Treatment as long-term prevention: sustained reduction in HIV sexual transmission risk with use of antiretroviral therapy in rural Uganda

AIDS
Mark J SiednerDavid R Bangsberg

Abstract

Suppressive antiretroviral therapy (ART) substantially decreases HIV transmission in clinical research settings. We sought to measure the frequency and correlates of periods of transmission risk among individuals taking ART during multiple years of observation in rural, southwestern Uganda. Observational cohort study. We collected sexual behavior and viral load data in a Ugandan cohort of people living with HIV/AIDS from the time of ART initiation. We defined each 90-day visit as a potential transmission period if HIV-1 RNA was more than 400 copies/ml and the participant reported sexual transmission risk behavior, defined as unprotected sexual contact with at least 1 HIV-uninfected partners or partners of unknown serostatus in the prior 90 days. We evaluated data from 463 individuals on ART over a median 3.5 years of observation and 5293 total study visits. During that time, over half (259, 56%) had detectable viremia or reported sexual transmission risk behavior at least once. However, only 23 (5%) had both simultaneously, at 28 (<1%) of all visits. Transmission sexual behavior was reported at 6% of visits with detectable viremia. In multivariable regression modeling, correlates of transmission risk periods included younger ag...Continue Reading

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Citations

Sep 27, 2014·AIDS·Jean-Jacques Parienti
Oct 27, 2015·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Lynn T MatthewsDavid R Bangsberg
Jan 13, 2015·Journal of the International AIDS Society·Caiyun LiaoJenell S Coleman
Feb 7, 2014·Annals of Behavioral Medicine : a Publication of the Society of Behavioral Medicine·Sae TakadaAlexander C Tsai
Dec 18, 2014·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Mark J SiednerAlexander C Tsai
Nov 27, 2019·PLoS Medicine·Alexander C TsaiAtheendar S Venkataramani
May 31, 2018·International Journal of Environmental Research and Public Health·Thuc Minh Thi VuRoger C M Ho

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