetectable self-reported viral load; 9.8% among those on ART without undetectable self-reported viral load. Compared with ‘on ART with undetectable self-reported viral load’, prevalence ratios (95% confidence interval) adjusted for demographic/HIV-related factors were: 0.66 (0.45, 0.95) for ‘on ART without undetectable self-reported viral load’, and 1.08 (0.78, 1.49) for ‘not on ART’ (global P = 0.021). Among heterosexual men and women (combined), ART/self-reported viral load was not associated with CLS-D [corresponding adjusted prevalence ratios: 1.14 (0.73, 1.79) for ‘on ART without undetectable self-reported viral load’; 0.88 (0.44, 1.77) for ‘not on ART’, P = 0.77]. CLS-D-HIV-risk prevalence was 3.2% among all participants; 16.1% for ‘not on ART’; 0.6% for ‘on ART with undetectable self-reported viral load; 4.2% for ‘on ART without undetectable self-reported viral load.’ Conclusion: Use of ART was not associated with increased prevalence of CLS-D, and was associated with greatly reduced prevalence of HIV-transmission risk sex.

Type: Article
Title: Sexual behaviour among people with HIV according to self-reported antiretroviral treatment and viral load status
Open access status: An open access version is available from UCL Discovery
DOI: 10.1097/QAD.0000000000001104
Publisher version: http://doi.org/10.1097/QAD.0000000000001104
Language: English
Additional information: © 2016 Wolters Kluwer Health, Inc. All rights reserved. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. http://creativecommons.org/licenses/by-nc-nd/4.0
Keywords: Science & Technology, Life Sciences & Biomedicine, Immunology, Infectious Diseases, Virology, antiretroviral treatment, condomless sex, self-report, sexual behaviour, viral load, UNPROTECTED ANAL INTERCOURSE, RISK BEHAVIOR, TRANSMISSION RISK, UNITED-STATES, HETEROSEXUAL TRANSMISSION, PROSPECTIVE COHORT, HOMOSEXUAL-MEN, THERAPY, INFECTION, CARE
UCL classification: UCL > Provost and Vice Provost Offices
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 Pop Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute for Global Health > Infection and Population Health
URI: https://discovery.ucl.ac.uk/id/eprint/1480007
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