Santa Fe 2011 Santa Fe, USA 2011
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Abstract #359  -  The Swiss Statement, who knows about it and what are its effects on PLWHIV? Results from the “VIH, Hépatites et vous” Survey
  Presenting Author:   Mrs Daniela Rojas Castro - AIDES
  Additional Authors:  Dr Jean-Marie Le Gall, Mrs Elise Bourgeois-Fisson, Mr Franck Barbier, Mr Lionel Fugon, Dr Bruno Spire,  
In January 2008, the publication of the “Swiss statement”, asserting that HIV-positive individuals on effective antiretroviral therapy who have had an undetectable viral load for at least six months and who do not have sexually transmitted infections are sexually non-infectious, induced a vigorous debate in both medical and associative fields. AIDES, the largest French HIV community-based organization, whose prevention activities are based on sexual risk reduction strategies, was interested in having a better knowledge of HIV+ people who are aware of this information, and its impact on several aspects of life with HIV. For this purpose, we used the results of the “HIV, Hepatitis and you” survey.
  Method / Issue:
A one-week cross-sectional nation-wide survey, filled out by 2,356 respondents, was carried out in October 2010. A self-administered questionnaire was offered to every person in contact with AIDES or an online version of the questionnaire was announced on several community websites. The questionnaire includes standardized items concerning socio-demographics, health status, psychosocial and economical situations, drug use, feelings of belonging to a community, access to health services and the use of solidarity networks. A logistic regression was used to determine factors associated with knowledge of the “Swiss statement”. We focus only on PLWHA who filled in the questionnaire (N=977).
  Results / Comments:
Among them, 57% (N=556) reported being aware of the statement. The main source of information was the associative setting (53%), while medical settings were cited by 30% of respondents. No differences were found according to age, hepatitis co-infection and having a job among those aware and unaware of the “Swiss statement”. PLWHA aware of the “Swiss statement” where significantly more likely to be in contact with solidarity networks (p<10-3), to live in stable housing (p=0.006), to consider themselves as belonging to the LGBT (Lesbian Gay Bi Trans) community (p=0.002) and to have filled out the questionnaire on-line (p=0.003). Moreover, respondents knowing about the “Swiss statement” were more likely to have an undetectable viral load (p=0.01) and to have CD4 levels above 350 cells/mm3 (p<10-3). Among the 556 PLWHA who reported knowing about the “Swiss statement”, 31% stated “feeling less fear of transmitting HIV”, 55% reported “having less difficulty speaking about HIV with sexual partners”, 14% declared having better quality of sexual life and 15% reported better adherence to HIV treatment. Moreover, 76% declared no changes in consistent condom use with negative partners, while 13% used condoms less frequently and 11% used them more than before.
These results provide new information about the characteristics of people who are aware of the “Swiss statement”. It suggests that PLWHA who belong to LGBT community groups and who speak openly about their illness through HIV solidarity networks are more incline to look for information about HIV transmission. By contrast, social vulnerability appears to be an obstacle to knowledge of the "Swiss statement" suggesting that these vulnerable groups are less concerned by prevention issues than other daily life problems. Outreach interventions aimed at updating prevention knowledge are needed among migrants and drug users living with HIV.
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