期刊
AIDS
卷 18, 期 1, 页码 81-88出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/00002030-200401020-00010
关键词
HIV; infectivity; transmission; highly active antiretroviral therapy; epidemiology; homosexual men; statistics
资金
- NCI NIH HHS [U01-CA78124] Funding Source: Medline
- NCRR NIH HHS [M01 RR00083, M01 RR000079, M01 RR000083, M02 RR00079] Funding Source: Medline
- NIAID NIH HHS [P30 AI277763, P30 AI27763, P30 AI027763] Funding Source: Medline
- NIDA NIH HHS [R01 DA013510, 5R01-DA13510] Funding Source: Medline
- NIDCR NIH HHS [R01 DE012911, 5R01-DE12911-03] Funding Source: Medline
- NIMH NIH HHS [P30 MH062246, P30 MH62246] Funding Source: Medline
Objective: Little is known about the degree to which widespread use of antiretroviral therapy in a community reduces uninfected individuals' risk of acquiring HIV. We estimated the degree to which the probability of HIV infection from an infected partner (the infectivity) declined following the introduction of highly active antiretroviral therapy (HAART) in San Francisco. Design: Homosexual men from the San Francisco Young Men's Health Study, who were initially uninfbcted with HIV, were asked about sexual practices, and tested for HIV antibodies at each of four follow-up visits during a 6-year period spanning the advent of widespread use of HAART (1994 to 1999). Methods: We estimated the infectivity of HIV (per-partnership probability of transmission from an infected partner) using a probabilistic risk model based on observed incident infections and self-reported sexual risk behavior, and tested the hypothesis that infectivity was the same before and after HAART was introduced. Results: A total of 534 homosexual men were evaluated. Decreasing trends in HIV seroincidence were observed despite increases in reported number of unprotected receptive anal intercourse partners. Conservatively assuming a constant prevalence of HIV infection between 1994 and 1999, HIV infectivity decreased from 0.120 prior to widespread use of HAART, to 0.048 after the widespread use of HAART-a decline of 60% (P=0.028). Conclusions: Use of HAART by infected persons in a community appears to reduce their infectiousness and therefore may provide an important HIV prevention tool. (C) 2004 Lippincott Williams Wilkins.
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