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. 2002 Mar;92(3):388-94.
doi: 10.2105/ajph.92.3.388.

Impact of highly active antiretroviral treatment on HIV seroincidence among men who have sex with men: San Francisco

Mitchell H Katz  1 , Sandra K Schwarcz, Timothy A Kellogg, Jeffrey D Klausner, James W Dilley, Steven Gibson, William McFarland
Affiliations

Impact of highly active antiretroviral treatment on HIV seroincidence among men who have sex with men: San Francisco

Mitchell H Katz et al. Am J Public Health. 2002 Mar.

Abstract

Objectives: This study assessed the countervailing effects on HIV incidence of highly active antiretroviral treatment (HAART) among San Francisco men who have sex with men (MSM).

Methods: Behavioral risk was determined on the basis of responses to cross-sectional community interviews. HIV incidence was assessed through application of an enzyme-linked immunoassay testing strategy.

Results: Use of HAART among MSM living with AIDS increased from 4% in 1995 to 54% in 1999. The percentage of MSM who reported both unprotected anal intercourse and multiple sexual partners increased from 24% in 1994 to 45% in 1999. The annual HIV incidence rate increased from 2.1% in 1996 to 4.2% in 1999 among MSM who sought anonymous HIV testing, and the rate was high (5.3%) but stable in a blinded survey of MSM seeking sexually transmitted disease services.

Conclusions: Any decrease in per contact risk of HIV transmission due to HAART use appears to have been counterbalanced or overwhelmed by increases in the number of unsafe sexual episodes.

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Figures

FIGURE 1—
FIGURE 1—
AIDS incidence, mortality, prevalence, and use of highly active antiretroviral therapy (HAART) among men who have sex with men (MSM): San Francisco, 1980–1999.
FIGURE 2—
FIGURE 2—
Reported sexual behaviors among men who have sex with men and male rectal gonorrhea cases: San Francisco, 1994–1999.
FIGURE 3—
FIGURE 3—
Hypothesized effect of highly active antiretroviral therapy (HAART) on HIV seroincidence among men who have sex with men (MSM) in San Francisco. GC = gonorrhea.
See this image and copyright information in PMC

Comment in

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