@article{fdi:010068949,
  title = {{W}hat level of risk compensation would offset the preventive effect of early antiretroviral therapy ? {S}imulations from the {TEMPRANO} trial},
  author = {{J}ean, {K}. and {B}oily, {M}. {C}. and {D}anel, {C}. and {M}oh, {R}. and {B}adje, {A}. and {D}esgr{\'e}es du {L}oû, {A}nnabel and {E}holie, {S}. and {L}ert, {F}. and {D}ray-{S}pira, {R}. and {A}nglaret, {X}. and {O}uattara, {E}.},
  editor = {},
  language = {{ENG}},
  abstract = {{W}hether risk compensation could offset the preventive effect of early initiation of antiretroviral therapy ({ART}) on human immunodeficiency virus ({HIV}) transmission remains unknown. {U}sing virological and behavioral data collected 12 months after inclusion in the {TEMPRANO} randomized trial of early {ART} ({A}bidjan, {C}ote d'{I}voire, 2009-2012), we estimated the risk of {HIV} transmission and compared it between the intervention (early {ART}; n = 490) and control (deferred {ART}; n = 467) groups. {W}e then simulated increases in various sexual risk behaviors in the intervention group and estimated the resulting preventive effect. {O}n the basis of reported values of sexual behaviors, we estimated that early {ART} had an 89% (95% confidence interval: 81, 95) preventive effect on the cumulative risk of {HIV} transmission over a 1-month period. {T}his preventive effect remained significant for a wide range of parameter combinations and was offset (i.e., nonsignificant) only for dramatic increases in different sexual behaviors simulated simultaneously. {F}or example, when considering a 2-fold increase in serodiscordance and the frequency of sexual intercourse together with a 33% decrease in condom use, the resulting preventive effect was 47% (95% confidence interval: -3, 74). {A}n important reduction of {HIV} transmission may thus be expected from the scale-up of early {ART}, even in the context of behavioral change.},
  keywords = {antiretroviral therapy ; {HIV} ; prevention ; risk compensation ; sexual behaviors ; sub-{S}aharan {A}frica ; {COTE} {D}'{IVOIRE} ; {ABIDJAN}},
  booktitle = {},
  journal = {{A}merican {J}ournal of {E}pidemiology},
  volume = {184},
  numero = {10},
  pages = {755--760},
  ISSN = {0002-9262},
  year = {2016},
  DOI = {10.1093/aje/kww127},
  URL = {https://www.documentation.ird.fr/hor/fdi:010068949},
}