HIV transmission among men who have sex with men due to condom failure
Autor: | Juan Liu, Rupert Kaul, Robert S. Remis, Robert W. H. Palmer, Michel Alary |
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Jazyk: | angličtina |
Rok vydání: | 2014 |
Předmět: |
Male
Safe Sex Human immunodeficiency virus (HIV) lcsh:Medicine HIV Infections medicine.disease_cause law.invention Men who have sex with men Condoms Immunodeficiency Viruses law Risk Factors Prevalence Medicine Homosexuals Homosexuality Hiv transmission lcsh:Science media_common Ontario Multidisciplinary virus diseases Infectious Diseases Medical Microbiology Viral Pathogens Equipment Failure Developed country Research Article medicine.medical_specialty media_common.quotation_subject Sexual Behavior HIV prevention Microbiology Condom Humans Homosexuality Male Microbial Pathogens Gynecology Medicine and health sciences Preventive medicine business.industry lcsh:R Sexual Preferences Biology and Life Sciences Antiretroviral therapy Confidence interval Public and occupational health People and Places Population Groupings lcsh:Q business Demography |
Zdroj: | PLoS ONE, Vol 9, Iss 9, p e107540 (2014) PLoS ONE |
ISSN: | 1932-6203 |
Popis: | Background Despite preventive efforts, HIV incidence remains high among men who have sex with men (MSM) in industrialized countries. Condoms are an important element in prevention but, given the high frequency of condom use and their imperfect effectiveness, a substantial number and proportion of HIV transmissions may occur despite condoms. We developed a model to examine this hypothesis. Methods We used estimates of annual prevalent and incident HIV infections for MSM in Ontario. For HIV-negative men, we applied frequencies of sexual episodes and per-contact HIV transmission risks of receptive and insertive anal sex with and without a condom and oral sex without a condom. We factored in the proportion of HIV-infected partners receiving antiretroviral therapy and its impact in reducing transmissibility. We used Monte-Carlo simulation to determine the plausible range for the proportion of HIV transmissions for each sexual practice. Results Among Ontario MSM in 2009, an estimated 92,963 HIV-negative men had 1,184,343 episodes of anal sex with a condom and 117,133 anal sex acts without a condom with an HIV-positive partner. Of the 693 new HIV infections, 51% were through anal sex with a condom, 33% anal sex without a condom and 16% oral sex. For anal sex with a condom, the 95% confidence limits were 17% and 77%. Conclusions The proportion of HIV infections related to condom failure appears substantial and higher than previously thought. That 51% of transmissions occur despite condom use may be conservative (i.e. low) since we used a relatively high estimate (87.1%) for condom effectiveness. If condom effectiveness were closer to 70%, a value estimated from a recent CDC study, the number and proportion of HIV transmissions occurring despite condom use would be much higher. Therefore, while condom use should continue to be promoted and enhanced, this alone is unlikely to stem the tide of HIV infection among MSM. |
Databáze: | OpenAIRE |
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