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Medical News

Changes in Sexual Behavior and Risk of HIV Transmission After Antiretroviral Therapy and Prevention Interventions in Rural Uganda

December 9, 2005

The authors conducted a prospective cohort study to assess changes in risky sexual behavior and estimated HIV transmission from HIV-infected adults in rural Uganda after six months of antiretroviral therapy (ART).

Between May 2003 and December 2004, 926 HIV-positive adults were enrolled and followed in a home-based ART program that included prevention counseling, voluntary counseling and testing (VCT) for cohabitating partners, and condom provision. The researchers then assessed participants' HIV plasma viral load and partner-specific sexual behaviors at baseline and follow-up. Risky sex rates were compared using a Poisson regression model, and per-partner transmission risk was estimated based on established viral load-specific transmission rates. Risky sex was defined as inconsistent or no condom use with HIV-negative partners or with partners of unknown serostatus in the preceding three months.

Six months after ART initiation, risky sexual behavior reduced by 70 percent [adjusted risk ratio, 0.3;95 percent confidence interval (CI),0.2-0.7;P=0.0017]. More than 85 percent of risky sexual acts occurred within married couples. Median baseline viral load among those reporting risky sex was 122,500 copies/ml, and at follow-up, <50 copies/ml. Estimated risk of HIV transmission from cohort members declined by 98 percent, from 45.7 to 0.9 per 1,000 person years.

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"Providing ART, prevention counseling, and partner VCT was associated with reduced sexual risk behavior and estimated risk of HIV transmission among HIV-infected Ugandan adults during the first 6 months of therapy," the researchers concluded. "Integrated ART and prevention programs may reduce HIV transmission in Africa."

Back to other news for December 9, 2005

Adapted from:
AIDS
01.02.2006; Vol. 20; No. 1: P. 85-92; Rebecca Bunnell; John Paul Ekwaru; Peter Solberg; Nafuna Wamai; Winnie Bikaako-Kajura; Willy Were; Alex Coutinho; Cheryl Liechty; Elizabeth Madraa; George Rutherford; Jonathan Mermin


  
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This article was provided by CDC National Prevention Information Network. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update.
 
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