title: The 'Antiretrovirals, Sexual Transmission Risk and Attitudes' (ASTRA) study. Design, methods and participant characteristics.
abstract: Life expectancy for people diagnosed with HIV has improved dramatically however the number of new infections in the UK remains high. Understanding patterns of sexual behaviour among people living with diagnosed HIV, and the factors associated with having condom-less sex, is important for informing HIV prevention strategies and clinical care. In addition, in view of the current interest in a policy of early antiretroviral treatment (ART) for all people diagnosed with HIV in the UK, it is of particular importance to assess whether ART use is associated with increased levels of condom-less sex. In this context the ASTRA study was designed to investigate current sexual activity, and attitudes to HIV transmission risk, in a large unselected sample of HIV-infected patients under care in the UK. The study also gathered background information on demographic, socio-economic, lifestyle and disease-related characteristics, and physical and psychological symptoms, in order to identify other key factors impacting on HIV patients and the behaviours which underpin transmission. In this paper we describe the study rationale, design, methods, response rate and the demographic characteristics of the participants. People diagnosed with HIV infection attending 8 UK HIV out-patient clinics in 2011-2012 were invited to participate in the study. Those who agreed to participate completed a confidential, self-administered pen-and-paper questionnaire, and their latest CD4 count and viral load test results were recorded. During the study period, 5112 eligible patients were invited to take part in the study and 3258 completed questionnaires were obtained, representing a response rate of 64% of eligible patients. The study includes 2248 men who have sex with men (MSM), 373 heterosexual men and 637 women. Future results from ASTRA will be a key resource for understanding HIV transmission within the UK, targeting prevention efforts, and informing clinical care of individuals living with HIV.
authors.affiliation: Research Department of Infection & Population Health, UCL, London, United Kingdom.
authors.forename: Andrew
authors.initials: A
authors.lastname: Speakman
authors.forename: Alison
authors.initials: A
authors.lastname: Rodger
authors.forename: Andrew N
authors.initials: AN
authors.lastname: Phillips
authors.forename: Richard
authors.initials: R
authors.lastname: Gilson
authors.forename: Margaret
authors.initials: M
authors.lastname: Johnson
authors.forename: Martin
authors.initials: M
authors.lastname: Fisher
authors.lastname: Ed Wilkins
authors.forename: Jane
authors.initials: J
authors.lastname: Anderson
authors.forename: Rebecca
authors.initials: R
authors.lastname: O'Connell
authors.forename: Monica
authors.initials: M
authors.lastname: Lascar
authors.forename: Kazeem
authors.initials: K
authors.lastname: Aderogba
authors.forename: Simon
authors.initials: S
authors.lastname: Edwards
authors.forename: Jeffrey
authors.initials: J
authors.lastname: McDonnell
authors.forename: Nicky
authors.initials: N
authors.lastname: Perry
authors.forename: Lorraine
authors.initials: L
authors.lastname: Sherr
authors.forename: Simon
authors.initials: S
authors.lastname: Collins
authors.forename: Graham
authors.initials: G
authors.lastname: Hart
authors.forename: Anne M
authors.initials: AM
authors.lastname: Johnson
authors.forename: Alec
authors.initials: A
authors.lastname: Miners
authors.forename: Jonathan
authors.initials: J
authors.lastname: Elford
authors.forename: Anna-Maria
authors.initials: AM
authors.lastname: Geretti
authors.forename: William J
authors.initials: WJ
authors.lastname: Burman
authors.forename: Fiona C
authors.initials: FC
authors.lastname: Lampe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D015340:Epidemiologic Research Design; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology* / Q000635:transmission; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D012306:Risk; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents