Barcelona 2013
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| Abstract #162 - Biomedical Prevention | ||||
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Session: 40.3: Biomedical Prevention (Parallel) on Tuesday @ 16.30-18.30 in Raval Chaired by Olive Shisana, Chinese Authors: Presenting Author: Dr Annabel DESGREES du LOU - IRD, France |
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| Additional Authors: Dr. Prashant Sharma, Dr. Manorama Bhargava, | ||||
| Aim: The international debate around ?Treatment as Prevention? raises many issues, especially in terms of the social impact of very early ART. Initiating ART immediately after HIV diagnosis implies treating people who do not feel the need for a medical treatment, who do not perceive themselves nor are perceived by their family or friends as ?ill?. It may then have an impact on their social, conjugal and family life. Being on treatment may expose them to additional discrimination. | ||||
| Method / Issue: This is a cross sectional survey nested in randomized trial (Temprano ANRS 12136) aiming to compare immediate ART initiation to ART initiation as per WHO guidelines in patients with <800 CD4/mm3 and no WHO criteria for starting ART in Côte d?Ivoire. All participants enrolled between January 2010 and august 2012 were interviewed at their 12-month visit, to document HIV status disclosure, HIV stigma, and conjugal union events. | ||||
| Results / Comments: 1107 patients participated in the survey, of whom 563 were randomized in the immediate ART initiation strategy (?early ART?) and 544 in the WHO guidelines-based ART initiation strategy (?standart ART?). Disclosure of HIV serostatus to at least one member of their household was reported by 58.2% of patients in early ART and 59.0% in standard ART (p=0.80). Having being treated unfairly due to their HIV status was reported by 2.5% of patients in early ART and 1.5% in standard ART (p=0.23). The feeling of loneliness was reported by 19.3% of patients in early ART and 24.0% in standard ART (p=0.05). Among the 732 patients living in couple, disclosure to the partner was reported by 65.2% of patients in early ART and 68.0% in standard ART (p=0.42). Couple breakdown was reported by 2.9 % of patients in early ART and 3.6% in standard ART (p=0.72). Eventually, we didn?t observe any significant difference between the two arms for the indicator of professional activity. | ||||
| Discussion: In the first year of follow-up, patients on early ART and standard ART declared similar rates of HIV status disclosure, stigmatization, conjugal separation, or professional activity. This absence of short term social consequences of starting ART early has to be confirmed on a longer term. | ||||
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