title: Use of and adherence to antiretroviral therapy is associated with decreased sexual risk behavior in HIV clinic patients.
abstract: Previous research suggested that the availability of highly active antiretroviral therapy (ART) was associated with increased risky sexual behavior. This study examined the relationship between unprotected anal or vaginal sex (UAV) and ART use and adherence in a cross-sectional survey conducted in 874 randomly selected, sexually active patients at 6 public HIV clinics in California. Patients completed a standardized interview in 1998-1999 regarding HIV history, sexual behavior, illicit drug use, and ART use and adherence. Thirty-four percent reported UAV, defined as anal or vaginal sex without a condom within the past 3 months. Of 79% on ART, 26% reported <95% adherence. Decreased odds for UAV were found for both ART use, odds ratio (OR) 0.5 (95% CI 0.4-0.7, P < 0.001) and adherence to ART of > or = 95%, OR 0.6 (95% CI 0.4-0.8, P < 0.001). These relationships persisted in most stratified analysis for both ART use and adherence but in multivariate analysis only for ART use. An undetectable HIV RNA was associated with decreased odds of UAV, OR 0.6 (95% CI 0.5-0.8, P < 0.001). Contrary to expectations, use of and adherence to ART and their consequent suppression of HIV were associated with a decreased prevalence of self-reported risky sexual behavior.
authors.affiliation: University of California Irvine Medical Center, Department of Internal Medicine, Orange, CA, USA. diamondc@uci.edu
authors.forename: Catherine
authors.initials: C
authors.lastname: Diamond
authors.forename: Jean L
authors.initials: JL
authors.lastname: Richardson
authors.forename: Joel
authors.initials: J
authors.lastname: Milam
authors.forename: Susan
authors.initials: S
authors.lastname: Stoyanoff
authors.forename: J Allen
authors.initials: JA
authors.lastname: McCutchan
authors.forename: Carol
authors.initials: C
authors.lastname: Kemper
authors.forename: Robert A
authors.initials: RA
authors.lastname: Larsen
authors.forename: Harry
authors.initials: H
authors.lastname: Hollander
authors.forename: Penny
authors.initials: P
authors.lastname: Weismuller
authors.forename: Robert
authors.initials: R
authors.lastname: Bolan
mesh_terms: D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002140:California; D003863:Depression / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology*; D015438:Health Behavior; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D044469:Racial Groups; D012189:Retrospective Studies; D012309:Risk-Taking; D021841:Safe Sex / Q000523:psychology*; D012725:Sexual Behavior
chemical_list: D019380:Anti-HIV Agents