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No effect of test and treat on sexual behaviours at population level in rural South Africa

CONTEXT: Within the community-randomized ANRS 12249 Treatment-as-Prevention trial conducted in rural South Africa, we analysed sexual behaviours stratified by sex over time, comparing immediate antiretroviral therapy irrespective of CD4(+) cell count vs. CD4(+)-guided antiretroviral therapy (start a...

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Autores principales: Rolland, Matthieu, McGrath, Nuala, Tiendrebeogo, Thierry, Larmarange, Joseph, Pillay, Deenan, Dabis, François, Orne-Gliemann, Joanna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7373441/
https://www.ncbi.nlm.nih.gov/pubmed/30608273
http://dx.doi.org/10.1097/QAD.0000000000002104
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author Rolland, Matthieu
McGrath, Nuala
Tiendrebeogo, Thierry
Larmarange, Joseph
Pillay, Deenan
Dabis, François
Orne-Gliemann, Joanna
author_facet Rolland, Matthieu
McGrath, Nuala
Tiendrebeogo, Thierry
Larmarange, Joseph
Pillay, Deenan
Dabis, François
Orne-Gliemann, Joanna
author_sort Rolland, Matthieu
collection PubMed
description CONTEXT: Within the community-randomized ANRS 12249 Treatment-as-Prevention trial conducted in rural South Africa, we analysed sexual behaviours stratified by sex over time, comparing immediate antiretroviral therapy irrespective of CD4(+) cell count vs. CD4(+)-guided antiretroviral therapy (start at CD4(+) cell count > 350 cells/μl then >500 cells/μl) arms. METHODS: As part of the 6-monthly home-based trial rounds, a sexual behaviour individual questionnaire was administered to all residents at least 16 years. We considered seven indicators: sexual intercourse in the past month; at least one regular sexual partner in the past 6 months; at least one casual sexual partner in the past 6 months and more than one sexual partner in the past 6 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. Generalized Estimating Equations 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 vs. 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 than 1% of individual questionnaires; among men, rates varied between 5–12%, and odds significantly and continuously declined between calendar rounds 1 and 7 [odds ratio = 4.2 (3.24–5.45)]. CONCLUSION: Universal Test and Treat was not associated with increased sexual risk behaviours.
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spelling pubmed-73734412020-08-05 No effect of test and treat on sexual behaviours at population level in rural South Africa Rolland, Matthieu McGrath, Nuala Tiendrebeogo, Thierry Larmarange, Joseph Pillay, Deenan Dabis, François Orne-Gliemann, Joanna AIDS Epidemiology and Social CONTEXT: Within the community-randomized ANRS 12249 Treatment-as-Prevention trial conducted in rural South Africa, we analysed sexual behaviours stratified by sex over time, comparing immediate antiretroviral therapy irrespective of CD4(+) cell count vs. CD4(+)-guided antiretroviral therapy (start at CD4(+) cell count > 350 cells/μl then >500 cells/μl) arms. METHODS: As part of the 6-monthly home-based trial rounds, a sexual behaviour individual questionnaire was administered to all residents at least 16 years. We considered seven indicators: sexual intercourse in the past month; at least one regular sexual partner in the past 6 months; at least one casual sexual partner in the past 6 months and more than one sexual partner in the past 6 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. Generalized Estimating Equations 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 vs. 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 than 1% of individual questionnaires; among men, rates varied between 5–12%, and odds significantly and continuously declined between calendar rounds 1 and 7 [odds ratio = 4.2 (3.24–5.45)]. CONCLUSION: Universal Test and Treat was not associated with increased sexual risk behaviours. Lippincott Williams & Wilkins 2019-03-15 2019-01-03 /pmc/articles/PMC7373441/ /pubmed/30608273 http://dx.doi.org/10.1097/QAD.0000000000002104 Text en Copyright © 2019 The Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by/4.0 This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0
spellingShingle Epidemiology and Social
Rolland, Matthieu
McGrath, Nuala
Tiendrebeogo, Thierry
Larmarange, Joseph
Pillay, Deenan
Dabis, François
Orne-Gliemann, Joanna
No effect of test and treat on sexual behaviours at population level in rural South Africa
title No effect of test and treat on sexual behaviours at population level in rural South Africa
title_full No effect of test and treat on sexual behaviours at population level in rural South Africa
title_fullStr No effect of test and treat on sexual behaviours at population level in rural South Africa
title_full_unstemmed No effect of test and treat on sexual behaviours at population level in rural South Africa
title_short No effect of test and treat on sexual behaviours at population level in rural South Africa
title_sort no effect of test and treat on sexual behaviours at population level in rural south africa
topic Epidemiology and Social
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7373441/
https://www.ncbi.nlm.nih.gov/pubmed/30608273
http://dx.doi.org/10.1097/QAD.0000000000002104
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