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CATIE-News: Bite-sized HIV/AIDS news bulletinsChanges in sexual behaviour and HIV riskThe widespread availability of highly active antiviral therapy (HAART) in high-income countries has had a profound impact—deaths from AIDS-related infections are uncommon, at least among people who are engaged in their care and treatment. By suppressing HIV levels, HAART increases CD4+ cell counts and allows the immune system to begin repairing itself. The partial rebuilding of the immune system that occurs because of HAART generally results in renewed energy and, in some cases, the possibility of a return to work or volunteer activities. What’s more, researchers expect that HIV-positive people who are engaged in their care and treatment and who have minimal co-existing health conditions can live near-normal life spans, at least in high-income countries with social-welfare systems. While HAART has had a profound impact on the health and lives of HIV-positive people, it may have had an inadvertent impact on HIV-negative people, as researchers have found these trends occurring in high-income countries:
An international team of researchers recently found that while HIV infections decreased between 1996 and 2000, they began to increase in 2001 and after in Australia, Canada, France, Germany, the Netherlands, the United Kingdom and the United States. As there is no cure or effective vaccine for HIV in the short term, the use of condoms remains a vital part of HIV prevention for sexually active people. SerosortingIn theory, another way to possibly reduce the risk of exposure to HIV is for people to serosort—have sex with other people of the same HIV status. For HIV-positive people, having sex only with other HIV-positive people may remove the burden of worry about infecting someone else. For HIV-negative people, serosorting may reduce the worry about getting HIV. In reality, serosorting carries risks, particularly when condoms are not used for intercourse:
Serosorting—study casts light on risksResearchers in Seattle conducted a study with gay and bisexual men between 2001 and 2007. They found that serosorting increased over time. Troublingly, they also found that during serosorting some men had unprotected anal intercourse. Although serosorting reduced the men’s risk for getting HIV, their risk for getting this infection was higher than if condoms had been used. What’s more, the study team noted that “from both a personal and public health perspective, the limits of serosorting seem to be profound.” Perhaps they reached this conclusion because serosorting only conferred partial protection from becoming HIV positive. They also found that 32% of all men who were newly diagnosed with HIV reported that unprotected anal intercourse with “a partner they believed to be HIV negative was their most risky sexual behaviour.” The study team was concerned that serosorting without condoms was such a risky behaviour for HIV negative men. Their findings need to be confirmed by other research teams. The Seattle researchers stated: “We did not routinely collect data on how [participants] knew a partner’s HIV status and some infections attributed to serosorting failure may reflect [participants’] assumptions about partners’ HIV status rather than inaccurate explicit discussions between men before sex.” This type of serosorting—based on assumptions or guesses—has been coined “seroguessing” by Australian researchers and is the focus of our next CATIE News story. —Sean R. Hosein REFERENCES:
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Created on: 11/10/2009 |
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Decisions about particular medical treatments should always be made in consultation with a qualified medical practitioner who is knowledgeable about HIV-related illness and the treatments in question. MORE | |