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Use of antivirals by HIV-infected persons reduced their ability to infect partners

The introduction and widespread use of highly active antiretroviral therapy (HAART) for HIV-infected persons in San Francisco in the late 1990s reduced their risks of infecting partners by 60 percent, according to a study conducted by researchers from the San Francisco Department of Public Health (SFDPH) and UCSF.

"While we found that antiretroviral use alone may account for a 60 percent reduction in risk of HIV transmission, a concurrent increase in risk behavior meant that rates of new infections did not decline sharply, but remained roughly stable for the period studied," said study lead investigator Travis Porco, PhD, MPH, an epidemiologist with SFDPH at the time the study was conducted.

The study, to be published in the January 2, 2004 issue of AIDS, analyzed data from 1994 to 1999 from the San Francisco Young Men's Health Study (YMHS), which followed young gay men who were initially uninfected with HIV. Participants were asked about their sexual practices and tested for HIV at four follow-up visits, which included two before the widespread introduction of HAART for people with HIV in San Francisco and two later visits.

The study estimated the chances that a HIV-uninfected person would become infected by a sexual partner after factoring in sexual practice and condom use. Researchers found a per partnership decline of 60 percent in risk of becoming infected that occurred following the introduction and the widespread use of HAART by HIV-infected persons in San Francisco.

"Unfortunately, the doubling of the rate of unprotected receptive anal intercourse by study participants offset the beneficial effects of antiretroviral treatments becoming widely available," said study co-author and YMHS lead investigator, Dennis Osmond, PhD, UCSF professor in the Department of Epidemiology and Biostatistics.

"While our findings confirm that treatment of HIV-infected individuals can have quite a significant impact on the spread of AIDS, t
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Contact: Jeff Sheehy
jsheehy@psg.ucsf.edu
415-597-8165
University of California - San Francisco
11-Dec-2003


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