Sexual Activity Without Condoms and Risk of HIV Transmission in Serodifferent Couples When the HIV-Positive Partner Is Using Suppressive Antiretroviral Therapy
| Autor: | Rodger, Alison J, Cambiano, Valentina, Bruun, Tina, Vernazza, Pietro, Collins, Simon, van Lunzen, Jan, Corbelli, Giulio Maria, Estrada, Vicente, Geretti, Anna Maria, Beloukas, Apostolos, Asboe, David, Viciana, Pompeyo, Gutiérrez, Félix, Clotet, Bonaventura, Pradier, Christian, Gerstoft, Jan, Weber, Rainer, Westling, Katarina, Wandeler, Gilles, Prins, Jan M, Rieger, Armin, Stoeckle, Marcel, Kümmerle, Tim, Bini, Teresa, Ammassari, Adriana, Gilson, Richard, Krznaric, Ivanka, Ristola, Matti, Zangerle, Robert, Handberg, Pia, Antela, Antonio, Allan, Sris, Phillips, Andrew N, Lundgren, Jens, Bini, T., Comi, L., Pandolfo, A., Suardi, E., Ammassari, A., Pierro, P., Carli, G., Orchi, N., Celesia, M., Mussini, C., DI BIAGIO, Antonio |
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| Přispěvatelé: | AII - Amsterdam institute for Infection and Immunity, Infectious diseases |
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Risk Anti-HIV Agents Sexual Behavior Observational Study HIV Infections Men who have sex with men Condoms 03 medical and health sciences 0302 clinical medicine Unsafe Sex HIV Seronegativity HIV Seropositivity Journal Article Humans Medicine Prospective Studies 030212 general & internal medicine 610 Medicine & health Phylogeny Family Characteristics 030505 public health business.industry Research Support Non-U.S. Gov't Absolute risk reduction virus diseases General Medicine Middle Aged Viral Load Treatment as prevention Confidence interval Multicenter Study Europe Sexual Partners Heterosexuality Immunology HIV-1 RNA Viral Female 0305 other medical science business Viral load Demography |
| Zdroj: | Rodger, A J, Cambiano, V, Bruun, T, Vernazza, P, Collins, S, van Lunzen, J, Corbelli, G M, Estrada, V, Geretti, A M, Beloukas, A, Asboe, D, Viciana, P, Gutiérrez, F, Clotet, B, Pradier, C, Gerstoft, J, Weber, R, Westling, K, Wandeler, G, Prins, J M, Rieger, A, Stoeckle, M, Kümmerle, T, Bini, T, Ammassari, A, Gilson, R, Krznaric, I, Ristola, M, Zangerle, R, Handberg, P, Antela, A, Allan, S, Phillips, A N, Lundgren, J & PARTNER Study Group (Lars Østergaard, member) 2016, ' Sexual Activity Without Condoms and Risk of HIV Transmission in Serodifferent Couples When the HIV-Positive Partner Is Using Suppressive Antiretroviral Therapy ', JAMA: The Journal of the American Medical Association, vol. 316, no. 2, pp. 171-81 . https://doi.org/10.1001/jama.2016.5148 JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION r-FISABIO: Repositorio Institucional de Producción Científica Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO) JAMA, 316(2), 171-181. American Medical Association r-FISABIO. Repositorio Institucional de Producción Científica instname |
| ISSN: | 0098-7484 |
| Popis: | IMPORTANCE: A key factor in assessing the effectiveness and cost-effectiveness of antiretroviral therapy (ART) as a prevention strategy is the absolute risk of HIV transmission through condomless sex with suppressed HIV-1 RNA viral load for both anal and vaginal sex.OBJECTIVE: To evaluate the rate of within-couple HIV transmission (heterosexual and men who have sex with men [MSM]) during periods of sex without condoms and when the HIV-positive partner had HIV-1 RNA load less than 200 copies/mL.DESIGN, SETTING, AND PARTICIPANTS: The prospective, observational PARTNER (Partners of People on ART-A New Evaluation of the Risks) study was conducted at 75 clinical sites in 14 European countries and enrolled 1166 HIV serodifferent couples (HIV-positive partner taking suppressive ART) who reported condomless sex (September 2010 to May 2014). Eligibility criteria for inclusion of couple-years of follow-up were condomless sex and HIV-1 RNA load less than 200 copies/mL. Anonymized phylogenetic analysis compared couples' HIV-1 polymerase and envelope sequences if an HIV-negative partner became infected to determine phylogenetically linked transmissions.EXPOSURES: Condomless sexual activity with an HIV-positive partner taking virally suppressive ART.MAIN OUTCOMES AND MEASURES: Risk of within-couple HIV transmission to the HIV-negative partner.RESULTS: Among 1166 enrolled couples, 888 (mean age, 42 years [IQR, 35-48]; 548 heterosexual [61.7%] and 340 MSM [38.3%]) provided 1238 eligible couple-years of follow-up (median follow-up, 1.3 years [IQR, 0.8-2.0]). At baseline, couples reported condomless sex for a median of 2 years (IQR, 0.5-6.3). Condomless sex with other partners was reported by 108 HIV-negative MSM (33%) and 21 heterosexuals (4%). During follow-up, couples reported condomless sex a median of 37 times per year (IQR, 15-71), with MSM couples reporting approximately 22,000 condomless sex acts and heterosexuals approximately 36,000. Although 11 HIV-negative partners became HIV-positive (10 MSM; 1 heterosexual; 8 reported condomless sex with other partners), no phylogenetically linked transmissions occurred over eligible couple-years of follow-up, giving a rate of within-couple HIV transmission of zero, with an upper 95% confidence limit of 0.30/100 couple-years of follow-up. The upper 95% confidence limit for condomless anal sex was 0.71 per 100 couple-years of follow-up.CONCLUSIONS AND RELEVANCE: Among serodifferent heterosexual and MSM couples in which the HIV-positive partner was using suppressive ART and who reported condomless sex, during median follow-up of 1.3 years per couple, there were no documented cases of within-couple HIV transmission (upper 95% confidence limit, 0.30/100 couple-years of follow-up). Additional longer-term follow-up is necessary to provide more precise estimates of risk. |
| Databáze: | OpenAIRE |
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