HIV Infections Clinical Trial
Official title:
HIV Transmission Risk Behavior Substudy
The purpose of this study is to compare the effects of two different anti-HIV drug regimens on HIV transmission risk behavior among SMART study participants.
It is important to consider the role that HIV infected individuals play in ongoing HIV
transmission. Different anti-HIV treatment regimens may lead to variations in HIV
transmission risk behavior among HIV infected individuals. HIV infected people with viral
loads of less than 1,000 copies/ml are less likely to transmit HIV through heterosexual sex.
However, condom use sometimes decreases after individuals start combination antiretroviral
therapy (ART); also, some studies have shown an increased rate in acquiring sexually
transmitted infections (STIs) following initiation of ART, and those on ART may transmit a
drug-resistant strain of HIV. In the SMART study, participants were randomly assigned to one
of two treatment groups:
- Group 1 participants will follow a drug conservation (DC) regimen in which ART will be
stopped or deferred until CD4 cell count drops below 250 cells/mm3, will be initiated
until CD4 cell count is at least 350 cells/mm3, and then will be followed by episodic
ART based on CD4 cell count.
- Group 2 participants will follow a viral suppression (VS) regimen in which ART is
continued to keep viral loads as low as possible, regardless of CD4 cell count.
The purpose of this study is to compare how the DC and VS regimens affect HIV transmission
risk behavior among SMART study participants.
At baseline, participants will complete a questionnaire about their sexual behavior during
the previous 2 months. They will also undergo urine and blood collection for STI testing.
These same procedures will occur at Months 4 and 12, then every year thereafter for the
first 4 years that a participant is in the parent study. Participants and their physicians
will be notified of STI testing results so that patients can be referred to appropriate
care.
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Observational Model: Cohort, Time Perspective: Prospective
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