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Marion Di Ciaccio - One of the best experts on this subject based on the ideXlab platform.

Nelly Mugo - One of the best experts on this subject based on the ideXlab platform.

  • sexual behaviour of heterosexual men and women receiving antiretroviral pre exposure Prophylaxis for hiv prevention a longitudinal analysis
    Lancet Infectious Diseases, 2013
    Co-Authors: Kenneth Mugwanya, Deborah Donnell, Connie Celum, Katherine K Thomas, Patrick Ndase, Nelly Mugo
    Abstract:

    Summary Background Scarce data are available to assess sexual behaviour of individuals using antiretroviral Pre-Exposure Prophylaxis for HIV prevention. Increased sexual risk taking by individuals using effective HIV prevention strategies, like Pre-Exposure Prophylaxis, could offset the benefits of HIV prevention. We studied whether the use of Pre-Exposure Prophylaxis in HIV-uninfected men and women in HIV-serodiscordant couples was associated with increased sexual risk behaviour. Methods We undertook a longitudinal analysis of data from the Partners PrEP Study, a double-blind, randomised, placebo-controlled trial of daily oral Pre-Exposure Prophylaxis among HIV-uninfected partners of heterosexual HIV-serodiscordant couples (n=3163, ≥18 years of age). Efficacy for HIV prevention was publicly reported in July 2011, and participants continued monthly follow-up thereafter. We used regression analyses to compare the frequency of sex—unprotected by a condom—during the 12 months after compared with the 12 months before July 2011, to assess whether knowledge of Pre-Exposure Prophylaxis efficacy for HIV prevention caused increased sexual risk behaviour. Results We analysed 56 132 person-months from 3024 HIV-uninfected individuals (64% male). The average frequency of unprotected sex with the HIV-infected study partner was 59 per 100 person-months before unmasking versus 53 after unmasking; we recorded no immediate change (p=0·66) or change over time (p=0·25) after July, 2011. We identified a significant increase in unprotected sex with outside partners after July, 2011, but the effect was small (average of 6·8 unprotected sex acts per year vs 6·2 acts in a predicted counterfactual scenario had patients remained masked, p=0·04). Compared with before July, 2011, we noted no significant increase in incident sexually transmitted infections or pregnancy after July, 2011. Interpretation Pre-Exposure Prophylaxis, provided as part of a comprehensive prevention package, might not result in substantial changes in risk-taking sexual behaviour by heterosexual couples. Funding The Bill & Melinda Gates Foundation and the US National Institute of Mental Health.

Patrick S. Sullivan - One of the best experts on this subject based on the ideXlab platform.

Haradanahalli S Ravish - One of the best experts on this subject based on the ideXlab platform.

Claire Pintado - One of the best experts on this subject based on the ideXlab platform.