ArticleAIDS (London, England)2012
Changes in sexual and drug-related risk behavior following antiretroviral therapy initiation among HIV-infected injection drug users.
Article in AIDS (London, England), 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.
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Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Adherence to antiretroviral medications among persons who inject drugs in transitional, low and middle income countries: an international systematic review.AIDS and behavior · 2015Pooled it
- Guideline
- Regional differences between people who inject drugs in an HIV prevention trial integrating treatment and prevention (HPTN 074): a baseline analysis.Journal of the International AIDS Society · 2018Trial
- Association of Injection Practices and Overdose With Drug Use Typologies: A Latent Class Analysis Among People Who Inject Drugs in Baltimore, 2017.AIDS education and prevention : official publication of the International Society for AIDS Education · 2019Article
- Article
- Article
- The impact of buprenorphine/naloxone treatment on HIV risk behaviors among HIV-infected, opioid-dependent patients.Drug and alcohol dependence · 2014Article
- Factors Associated with HIV Testing History among Pregnant Women and Their Partners in Georgia: The ANRS 12127 Prenahtest Trial.AIDS research and treatment · 2014Article
- Inconsistent condom use among HIV-positive women in the "Treatment as Prevention Era": data from the Italian DIDI study.Journal of the International AIDS Society · 2013Article
- Smartphone Delivery of Mobile HIV Risk Reduction Education.AIDS research and treatment · 2013Article
- Putting risk compensation to rest: reframing the relationship between risk behavior and antiretroviral therapy among injection drug users.AIDS (London, England) · 2012Article
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7 authors.
Funding
Abstract
objectiveTo evaluate whether HAART is associated with subsequent sexual and drug-related risk behavior compensation among injection drug users (IDUs).
designA community-based cohort study of 362 HIV-infected IDUs initiating HAART in Baltimore, Maryland.
methodsHAART use and risk behavior was assessed at 8316 biannual study visits (median 23). Using logistic regression with generalized estimating equations (GEE), we examined the effect of HAART initiation on changes in risk behavior while adjusting for sociodemographics, alcohol use, CD4 cell count, year of initiation and consistency of HAART use.
resultsAt HAART initiation, participants were a median of 44.4 years old, 71.3% men and 95.3% African-American. In multivariable analysis, HAART initiation was associated with a 75% reduction in the likelihood of unprotected sex [adjusted odds ratio (aOR) 0.25; 95% confidence interval (CI), 0.19-0.32] despite no change in overall sexual activity (aOR 0.95; 0.80-1.12). Odds of any injecting decreased by 38% (aOR 0.62; 0.51-0.75) after HAART initiation. Among the subset of persistent injectors, needle-sharing increased nearly two-fold (aOR 1.99; 1.57-2.52). Behavioral changes were sustained for more than 5 years after HAART initiation and did not differ by consistency of HAART use. Reporting specific high-risk behaviors in the year prior to initiation was a robust predictor of engaging in those behaviors subsequent to HAART.
conclusionOverall, substantial declines in sexual risk-taking and active injecting argue against significant behavioral compensation among IDUs following HAART initiation. These data also provide evidence to support identifying persons with risky pre-HAART behavior for targeted behavioral intervention.
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