Session 116Poster Presentations The HIV/STD Interface Session Day and Time: Tuesday 1:30 - 3:30 pm Room: Hall B
921 Safer Sex After Initiation of Antiretroviral Therapy in a Public HIV Clinic in Brazil
P. F. Barroso*1, M. Schechter1, J. Cerbino-Neto1, M. H. H. Almeida1, L. H.Harrison2 1HUCFF-Univ Federal do Rio de Janeiro, Brazil and 2Univ of Pittsburgh, PA
Background: Access to antiretroviral therapy (ART) is increasing in the developing world. There is a risk that the provision of ART could lead to an increase in sexual activity among HIV treated subjects. This would have a deleterious impact on the dynamics of the epidemic because a substantial proportion of subjects on ART shed virus in genital secretions.
Objective: To determine the frequency of sexual contacts and condom use in a cohort of patients (pts) using ART in a developing country
Methods: Before and after analysis in 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 (mos).
Results: We report results on 103 pts who were enrolled in this study and had at least 1 interview. Mean age was 33.8 yrs 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. Sixty percent (60%) of the pts reported at least 1 sexual encounter per month (mo) before the initiation of ART. This proportion was 66% after 6 mos (p = 0.46), 73% (p = 0.11) after 12 mos and 78% (p = 0.03) after 24 mos. 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 mos (p = 0.30), 100% after 12 mos (p = 0.01) and 85% after 24 mos (p = 0.15).
Conclusions: Although the proportion of pts having sexual activity while on ART increased in this developing country setting, adherence to condom use also increased. The net impact of these changes on the dynamics of HIV transmission needs to be determined.