@article{rolland_no_2019, title = {No effect of test and treat on sexual behaviours at population level in rural {South} {Africa}}, volume = {33}, issn = {0269-9370}, url = {https://journals.lww.com/aidsonline/Abstract/2019/03150/No_effect_of_test_and_treat_on_sexual_behaviours.14.aspx}, doi = {10.1097/qad.0000000000002104}, 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 {\textgreater} 350 cells/μl then {\textgreater}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 {\textless} 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.}, language = {en-US}, number = {4}, urldate = {2019-03-05}, journal = {AIDS}, author = {Rolland, Matthieu and McGrath, Nuala and Tiendrebeogo, Thierry and Larmarange, Joseph and Pillay, Deenan and Dabis, François and Orne-Gliemann, Joanna and Group, for the ANRS 12249 TasP study}, month = mar, year = {2019}, pages = {709}, }