@article{fdi:010062217,
  title = {{D}ecrease in sexual risk behaviours after early initiation of antiretroviral therapy : a 24-month prospective study in {C}{\^o}te d'{I}voire},
  author = {{K}{\'e}vin, {J}. and {G}abillard, {D}. and {M}oh, {R}. and {D}anel, {C}. and {D}esgr{\'e}es du {L}oû, {A}nnabel and {N}'{T}akpe, {J}.{B}. and {L}e {C}arrou, {J}. and {B}adj{\'e}, {A}. and {E}holi{\'e}, {S}. and {L}ert, {F}. and {A}nglaret, {X}. and {D}ray-{S}pira, {R}.},
  editor = {},
  language = {{ENG}},
  abstract = {{I}ntroduction: {W}hether early antiretroviral therapy ({ART}) initiation could impact sexual risk behaviours remains to be documented. {W}e aimed to investigate changes in sexual behaviours within the 24 months following an early versus standard {ART} initiation in {HIV}-positive adults with high {CD}4 counts. {M}ethods: {W}e used data from a prospective behavioural study nested in a randomized controlled trial of early {ART} ({T}emprano- {ANRS}12136). {T}ime trends in sexual behaviours from enrolment in the trial ({M}0) to 12-month ({M}12) and 24-month ({M}24) visits were measured and compared, using {G}eneralized {E}stimating {E}quations models, between participants randomly assigned either to initiate {ART} immediately (early {ART}) or to defer {ART} initiation until on-going {WHO} starting criteria are met (standard {ART}). {I}ndicators of sexual behaviours included 1) sexual activity in the past year, 2) multiple partnership in the past year, 3) unprotected sex at last intercourse and 4) risky sex (i.e. unprotected sex with a partner of {HIV} negative/unknown status) at last intercourse. {R}esults: {A}nalyses included 1952 participants (975 with early {ART} and 977 with standard {ART}; overall median baseline {CD}4 count: 469/mm3). {A}mong participants with early {ART}, significant decreases were found between {M}0 and {M}24 in sexual activity ({O}dds {R}atio [{OR}] 0.72, 95% {C}onfidence {I}nterval [95% {CI}] 0.570.92), multiple partnership ({OR} 0.57, 95% {CI} 0.410.79), unprotected sex ({OR} 0.59, 95% {CI} 0.470.75) and risky sex ({OR} 0.58, 95% {CI} 0.450.76). {A}mong participants with standard {ART}, sexual behaviours showed similar trends over time. {T}hese decreases mostly occurred within the 12 months following enrolment in the trial in both groups and prior to {ART} initiation in participants with standard {ART}. {F}or unprotected sex and risky sex, decreases were or tended to be more pronounced among patients reporting that their last sexual partner was non-cohabiting. {C}onclusions: {I}n these sub-{S}aharan adults with high {CD}4 counts, entry into {HIV} care, rather than {ART} initiation, resulted in decreased sexual activity and risky sexual behaviours. {W}e did not observe any evidence of a risk compensation phenomenon associated with early {ART} initiation. {T}hese results illustrate the potential behavioural preventive effect of early entry into care, which goes hand in hand with early {ART} initiation.},
  keywords = {{SIDA} ; {TRANSMISSION} ; {ADULTE} ; {TRAITEMENT} {MEDICAL} ; {COMPORTEMENT} {SEXUEL} ; {PREVENTION} {SANITAIRE} ; {ETUDE} {REGIONALE} ; {ETUDE} {COMPARATIVE} ; {THERAPIE} {ANTIRETROVIRALE} ; {CHANGEMENT} ; {PARTENAIRE} {SEXUEL} ; {QUESTIONNAIRE} ; {COTE} {D}'{IVOIRE}},
  booktitle = {},
  journal = {{J}ournal of {I}nternational {AIDS} {S}ociety},
  volume = {17},
  numero = {},
  pages = {18977 [9  en ligne]},
  ISSN = {1758-2652},
  year = {2014},
  DOI = {10.7448/{IAS}.17.1.18977},
  URL = {https://www.documentation.ird.fr/hor/fdi:010062217},
}