AEGiS-12IAC: Awareness of PEP and viral suppressive therapy have little effect on sexual risk behavior in heterosexual HIV-discordant couples.

12th International AIDS Conference

Geneva, Switzerland - June 28-July 3, 1998

Awareness of PEP and viral suppressive therapy have little effect on sexual risk behavior in heterosexual HIV-discordant couples.

Int Conf AIDS 1998 Jun 28-Jul 3; 12:211-2 (abstract no. 14146)

Van der Straten A, Gomez CA, Saul J, Padian N
UCSF, Center for AIDS Prevention Studies, USA.

OBJECTIVE: To describe beliefs about anti-retroviral (ARV) treatments, viral load (VL) monitoring and post-exposure prevention (PEP), and their effect on risk perception and sexual behavior in heterosexual HIV-discordant couples.

METHODS: The California Partners Study II is an intervention for HIV-discordant couples in Northern California. Questions about awareness and use of PEP, VL monitoring, ARV treatments, and their effect on sexual behavior were asked at intake. Risk perception and transmission concerns in light of these medical advances were also assessed.

RESULTS: 32 out of an anticipated 90 couples have been analyzed. Of the 64 subjects, 51% were < 40 years old, 44% black, 20% current IDU, 66% started the relationship ≥ 1 year ago. Unprotected sex in the past six months was reported in 69% of the couples. 28% of both the HIV(+) and (-) partners had heard about PEP. Of those, none reported modifying condom use because of the availability of PEP. 55% of the HIV(-) partners believed PEP prevented transmission ≥ 1/2 time and 78% said that it was likely that they would take PEP if exposed. Concerns for both couple members centered around PEP's side effects, toxicity and effectiveness. Of the HIV(+) partners, 50% were currently taking ARV treatments, 88% had their VL measured and of those, 43% said it was undetectable. > 90% of the HIV(+) and (-) partners said that knowledge of VL had not changed their condom use. HIV(+) and (-) partners disagreed about sexual risk taking in the couple due to ARV treatments: At this time, self-reported condom use was not significantly associated with risk perception, VL level or awarness of PEP. TABULAR DATA, SEE ABSTRACT VOLUME

CONCLUSIONS: ARV treatments have decreased concerns about infection and increased willingness to take risks in a substantial minority of couples. While new medical advances (PEP, VL, viral supressive therapy) may not increase unprotected sex, they may provide additional rationale for it, particularly for some uninfected partners. Monitoring their effect on risk perception and risk taking should continue. These issues should be addressed by providers and in interventions for HIV(+) and high risk heterosexuals.

Keywords: AEGIS, Heterosexuality, Sex Behavior, Risk-Taking, HIV, HIV Infections, HIV Seropositivity, Viral Load, Health Knowledge, Attitudes, Practice, Anti-HIV Agents, Safe Sex, HIV Protease Inhibitors, HIV Seronegativity, California, therapy, immunology, virology, ICA12
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