No effect of test and treat on sexual behaviours at population level in rural South Africa
Language
EN
Article de revue
This item was published in
AIDS. Official journal of the international AIDS Society. 2019-03-15, vol. 33, n° 4, p. 709-722
English Abstract
CONTEXT: Within the community-randomised ANRS 12249 Treatment-as-Prevention (TasP) trial conducted in rural South Africa, we analysed sexual behaviours stratified by sex over time, comparing immediate ART irrespective of ...Read more >
CONTEXT: Within the community-randomised ANRS 12249 Treatment-as-Prevention (TasP) trial conducted in rural South Africa, we analysed sexual behaviours stratified by sex over time, comparing immediate ART irrespective of CD4 count vs CD4-guided ART (start at CD4>350 then >500) arms. METHODS: As part of the 6-monthly home-based trial rounds, a sexual behaviour questionnaire (IQ) was administered to all residents >/=16 years. We considered seven indicators: sexual intercourse in the past month; at least one regular sexual partner in the past six months; at least one casual sexual partner in the past six months and more than one sexual partner in the past six months; condom use at last sex (CLS) with regular partner, CLS with casual partner, and point prevalence estimate of concurrency. We conducted repeated cross-sectional analyses, stratified by sex. GEE models were used, including trial arm, trial time, calendar time and interaction between trial arm and trial time. RESULTS: CLS with regular partner varied between 29%-51% and 23%- 46% for men and women, respectively, with significantly lower odds among women in the control versus intervention arm by trial end (p < 0.001). CLS with casual partner among men showed a significant interaction between arm and trial round, with no consistent pattern. Women declared more than one partner in the past 6 months in less that 1% of IQs; among men, rates varied between 5%-12%, and odds significantly and continuously declined between calendar rounds 1 and 7 (OR = 4.2 [3.24-5.45]). CONCLUSION: Universal Test and Treat was not associated with increased sexual risk behaviours.Read less <
English Keywords
IDLIC
ANRS 12249 TaSP