Sexual behavior following a diagnosis of acute HIV in men who have sex with men and in transgender women in the Sabes study in Lima, Peru

Thesis (Master's)--University of Washington, 2016-12Objectives: To determine the impact of early antiretroviral therapy (ART) on risky sexual behavior practices during the acute period of human immunodeficiency virus (HIV) infection and compare the ability of different survey modalities to capture these risky sexual behavior practices. Methods/Study Population: Our study looked at a cohort of 83 individuals, a subset of Sabes participants, who were either men who have sex with men (MSM) or transgender women (TW) living in Lima, Peru and observed their sexual behavior patterns over a year following diagnosis of acute HIV. Participants had been randomly assigned to initiate ART either immediately or after six months. We followed self-reported behavior and sexually transmitted infection (STI) diagnosis to determine if ART had an impact on an individual’s sexual behavior patterns. We collected information about sexual behavior practices using both computer-assisted self-interviewing (CASI) and in-person interviewing, and biologic data from testing for gonorrhea and chlamydia at specified intervals. Results: Our results indicate that during the acute period of HIV, when chances for transmission to a seronegative partner are the highest, individuals with HIV continue to practice risky sexual behavior which occurs regardless of ART use and continues even up to 48 weeks after known diagnosis. Individuals in our study, however, were not consistent with their reporting of condomless sex through either CASI or in-person interviewing and many documented STIs did not have corresponding reports of condomless sex by participants. Discussion/Significance of Impact: Our study is significant in its use of both biologic and survey data on sexual behavior over 48 weeks in a defined cohort of newly diagnosed individuals. Through understanding the behavior patterns during acute HIV, we can design better interventions aimed at these behaviors to reduce onward transmission and population-level incidence