@article{fdi:010061487,
  title = {{E}ffect of early antiretroviral therapy on sexual behaviors and {HIV}-1 transmission risk among adults with diverse heterosexual partnership statuses in {C}ote d'{I}voire},
  author = {{J}ean, {K}. and {G}abillard, {D}. and {M}oh, {R}. and {D}anel, {C}. and {F}assassi, {R}. and {D}esgr{\'e}es du {L}oû, {A}nnabel and {E}holie, {S}. and {L}ert, {F}. and {A}nglaret, {X}. and {D}ray-{S}pira, {R}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground. {T}he effect of early initiation of antiretroviral therapy ({ART}; ie, at {CD}4(+) {T}-cell counts >350 cells/mm(3)) on sexual behaviors and human immunodeficiency virus type 1 ({HIV}) transmission risk has not been documented in populations other than {HIV}-serodiscordant couples in stable relationships. {M}ethods. {O}n the basis of data from a behavioral study nested in a randomized, controlled trial ({T}emprano-{ANRS}12136) of early {ART}, we compared proportions of risky sex (ie, unprotected sex with a partner of negative/unknown {HIV} status) reported 12 months after inclusion between participants randomly assigned to initiate {ART} immediately (hereafter, "early {ART}") or according to ongoing {W}orld {H}ealth {O}rganization criteria. {G}roup-specific {HIV} transmission rates were estimated on the basis of sexual behaviors and viral load-specific per-act {HIV} transmission probabilities. {T}he ratio of transmission rates was computed to estimate the protective effect of early {ART}. {R}esults. {A}mong 957 participants (baseline median {CD}4(+) {T}-cell count, 478 cells/mm(3)), 46.0% reported sexual activity in the past month; of these 46.0%, sexual activity for 41.5% involved noncohabiting partners. {T}he proportion of subjects who engaged in risky sex was 10.0% in the early {ART} group, compared with 12.8% in the standard {ART} group ({P} = .17). {A}fter accounting for sexual behaviors and viral load, we estimated that the protective effect of early {ART} was 90% (95% confidence interval, 81%-95%). {C}onclusion. {T}welve months after inclusion, patients in the early and standard {ART} groups reported similar sexual behaviors. {E}arly {ART} decreased the estimated risk of {HIV} transmission by 90%, suggesting a major prevention benefit among seronegative sex partners in stable or casual relationships with seropositive individuals.},
  keywords = {{HIV} prevention ; antiretroviral treatment ; sexual behaviors ; {HIV}-1 sexual ; transmission ; treatment as prevention ; epidemiology ; sub-{S}aharan {A}frica ; {COTE} {D}'{IVOIRE}},
  booktitle = {},
  journal = {{J}ournal of {I}nfectious {D}iseases},
  volume = {209},
  numero = {3},
  pages = {431--440},
  ISSN = {0022-1899},
  year = {2014},
  DOI = {10.1093/infdis/jit470},
  URL = {https://www.documentation.ird.fr/hor/fdi:010061487},
}