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Frequency and Determinants of Unprotected Sex among HIV-Infected Persons: The Swiss HIV Cohort Study

Hasse, Barbara ; Ledergerber, Bruno ; Hirschel, Bernard ; Vernazza, Pietro ; Glass, Tracy R. ; Jeannin, Andre ; Evison, John-Marc ; Elzi, Luigia ; Cavassini, Matthias ; Bernasconi, Enos ; Nicca, Dunja ; Weber, Rainer

In: Clinical Infectious Diseases, 2010, vol. 51, no. 11, p. 1314-1322

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    Titel
    • Frequency and Determinants of Unprotected Sex among HIV-Infected Persons: The Swiss HIV Cohort Study
    Autor
    • Hasse, Barbara. Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
    • Ledergerber, Bruno. Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
    • Hirschel, Bernard. Division of Infectious Diseases, University Hospital Geneva, Geneva, Switzerland
    • Vernazza, Pietro. Division of Infectious Diseases, Cantonal Hospital, St. Gallen, Switzerland
    • Glass, Tracy R.. Basel Institute for Clinical Epidemiology and Biostatistics, University of Basel, Basel, Switzerland
    • Jeannin, Andre. Institute for Social and Preventive Medicine, University of Lausanne, Lausanne, Switzerland
    • Evison, John-Marc. Division of Infectious Diseases, University Hospital Berne, Berne, Switzerland
    • Elzi, Luigia. Division of Infectious Diseases, University Hospital Basel, Basel, Switzerland
    • Cavassini, Matthias. Division of Infectious Diseases, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
    • Bernasconi, Enos. Division of Infectious Diseases, Regional Hospital, Lugano, Switzerland
    • Nicca, Dunja. Division of Infectious Diseases, Cantonal Hospital, St. Gallen, Switzerland
    • Weber, Rainer. Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
    Dokumententyp
    • Postprint
    Sprache
    • Englisch
    Veröffentlicht in
    • Clinical Infectious Diseases, 2010, vol. 51, no. 11, p. 1314-1322. The University of Chicago Press
    Andere elektronische Ausgabe
    Klassifikation
    • Gesundheit
    OAI-PMH-ID
    • oai:doc.rero.ch:302738
    Summary
    Background. Access to antiretroviral therapy may have changed condom use behavior. In January 2008, recommendations on condom use for human immunodeficiency virus (HIV)-positive persons were published in Switzerland, which allowed for unprotected sex under well-defined circumstances ("Swiss statement”). We studied the frequency, changes over time, and determinants of unprotected sex among HIV-positive persons. Methods. Self-reported information on sexual preference, sexual partners, and condom use was collected at semi-annual visits in all participants of the prospective Swiss HIV Cohort Study from April 2007 through March 2009. Multivariable logistic regression models were fit using generalized estimating equations to investigate associations between characteristics of cohort participants and condom use. Findings. A total of 7309 participants contributed to 21,978 visits. A total of 4291 persons (80%) reported sexual contacts with stable partners, 1646 (30%) with occasional partners, and 557 (10%) with stable and occasional partners. Of the study participants, 5838 (79.9%) of 7309 were receiving antiretroviral therapy, and of these, 4816 patients (82%) had a suppressed viral load. Condom use varied widely and differed by type of partner (visits with stable partners, 10,368 [80%] of 12,983; visits with occasional partners, 4300 [88%] of 4880) and by serostatus of stable partner (visits with HIV-negative partners, 7105 [89%] of 8174; visits with HIV-positive partners, 1453 [48%] of 2999). Participants were more likely to report unprotected sex with stable partners if they were receiving antiretroviral therapy, if HIV replication was suppressed, and after the publication of the "Swiss statement.” Noninjection drug use and moderate or severe alcohol use were associated with unprotected sex. Conclusions. Antiretroviral treatment and plasma HIV RNA titers influence sexual behavior of HIV-positive persons. Noninjection illicit drug and alcohol use are important risk factors for unprotected sexual contacts