%0 Journal Article
%9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES
%A Rolland, M.
%A McGrath, N.
%A Tiendrebeogo, T.
%A Larmarange, Joseph
%A Pillay, D.
%A Dabis, F.
%A Orne-Gliemann, J.
%A ANRS TasP Study Group
%T No effect of test and treat on sexual behaviours at population level in rural South Africa
%D 2019
%L PAR00019640
%G ENG
%J AIDS
%@ 0269-9370
%K Africa ; antiretroviral therapy ; HIV ; prevention ; sexual behaviour
%K AFRIQUE DU SUD
%M ISI:000480690900014
%N 4
%P 709-722
%R 10.1097/qad.0000000000002104
%U https://www.documentation.ird.fr/hor/PAR00019640
%> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2023-08/010087821.pdf
%V 33
%W Horizon (IRD)
%X 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/mu l then >500 cells/mu l) 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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