RT Journal Article
T1 Sexual Activity Without Condoms and Risk of HIV Transmission in Serodifferent Couples When the HIV-Positive Partner Is Using Suppressive Antiretroviral Therapy.
A1 Rodger, Alison J
A1 Cambiano, Valentina
A1 Bruun, Tina
A1 Vernazza, Pietro
A1 Collins, Simon
A1 van Lunzen, Jan
A1 Corbelli, Giulio Maria
A1 Estrada, Vicente
A1 Geretti, Anna Maria
A1 Beloukas, Apostolos
A1 Asboe, David
A1 Viciana, Pompeyo
A1 Gutiérrez, Félix
A1 Clotet, Bonaventura
A1 Pradier, Christian
A1 Gerstoft, Jan
A1 Weber, Rainer
A1 Westling, Katarina
A1 Wandeler, Gilles
A1 Prins, Jan M
A1 Rieger, Armin
A1 Stoeckle, Marcel
A1 Kümmerle, Tim
A1 Bini, Teresa
A1 Ammassari, Adriana
A1 Gilson, Richard
A1 Krznaric, Ivanka
A1 Ristola, Matti
A1 Zangerle, Robert
A1 Handberg, Pia
A1 Antela, Antonio
A1 Allan, Sris
A1 Phillips, Andrew N
A1 Lundgren, Jens
A1 PARTNER Study Group, 
AB A key factor in assessing the effectiveness and cost-effectiveness of antiretroviral therapy (ART) as a prevention strategy is the absolute risk of HIV transmission through condomless sex with suppressed HIV-1 RNA viral load for both anal and vaginal sex. To evaluate the rate of within-couple HIV transmission (heterosexual and men who have sex with men [MSM]) during periods of sex without condoms and when the HIV-positive partner had HIV-1 RNA load less than 200 copies/mL. The prospective, observational PARTNER (Partners of People on ART-A New Evaluation of the Risks) study was conducted at 75 clinical sites in 14 European countries and enrolled 1166 HIV serodifferent couples (HIV-positive partner taking suppressive ART) who reported condomless sex (September 2010 to May 2014). Eligibility criteria for inclusion of couple-years of follow-up were condomless sex and HIV-1 RNA load less than 200 copies/mL. Anonymized phylogenetic analysis compared couples' HIV-1 polymerase and envelope sequences if an HIV-negative partner became infected to determine phylogenetically linked transmissions. Condomless sexual activity with an HIV-positive partner taking virally suppressive ART. Risk of within-couple HIV transmission to the HIV-negative partner. Among 1166 enrolled couples, 888 (mean age, 42 years [IQR, 35-48]; 548 heterosexual [61.7%] and 340 MSM [38.3%]) provided 1238 eligible couple-years of follow-up (median follow-up, 1.3 years [IQR, 0.8-2.0]). At baseline, couples reported condomless sex for a median of 2 years (IQR, 0.5-6.3). Condomless sex with other partners was reported by 108 HIV-negative MSM (33%) and 21 heterosexuals (4%). During follow-up, couples reported condomless sex a median of 37 times per year (IQR, 15-71), with MSM couples reporting approximately 22,000 condomless sex acts and heterosexuals approximately 36,000. Although 11 HIV-negative partners became HIV-positive (10 MSM; 1 heterosexual; 8 reported condomless sex with other partners), no phylogenetically linked transmissions occurred over eligible couple-years of follow-up, giving a rate of within-couple HIV transmission of zero, with an upper 95% confidence limit of 0.30/100 couple-years of follow-up. The upper 95% confidence limit for condomless anal sex was 0.71 per 100 couple-years of follow-up. Among serodifferent heterosexual and MSM couples in which the HIV-positive partner was using suppressive ART and who reported condomless sex, during median follow-up of 1.3 years per couple, there were no documented cases of within-couple HIV transmission (upper 95% confidence limit, 0.30/100 couple-years of follow-up). Additional longer-term follow-up is necessary to provide more precise estimates of risk.
YR 2016
FD 2016
LK http://hdl.handle.net/10668/10259
UL http://hdl.handle.net/10668/10259
LA en
DS RISalud
RD Apr 8, 2025