Sexual risk behaviors among heterosexual HIV serodiscordant couples in the era of post-exposure prevention and viral suppressive therapy
Sexual risk behaviors among heterosexual HIV serodiscordant couples in the era of post-exposure prevention and viral suppressive therapy
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DOI：
10.1097/00002030-200003100-00003
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发表时间：
2000-03-10
期刊：
影响因子：
3.8
通讯作者：
Padian, N
中科院分区：
文献类型：
--
作者：
van der Straten, A;Gómez, CA;Padian, N
目的：描述抗逆转录病毒治疗、病毒载量监测和暴露后预防的认识和使用情况；评估对艾滋病毒传播不断变化的关注；并研究这些进展对艾滋病毒血清不一致的异性恋夫妇的性行为的影响。方法：对来自加州伴侣研究II的104对夫妇（n = 208个人）的基线样本进行横断面分析，这是一项针对加州hiv血清不一致夫妇的干预试验。性行为、病毒载量检测、HIV治疗、暴露后预防等问题，以及它们对性行为、风险承担和传播问题的影响。结果：超过三分之二的受访夫妇报告在过去6个月内与伴侣发生过无保护措施的性行为。在血清学阳性的应答者中，37%正在接受蛋白酶抑制剂治疗，92%接受了病毒载量检测，其中40%的人表示在最近的检测中未检测到病毒。大多数应答者，无论其血清状态如何，都表示病毒载量检测和接触后预防意识对他们使用安全套没有影响。此外，在血清阴性的受试者中，意识到他们的伴侣有无法检测到的病毒载量与保护性行为有关（P < 0.05）。服用蛋白酶抑制剂的血清阳性应答者报告无保护性行为的可能性是未服用蛋白酶抑制剂者的2.4倍（P = 0.05）。然而，高达33%的血清阳性应答者和40%的血清阴性应答者承认，鉴于新的艾滋病毒治疗方法，传播问题有所减少。与血清呈阳性的伴侣相比，血清呈阴性的个体更有可能认识到风险的增加和艾滋病毒传播的减少（P < 0.05）。结论：新的医学进展与艾滋病毒血清不一致夫妇的无保护性行为无关。然而，新的治疗方案可能会减少对艾滋病毒传播的担忧，特别是在血清阴性伴侣之间。提供者应与患者讨论抗逆转录病毒治疗对性传播风险的影响。将血清阴性伴侣纳入咨询干预可能会降低血清不一致夫妇的风险承担。(C) 2000 Lippincott Williams & Wilkins。
Objectives: To describe awareness and use of antiretroviral treatments, viral load monitoring, and post-exposure prevention; to assess changing concerns about HIV transmission; and to examine the effect of these advances on sexual behavior in HIV-serodiscordant heterosexual couples.Methods: Cross-sectional analysis of a baseline sample of 104 couples (n = 208 individuals) from the California Partners Study II, an intervention trial for HIV-serodiscordant couples in California. Questions on sexual practices, viral load testing, HIV treatment, post-exposure prevention, and their effect on sexual behaviors, risk taking and transmission concerns were measured at intake.Results: Over two-thirds of couple members surveyed reported unprotected sex with their partner in the past 6 months. Among seropositive respondents, 37% were taking protease inhibitor therapy, 92% had undergone viral load testing, and of those, 40% said it had ben undetectable at their most recent test. Most respondents, regardless of serostatus, said that viral load testing and awareness of post-exposure prevention had no effect on their condom use. In addition, perceiving that their partner had an undetectable viral load was associated with having protected sex among seronegative subjects (P < 0.05). Seropositive respondent taking protease inhibitors were 2.4 times less likely to report unprotected sex compared with those not taking protease inhibitors (P = 0.05). However, up to 33% of seropositive and 40% of seronegative respondents acknowledged decreased transmission concerns in the light of the new HIV treatments. In comparison with their seropositive partners, seronegative individuals were more likely to acknowledge increased risk taking and decreased HIV transmission concerns (P < 0.05).Conclusions: New medical advances were not associated with unprotected sex in HIV-serodiscordant couples. However, new treatment options may decrease concerns about HIV transmission, particularly among seronegative partners. Providers should discuss the effect of antiretroviral treatments on sexual transmission risk with theirpatients. The inclusion of seronegative partners in counseling interventions may decrease risk taking in serodiscordant couples. (C) 2000 Lippincott Williams & Wilkins.