Effect of early antiretroviral therapy on sexual behaviors and HIV-1 transmission risk in adults with diverse heterosexual partnership status in Cote d'Ivoire.: Effect of early ART on sexual behaviors

Kévin Jean 1, 2, * Delphine Gabillard 3 Raoul Moh 4 Christine Danel 4 Raïmi Fassassi 5 Annabel Desgrees-Du-Lou 6 Serge Eholie 4, 7 France Lert 1, 2 Xavier Anglaret 3, 4 Rosemary Dray-Spira 1, 2
* Auteur correspondant
1 CESP - Centre de recherche en épidémiologie et santé des populations
2 UVSQ - Université de Versailles Saint-Quentin-en-Yvelines
3 Epidémiologie et Biostatistique [Bordeaux]
4 Programme PAC-CI
5 Department of Population Research and Development
6 CEPED - UMR_D 196 - Centre population et développement
7 SMIT - Service des Maladies Infectieuses et Tropicales
Abstract : Background. The effect of early antiretroviral therapy (ART) on sexual behaviors and HIV-1 transmission risk has not been documented beyond the specific population of stable serodiscordant couples.Methods. Based on a behavioral study nested in a randomized controlled trial (Temprano-ANRS12136) of early ART, we compared proportions of risky sex (unprotected sex with a partner of negative/unknown HIV status) reported 12 months after inclusion between participants randomized to initiate ART immediately ('early ART') or according to WHO criteria ('standard ART'). Group-specific HIV-transmission rates were estimated based on sexual behaviors and viral load-specific per-act HIV-1 transmission probabilities. Their ratio was computed to estimate the protective effect of early ART.Results. Among 957 participants (baseline CD4: 478/mm(3)), 46.0% reported sexual activity in the past month, 41.5% of them with non-cohabiting partners. Proportion of risky sex was 10.0% vs. 12.8%, respectively, in participants on early vs. standard ART (p=0.17). Accounting for sexual behaviors and viral load, the estimated protective effect of early ART was 90% (95%CI 81-95%).Conclusion. Twelve months after inclusion, patients on early and standard ART reported similar sexual behaviors. Early ART decreased the estimated risk of HIV transmission by 90%, suggesting a major prevention benefit among both stable and casual partners.
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Article dans une revue
Journal of Infectious Diseases, Oxford University Press (OUP), 2014, 209 (3), pp.431-40. 〈10.1093/infdis/jit470〉
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Kévin Jean, Delphine Gabillard, Raoul Moh, Christine Danel, Raïmi Fassassi, et al.. Effect of early antiretroviral therapy on sexual behaviors and HIV-1 transmission risk in adults with diverse heterosexual partnership status in Cote d'Ivoire.: Effect of early ART on sexual behaviors. Journal of Infectious Diseases, Oxford University Press (OUP), 2014, 209 (3), pp.431-40. 〈10.1093/infdis/jit470〉. 〈inserm-00866311〉

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