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Highly active antiretroviral treatment does not increase sexual risk behaviour among French HIV infected injecting drug users
  1. A-D Bouhnik1,2,
  2. J P Moatti2,3,
  3. D Vlahov4,
  4. H Gallais5,
  5. P Dellamonica6,
  6. Y Obadia1,2,
  7. and the MANIF 2000 Study Group7
  1. 1Regional Centre for Disease Control of South-Eastern France (ORS-PACA), Marseilles, France
  2. 2INSERM Research Unit 379, Epidemiology and Social Sciences Applied to Medical Innovation, Institut Paoli-Calmettes, Marseilles, France
  3. 3Department of Economics, University of Aix-Marseilles II, France
  4. 4Center for Urban Epidemiologic Studies, New York Academy of Medicine, USA
  5. 5Department of Infectious Diseases, “La Conception” Hospital, Marseilles, France
  6. 6Department of Tropical and Infectious Diseases, “L'Archet” Hospital, Nice, France
  7. 7C Boirot, A D Bouhnik, M P Carrieri, J P Cassuto, P Dellamonica, N Escaffre, G Fuzibet, H Gallais, J A Gastaut, G Lepeu, A Loundou, C Marimoutou, D Mechali, J P Moatti, J Moreau, Y Obadia, C Pradier, D Rey, C Raynaud-Maurupt, A Schaeffer, A Sobel, B Spire, C Tamalet, F Trémoliéres, D Vlahov
  1. Correspondence to:
 Dr Y Obadia, ORS-PACA, 23 rue Stanislas Torrents, 13006 Marseille, France;


Study objective: This study examined the impact of highly active antiretroviral therapies (HAART) on sexual risk behaviours of HIV infected injecting drug users (IDUs) included in the French MANIF 2000 cohort study.

Design: Longitudinal analysis including baseline and last follow up characteristics using generalised estimating equations (GEE).

Setting: Hospital departments for specialist AIDS care in south eastern France and inner suburbs of Paris.

Patients: All patients antiretrovial treatment naive, who reported being sexually active at enrolment, and who had at least one follow up visit in the cohort between October 1996 and May 1998 (n=188).

Main results: Of the 188 HIV infected IDUs who were antiretroviral treatment naive at enrolment, 34 were prescribed HAART during follow up. Proportion of patients who reported at least one episode of unprotected sexual intercourse in the previous six months only significantly decreased in the HAART treated group (from 47.1% to 23.5%, p=0.008, compared with 43.5% to 35.7% in the rest of the sample, p=0.10). GEE multivariate model confirmed that prescription of HAART was associated with reduced sexual risk.

Conclusions: The concern that HAART might result in clinical improvement leading to resumption of high risk activities that could inadvertently result in HIV transmission was not supported by these data. Reasons for further reductions in HIV risk with taking HAART remain to be clarified.

  • HAART treatment
  • sexual risk behaviours
  • HIV infection
  • HAART, highly active antiretroviral therapies
  • IDU
  • injecting drug user
  • GEE, generalised estimating equations

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  • Funding: The MANIF 2000 cohort study is supported by the French National Agency for AIDS Research (ANRS).

  • Conflicts of interest: none.

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