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
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