Sexual risk behaviour among people living with HIV according to the biomedical risk of transmission: results from the ANRS-VESPA2 survey
Résumé
Introduction: People living with HIV (PLHIV) on antiretroviral therapy (ART), with sustained undetectable viral load (sUVL) and no
history of sexually transmitted infections for at least six months, are considered to have a low risk of HIV transmission (LRT). We
aimed to characterize, in a representative sample of French PLHIV, the sexual behaviour of LRT PLHIV compared with non-LRT
PLHIV.
Methods: The cross-sectional ANRS-VESPA2 survey was conducted on adult PLHIV attending French hospitals in 2011. The LRT
PLHIV group included participants with sUVL and no sexually transmitted infection for at least 12 months. Socio-behavioural and
medical data were collected. Chi-square tests helped compare sexual risk indicators between LRT and non-LRT PLHIV. The
survey’s retrospective nature allowed us to perform complementary category-based analyses of LRT PLHIV according to whether
they had sUVL for at least 18, 24 or 36 months in three socio-epidemiological groups: men who have sex with men (MSM), other
men and women.
Results: Analysis included 2638 PLHIV diagnosed 12 months with available viral load data. The proportion of LRT PLHIV varied
from 58% (]12 months sUVL) to 38% (]36 months sUVL). Irrespective of sUVL duration, we found the following: 1) LRT men
(MSM and other men) were more likely to report having no sexual partner than their non-LRT counterparts. Among men having
sexual partners in the previous 12 months, no significant difference was seen between LRT and non-LRT men in the number of
sexual partners. LRT women were less likely to report having more than one sexual partner than non-LRT women; 2) LRT MSM
were more likely to report being in sexually inactive couples than their non-LRT counterparts; 3) among sexually active
participants, no difference was observed between LRT and non-LRT PLHIV concerning condom use with their serodiscordant
steady partner or with their most recent casual sexual partners.
Conclusions: LRT PLHIV with sUVL ]12 months did not report more sexual risk behaviours than their non-LRT counterparts.
Because the same result was obtained for those having a sUVL ]36 months, the hypothesis of increased sexual risk behaviour
over time in PLHIV meeting non-transmission biomedical criteria is not supported.
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