NDLI: Per-contact probability of HIV transmission in homosexual men in Sydney in the era of HAART.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Jin, Fengyi Jansson, James Law, Matthew Prestage, Garrett P. Zablotska, Iryna Imrie, John C. G. Kippax, Susan C. Kaldor, John M. Grulich, Andrew E. Wilson, David P.
Spatial Coverage	Australia
Description	Country affiliation: Australia Author Affiliation: Jin F ( National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Darlinghurst, Australia. jjin@nchecr.unsw.edu.au)
Abstract	OBJECTIVE: The objective of this study is to estimate per-contact probability of HIV transmission in homosexual men due to unprotected anal intercourse (UAI) in the era of HAART. DESIGN: Data were collected from a longitudinal cohort study of community-based HIV-negative homosexual men in Sydney, Australia. METHODS: A total of 1427 participants were recruited from June 2001 to December 2004. They were followed up with 6-monthly detailed behavioral interviews and annual testing for HIV till June 2007. Data were used in a bootstrapping method, coupled with a statistical analysis that optimized a likelihood function for estimating the per-exposure risks of HIV transmission due to various forms of UAI. RESULTS: During the study, 53 HIV seroconversion cases were identified. The estimated per-contact probability of HIV transmission for receptive UAI was 1.43% [95% confidence interval (CI) 0.48-2.85] if ejaculation occurred inside the rectum, and it was 0.65% (95% CI 0.15-1.53) if withdrawal prior to ejaculation was involved. The estimated transmission rate for insertive UAI in participants who were circumcised was 0.11% (95% CI 0.02-0.24), and it was 0.62% (95% CI 0.07-1.68) in uncircumcised men. Thus, receptive UAI with ejaculation was found to be approximately twice as risky as receptive UAI with withdrawal or insertive UAI for uncircumcised men and over 10 times as risky as insertive UAI for circumcised men. CONCLUSION: Despite the fact that a high proportion of HIV-infected men are on antiretroviral treatment and have undetectable viral load, the per-contact probability of HIV transmission due to UAI is similar to estimates reported from developed country settings in the pre-HAART era.
File Format	HTM / HTML
ISSN	02699370
e-ISSN	14735571
DOI	10.1097/QAD.0b013e3283372d90
Journal	AIDS
Issue Number	6
Volume Number	24
Language	English
Publisher	Lippincott Williams & Wilkins
Publisher Date	2010-03-27
Publisher Place	Great Britain (UK)
Access Restriction	Open
Subject Keyword	Discipline Immunology Hiv Infections Psychology Sexual Behavior Sexual Partners Adolescent Antiretroviral Therapy, Highly Active Epidemiology Transmission Health Knowledge, Attitudes, Practice Homosexuality Probability Risk-taking Viral Load Research Support, N.i.h., Extramural Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Infectious Diseases Immunology and Allergy Immunology

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Infectiousness of HIV-infected men who have sex with men in the era of highly active antiretroviral therapy.

Per-contact probability of HIV transmission in homosexual men in Sydney in the era of HAART

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Decreased sexual risk behavior in the era of HAART among HIV-infected urban and rural South Africans attending primary care clinics.

Decline in HIV infectivity following the introduction of highly active antiretroviral therapy.

Less decrease in risk behaviour from pre-HIV to post-HIV seroconversion among MSM in the combination antiretroviral therapy era compared with the pre-combination antiretroviral therapy era.

A resurgent HIV-1 epidemic among men who have sex with men in the era of potent antiretroviral therapy.

A behavioral intervention reduces HIV transmission risk by promoting sustained serosorting practices among HIV-infected men who have sex with men.

Per-contact probability of HIV transmission in homosexual men in Sydney in the era of HAART.

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