title: HIV Transmission Risk Behavior in a Cohort of HIV-Infected Treatment-Naïve Men and Women in the United States.
abstract: Antiretroviral therapy (ART) can minimize HIV transmission. Prevention benefits may be compromised by barriers to virologic suppression, and by increased condomless sex among those initiating ART. We evaluated condomless sex in a cohort of HIVinfected US individuals poised to initiate ART in a clinical trial. We assessed partner and sex act type, condom use, and perception of infectiousness. Six percent of participants reported as not infectious; men who have sex with men were more likely to perceive high infectivity. Prevalence of condomless sex was 44 %; 74 % of those also reported homosexual acquisition of HIV. Predictors of increased risk of condomless sex included greater numbers of lifetime partners, recent stimulant drug use and an HIV-positive or unknown serostatus partner. In the context of serodifferent partners, lower perception of infectiousness was also associated with a higher risk of condomless sex. Results highlight opportunities for prevention education for HIV infected individuals at ART initiation.
authors.affiliation: Division of Infectious Diseases, UCLA Center for Clinical AIDS Research and Education, University of California, Los Angeles, 11075 Santa Monica Blvd, Suite 100, Los Angeles, CA, 90025, USA. rlandovitz@mednet.ucla.edu.
authors.forename: Raphael J
authors.initials: RJ
authors.lastname: Landovitz
authors.affiliation: Center for Biostatistics in AIDS Research, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
authors.forename: Thuy Tien T
authors.initials: TT
authors.lastname: Tran
authors.affiliation: Division of Infectious Diseases, Northwestern University School of Medicine, Chicago, IL, USA.
authors.forename: Susan E
authors.initials: SE
authors.lastname: Cohn
authors.affiliation: Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Ighovwhera
authors.initials: I
authors.lastname: Ofotokun
authors.affiliation: Therapeutics Research Branch, Division of AIDS, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Catherine
authors.initials: C
authors.lastname: Godfrey
authors.affiliation: Division of Infectious Diseases, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Kuritzkes
authors.affiliation: Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Lennox
authors.affiliation: Division of Infectious Diseases, UCLA Center for Clinical AIDS Research and Education, University of California, Los Angeles, 11075 Santa Monica Blvd, Suite 100, Los Angeles, CA, 90025, USA.
authors.forename: Judith S
authors.initials: JS
authors.lastname: Currier
authors.affiliation: Center for Biostatistics in AIDS Research, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
authors.forename: Heather J
authors.initials: HJ
authors.lastname: Ribaudo
mesh_terms: D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D001294:Attitude to Health; D015331:Cohort Studies; D017280:Condoms / Q000706:statistics & numerical data; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000635:transmission*; D006679:HIV Seropositivity / Q000188:drug therapy* / Q000635:transmission*; D018451:Homosexuality, Male / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012747:Sexual Partners; D011795:Surveys and Questionnaires; D014481:United States; D047568:Unsafe Sex; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents
keywords: ART-naïve; Behavior; Condom use; HIV transmission