Barcelona 2013
Barcelona 2013
Abstract book - Abstract - 306
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Conference Details
International Committee
Plenary Speakers
Presenting Speakers
Scientific Committee
Abstract #306  -  Well Being and Life Expectancy
  25.8: Well Being and Life Expectancy (Parallel) on Tuesday @ 11.00-13.00 in Raval Chaired by Xiaming Li,
Carlos Mur

  Presenting Author:   Mr Nicolas Lorente - INSERM, France
  Additional Authors:   
Many studies showing the effectiveness of antiretroviral treatments (ART) in reducing HIV transmission rates among people living with HIV (PLWH) presenting with specific biomedical characteristics (e.g. undetectable viral load) have led to considerable debate about sexual risk compensation in this population. This study aimed to determine whether having such ?non-transmission? characteristics leads to risk compensation in PWLH, i.e. more unsafe sex and/or more sexual partners than those not having these characteristics.
Method / Issue:
The national ANRS-Vespa2 Survey was conducted between April 2011 and January 2012. A sample of 3022 patients was obtained after random selection from among PLWH diagnosed for more than 6 months attending adult outpatient services in French hospitals. Data were gathered using a questionnaire administered during face-to-face interviews (including a detailed section about sexual behaviours) and a medical questionnaire completed by medical staff (gathering key data of the disease: biological parameters at diagnosis and at time of study, etc). A non-transmission biomedical variable was built using the following criteria: receiving ART, having an undetectable viral load for >12 months, and no self-reported sexually transmitted infection in the previous 12 months. PLWH meeting these criteria were labelled non-transmitters; all others were labelled transmitters. Data were weighted and calibrated to be representative of the entire population of PLWH followed up in French hospitals. The present analysis included the 2633 PLWH: diagnosed for more than 12 months and who had the date of their most recent detectable viral load available (study sample). Fisher exact tests were used to compare transmitters and non-transmitters for (1) levels of condom use during vaginal and/or anal intercourse (in serodiscordant couples and in the most recent casual encounter when the partner was not HIV-positive) and (2) the number of sexual partners.
Results / Comments:
Overall, 57% of the study sample were non-transmitters. Condom use levels did not significantly differ between transmitters and non-transmitters, whether with a non-HIV positive steady partner (26% in both groups, p=0.99), or with their most recent non-HIV positive casual partner (9% versus 8%, p=0.78). However, non-transmitters in serodiscordant couples were more likely to be in sexually inactive couples (no sex during the previous year) compared with their transmitter counterparts (18% versus 11%, p=0.01). Overall, the number of sexual partners in the previous year did not differ between transmitters and non-transmitters for MSM and heterosexual men (p-values: 0.15 and 0.92 respectively). However, non-transmitter women were less likely to report more than one partner in the previous year than their transmitter counterparts (6% versus 11%, p=0.02). Furthermore, non-transmitter MSM were less likely to report sexual activity in the previous year than their transmitter counterparts (25% versus 17%, p=0.007).
Non-transmitter PLWH do not report more sexual risk behaviours than transmitter PLWH. When differences are observed, non-transmitters are less sexually active, or have fewer sexual partners than transmitter PLWH. Our results do not support the hypothesis of risk compensation among PLWH presenting with non-transmission biomedical criteria. Indeed, some risk indicators suggest the opposite tendency.
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