AEGiS-14IAC: Sexual activity after initiation of antiretroviral therapy in Brazil.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

Sexual activity after initiation of antiretroviral therapy in Brazil.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. C10687)

Barroso PF, Schechter M, Cerbino-Neto J, Almeida MH, Littleton M, Harrison LH
Hospital Universitario Clementino Fraga Filho-Universidade Federal do Rio de janeiro, Rio de Janeiro, Brazil

BACKGROUND: Access to antiretroviral therapy (ART) has led to greater life expectancy and sense of well being among HIV-infected subjects. There is a risk that an increase in sexual activity among HIV treated subjects might be associated with a deleterious impact on the dynamics of the epidemic because a substantial proportion of subjects shed virus in genital secretions while on ART. Brazil is the only developing country to provide universal access to ART free of charge.

OBJECTIVE: To determine the frequency of sexual contacts and condom use in a cohort of patients starting ART

METHODS: This was a prospective cohort study among men starting ART in Rio de Janeiro, Brazil. A structured interview with a detailed characterization of sexual activity was performed before initiation of therapy and at 6, 12 and 24 months.

RESULTS: We report results on 103 patients that were enrolled in this study and had at least one interview. Mean age was 33.8 years and 95% reported a sexual risk factor for contracting HIV. Median CD4 and viral load at time of initiation of therapy were 269/mm³ and 42,000 copies/ml, respectively. 60% of the patients reported at least one sexual encounter per month before the initiation of ART. This proportion was 66% after 6 months (p=0.46), 73% (p=0.11) after 12 months and 78% (p= 0.03) after 24 months. Among those who reported having sex, reported number of sexual encounters was similar before and during therapy (p>0.5 for all comparisons). Reported use of condom in all sexual encounters increased from 68% before initiation of ARV to 90% after 6 months (p=0.30), 100% after 12 months (p=0.01) and 85% after 24 months (p=0.15).

CONCLUSIONS: Our data show that, although the proportion of patients having sexual activity while on ART increases, adherence to condom use also increases. The net impact of these changes on the dynamics of HIV transmission needs to be determined.

Keywords: AEGIS, Sex Behavior, HIV Infections, Anti-HIV Agents, Condoms, HIV, Viral Load, Antiretroviral Therapy, Highly Active, Cohort Studies, Risk Factors, HIV Seropositivity, HIV Protease Inhibitors, Prospective Studies, Brazil, Human, Male, therapy, drug therapy

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C10687