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Abstract n° WEPDD104

Abstract n° WEPDD104. Sexual activity and risk behaviors among HIV-infected patients initiating ART in rural district hospitals in Cameroon Preliminary results of a 24-month follow-up (Stratall ANRS 12110/ESTHER trial).

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Abstract n° WEPDD104

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  1. Abstract n° WEPDD104 Sexual activity and risk behaviors among HIV-infected patients initiating ART in rural district hospitals in CameroonPreliminary results of a 24-month follow-up (Stratall ANRS 12110/ESTHER trial) Fabienne Marcellin1,2,3, Charles Kouanfack4, Julien Cohen1,2,3, Sylvie Boyer1,2,3, Jean-Paul Moatti1,2,3, Maria Patrizia Carrieri1,2,3, Eric Delaporte5,6, Christian Laurent5, Bruno Spire1,2,3 1 INSERM, U912 (SE4S), Marseille, France 2 Université Aix Marseille, IRD, UMR-S912, Marseille, France 3 ORS PACA, Observatoire Régional de la Santé Provence Alpes Côte d’Azur, Marseille, France 4 Central Hospital, Yaoundé, Cameroon 5 Institut de Recherche pour le Développement (IRD), University Montpellier 1, UMR 145, Montpellier, France 6Department of Infectious and Tropical Diseases, University Hospital, Montpellier, France

  2. The Stratall ANRS 12110/ESTHER trial • Randomized, 24-month, open-label, 459 HIV-infected ART-naïve adults • 9 rural district hospitals in Cameroon • PRIMARY OBJECTIVE • Clinical efficacy of the WHO “public health” approach vs. that of the standard clinical approach for ART follow-up in resource-limited settings • AMONG SECONDARY OBJECTIVES • Changes in patients’ sexual behaviors before (M0) and after ART initiation(M6, M12, M24)

  3. Changes in sexual activity* during the follow-up Characteristics of patients before ART initiation (M0, n=447) % of patients a median [interquartile range] b CES-D score >16 c score 1 or 2 on a 10-point scale (Singh-Manoux A. et al, Psychom Med 2005) d drinks 3 big bottles and/or 6 glasses of alcohol or more on one occasion Months of follow-up sexually active with HIV-positive partners with serodiscordant partners * defined as reporting  1 sexual partner during the previous 3 months

  4. Factors associated with sexual activity (mixed-effect logistic regression) Sexual risk behaviors after ART initiation (M6, M12, M24) Patients sexually abstinent before ART initiation (n=119) ICU 57% P=0.002 Patients sexually active before ART initiation (n=81) ICU 77% * p<0.01 ** p<0.05 ICU = inconsistent condom use with serodiscordant partners during the previous 3 months AOR = adjusted odds ratio; CI = confidence interval • CONCLUSIONS • ART initiation fosters resumption of sexual activity • ICU remains less frequent among patients who resume sexual activity • Need for exploring the role of adherence counseling in positive prevention

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