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Condomless Sex Among Virally Suppressed Women With HIV With Regular HIV-Serodiscordant Sexual Partners in the Era of Treatment as Prevention
- Source :
- Journal of acquired immune deficiency syndromes (1999). 76(4)
- Publication Year :
- 2017
-
Abstract
- Sexual HIV transmission does not occur with sustained undetectable viral load (VL) on antiretroviral therapy (ART). Awareness of ART prevention benefits and its influence on condom use among women with HIV (WWH) remain unexplored. We estimated prevalence and correlates of condomless sex with regular HIV-serodiscordant partners among WWH with undetectable VL on ART.We used baseline questionnaire data from the community-based longitudinal Canadian HIV Women's Sexual and Reproductive Health Cohort Study (CHIWOS). We included WWH self-reporting vaginal/anal sex with ≥1 HIV-negative/unknown status regular partner within 6 months, and undetectable VL (50 copies/mL) on ART. We excluded participants exclusively reporting female partners or missing condom-use data. Condomless sex was defined as100% condom use within 6 months. The primary explanatory variable was awareness of ART prevention benefits. Logistic regression identified factors independently associated with condomless sex.Of 271 participants (19% of the CHIWOS cohort), median age was 41 (interquartile range: 34-47), 51% were in a relationship, 55% reported condomless sex, and 75% were aware of ART prevention benefits. Among women aware, 63% reported condomless sex compared with 32% of women not aware (P0.001). Factors independently associated with condomless sex included being aware of ART prevention benefits (adjusted odds ratio: 4.08; 95% confidence interval: 2.04 to 8.16), white ethnicity, ≥high-school education, residing in British Columbia, and being in a relationship.Virally suppressed women aware of ART prevention benefits had 4-fold greater odds of condomless sex. Advancing safer sex discussions beyond condoms is critical to support women in regular serodiscordant partnerships to realize options for safe and satisfying sexuality in the Treatment-as-Prevention era.
- Subjects :
- Adult
Male
medicine.medical_specialty
Cross-sectional study
Anti-HIV Agents
Human immunodeficiency virus (HIV)
HIV Infections
medicine.disease_cause
law.invention
Condoms
03 medical and health sciences
0302 clinical medicine
Condom
law
HIV Seronegativity
HIV Seropositivity
medicine
Humans
Pharmacology (medical)
030212 general & internal medicine
Longitudinal Studies
Reproductive health
030505 public health
British Columbia
Unsafe Sex
business.industry
virus diseases
Middle Aged
Viral Load
Treatment as prevention
Infectious Diseases
Cross-Sectional Studies
Logistic Models
Reproductive Health
Sexual Partners
Family medicine
Serodiscordant
HIV-1
Women's Health
Female
Self Report
0305 other medical science
business
Post-Exposure Prophylaxis
Viral load
Subjects
Details
- ISSN :
- 19447884
- Volume :
- 76
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Journal of acquired immune deficiency syndromes (1999)
- Accession number :
- edsair.doi.dedup.....b67300b3582d2eae6c7d26fa02c16d3c