Official websites use. Share sensitive information only on official, secure websites. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Socio-behavioural and medical data were collected. 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.
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. Antiretroviral therapies ART are now part of combination HIV prevention strategies, as their efficacy in decreasing blood plasma viral load VL has led to a dramatic reduction in HIV-1 sexual transmission among heterosexual serodiscordant couples [ 1 — 4 ]. This statement has led to considerable debate about possible sexual risk disinhibition or risk compensation in this population [ 6 — 10 ], offsetting the benefits of current biomedical HIV prevention strategies.
This issue is particularly important since the number of new HIV diagnoses continues to grow in the most vulnerable populations, especially men who have sex with men MSM. Systematic reviews or meta-analyses of the association between ART, risk perception and sexual behaviour show no or short-term increases in sexual risk behaviour among people receiving ART [ 12 — 15 ].
Meta-analysis by Crepaz et al. However there was a high prevalence of condomless sex in persons — with known or unknown HIV status — who believed that being on ART or having an UVL protects against HIV transmission or who were less concerned about engaging in unsafe sex because of ART availability. A review of recent findings also supported the relationship between treatment-related optimistic beliefs and HIV transmission risk [ 16 ]. More recently, a cross-sectional study among a nationally representative sample of US PLHIV engaged in care showed that the majority did not engage in sexual risk behaviour and that half of those who did had a detectable VL during the previous 12 months [ 18 ].
The heterogeneity of results published in the literature reflects the diversity of the study designs they come from longitudinal studies, cohorts, cross-sectional surveys , the diversity of the studied populations heterosexual couples, MSM, drug users and potential cross-cultural differences. We used data collected during the ANRS-VESPA2 survey to analyze, for the first time, the evolution over time of sexual risk behaviour in three distinct socio-epidemiological groups: MSM, women and other men, according to the biomedical criterion of HIV transmission risk.
