No effect of test and treat on sexual behaviours at population level in rural South Africa
type: Article
item type: journalArticle
is part of: AIDS
authors: Person
  surname: Rolland
  given name: Matthieu
authors: Person
  surname: McGrath
  given name: Nuala
authors: Person
  surname: Tiendrebeogo
  given name: Thierry
authors: Person
  surname: Larmarange
  given name: Joseph
authors: Person
  surname: Pillay
  given name: Deenan
authors: Person
  surname: Dabis
  given name: François
authors: Person
  surname: Orne-Gliemann
  given name: Joanna
authors: Person
  surname: Group
  given name: for the ANRS 12249 TasP study
abstract: 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.
date: 2019-03-15
pages: 709
citation key: rollandNoEffectTest2019
date submitted: 2019-03-05 23:58:23
language: en-US
library catalog: journals.lww.com

AIDS
type: Journal
volume: 33
number: 4
identifier: DOI 10.1097/qad.0000000000002104
identifier: ISSN 0269-9370