Diamond C, Richardson JL, Milam J, Stoyanoff S, McCutchan JA, Kemper C, Larsen RA, Hollander H, Weismuller P, Bolan R; The California Collaborative Treatment Group; Conference on Retroviruses and Opportunistic Infections (11th : 2004 : San Francisco, Calif.).

Program Abstr Conf Retrovir Oppor Infect 11th 2004 San Franc Calif. 2004 Feb 8-11; 11: abstract no. 847.

Univ. of California, Irvine, USA

BACKGROUND: We wanted to determine the relationship between unprotected sex and antiretroviral use and adherence.METHODS: This was a cross-sectional survey conducted in 1998 to 1999 in 874 randomly selected, sexually active patients at 6 public HIV clinics in California. Patients completed a standardized interview regarding sociodemographics, HIV-related characteristics, sexual behavior, use of illicit drugs or alcohol, depression and health beliefs, experience with the medical system, and antiretroviral use and adherence. We defined unprotected sex as anal or vaginal sex without a condom over the past 3 months.RESULTS: The majority of patients (79%) took antiretrovirals. One third reported having unprotected sex and one quarter reported <95% adherence to antiretroviral therapy. Antiretroviral use was associated with decreased odds of unprotected sex, OR 0.5 (95%CI: 0.4 to 0.7, p <0.001); this negative relationship persisted in most stratified analyses, but was not significant in multivariate analysis, OR 0.8 (95%CI: 0.5 to 1.1, p = 0.19). HIV RNA status, marijuana use, and site and duration of clinic attendance confounded the relationship between unprotected sex and antiretroviral therapy in multivariate analysis; an undetectable viral load was associated with decreased odds of unprotected sex, OR 0.7 (95%CI: 0.5 to 1.0, p = 0.03). Adherence to antiretroviral therapy of =95% was associated with decreased odds of unprotected sex, OR 0.6 (95%CI: 0.4 to 0.8, p = 0.001); this negative relationship persisted in most stratified analyses but was not significant in multivariate analysis, OR 0.8 (95%CI: 0.5 to 1.2, p = 0.22). Number of sexual partners and amphetamine use confounded the relationship between antiretroviral adherence and unprotected sex in multivariate analysis. Of this group 7% (n = 57) of patients agreed with a statement that a low viral load would protect against HIV transmission and these patients had higher rates of unprotected sex than patients who disagreed with the statement. However, even among these 57 patients, those taking antiretrovirals still reported less unprotected sex than those who were not taking antiretrovirals (39% vs 63%, p = 0.22); similarly, those were =95% adherent with antiretroviral therapy were less likely to have unprotected sex than those were less adherent (31% vs 70%, p = 0.03).CONCLUSIONS: Use of and better adherence to antiretroviral therapy are associated with decreased unprotected sex but multiple factors confound these relationships.

Publication Types:

• Meeting Abstracts

Keywords:

• Acquired Immunodeficiency Syndrome
• Ambulatory Care Facilities
• California
• Condoms
• Cross-Sectional Studies
• Female
• HIV Infections
• HIV Seropositivity
• Humans
• Sexual Behavior
• Sexual Partners
• Unsafe Sex
• Viral Load

Other ID:

• GWAIDS0031399

UI: 102271036

From Meeting Abstracts