{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T15:00:38Z","timestamp":1791298838938,"version":"4.1.0"},"reference-count":34,"publisher":"Wiley","issue":"S1","license":[{"start":{"date-parts":[[2015,2,25]],"date-time":"2015-02-25T00:00:00Z","timestamp":1424822400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"crossref","award":["UM1-AI068641"],"award-info":[{"award-number":["UM1-AI068641"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000098","name":"NIH Clinical Center","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000098","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"crossref"}]},{"name":"National Institute of Arthritis and Musculoskeletal Disorders"},{"name":"French Agence Nationale de Recherches sur le SIDA et les H\u00e9patites Virales (ANRS)"},{"name":"German Ministry of Education and Research"},{"name":"European AIDS Treatment Network (NEAT)"},{"name":"Australian National Health and Medical Research Council"},{"DOI":"10.13039\/501100000265","name":"UK Medical Research Council","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"crossref"}]},{"name":"National Institute for Heath Research"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2015,4]]},"abstract":"Objectives<\/jats:title>A proportion of HIV<\/jats:styled-content>\u2010positive people have condomless sex. Antiretroviral treatment (ART<\/jats:styled-content>) reduces infectiousness, but a substantial proportion of HIV<\/jats:styled-content>\u2010diagnosed people are not yet on ART<\/jats:styled-content>. We describe baseline self\u2010reported risk behaviours in ART<\/jats:styled-content>\u2010na\u00efve S<\/jats:styled-content>trategic T<\/jats:styled-content>iming of A<\/jats:styled-content>ntiR<\/jats:styled-content>etroviral T<\/jats:styled-content>reatment (START<\/jats:styled-content>) trial participants.<\/jats:p><\/jats:sec>Methods<\/jats:title>All START<\/jats:styled-content> participants completed a risk behaviour questionnaire. Data were collected on sociodemographics, lifestyle factors, health and wellbeing status and clinical status. Recent sexual behaviour and HIV<\/jats:styled-content> transmission beliefs in the context of ART<\/jats:styled-content> were also assessed. The primary interest was in condomless sex with serodifferent partners (CLS<\/jats:styled-content>\u2010D<\/jats:styled-content>) in the past two months.<\/jats:p><\/jats:sec>Results<\/jats:title>A total of 4601 of 4685 HIV<\/jats:styled-content>\u2010positive participants (98%) completed the questionnaire [2559 men who have sex with men (MSM<\/jats:styled-content>), 803 heterosexual men and 1239 women]. Region of recruitment was E<\/jats:styled-content>urope\/I<\/jats:styled-content>srael, 33%; S<\/jats:styled-content>outh A<\/jats:styled-content>merica\/M<\/jats:styled-content>exico, 25%; A<\/jats:styled-content>frica, 22%; other, 21%. Median age was 36 years [interquartile range (IQR<\/jats:styled-content>) 29, 44 years]. Forty\u2010five per cent reported white ethnicity and 31% black ethnicity. Two per cent had HIV<\/jats:styled-content> viral load <\u200950 HIV<\/jats:styled-content>\u20101 RNA<\/jats:styled-content> copies\/mL. Seventeen per cent (767 of 4601) reported CLS<\/jats:styled-content>\u2010D<\/jats:styled-content>; 20% of MSM<\/jats:styled-content> compared with 10% of heterosexual men and 14% of women. MSM<\/jats:styled-content> were also more likely to report multiple CLS<\/jats:styled-content>\u2010D<\/jats:styled-content> partners. Possible risk limitation measures (reported by more than half of those who had CLS\u2010D<\/jats:styled-content>) were seropositioning (receptive anal CLS\u2010D<\/jats:styled-content> only) or withdrawal (insertive anal CLS\u2010D<\/jats:styled-content> always without ejaculation). CLS\u2010D<\/jats:styled-content> was more commonly reported by participants from S<\/jats:styled-content>outh A<\/jats:styled-content>merica\/M<\/jats:styled-content>exico and N<\/jats:styled-content>orth A<\/jats:styled-content>merica compared with E<\/jats:styled-content>urope; among heterosexual men and women CLS\u2010D<\/jats:styled-content> was also more commonly reported among participants from A<\/jats:styled-content>frica compared with E<\/jats:styled-content>urope. Knowledge of ART<\/jats:styled-content> impact on transmission risk was low.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>A substantial minority recruited to the START<\/jats:styled-content> study reported CLS<\/jats:styled-content>\u2010D<\/jats:styled-content> at baseline. CLS<\/jats:styled-content>\u2010D<\/jats:styled-content> reporting was higher in MSM<\/jats:styled-content> than heterosexuals and varied significantly according to region of recruitment. A<\/jats:styled-content> substantial proportion of MSM<\/jats:styled-content> reporting CLS<\/jats:styled-content>\u2010D<\/jats:styled-content> appear to take transmission risk limitation measures.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.12235","type":"journal-article","created":{"date-parts":[[2015,2,25]],"date-time":"2015-02-25T09:55:37Z","timestamp":1424858137000},"page":"64-76","source":"Crossref","is-referenced-by-count":16,"title":["Transmission risk behaviour at enrolment in participants in the INSIGHT S<\/scp>trategic T<\/scp>iming of A<\/scp>ntiR<\/scp>etroviral T<\/scp>reatment (START<\/scp>) trial"],"prefix":"10.1111","volume":"16","author":[{"given":"AJ","family":"Rodger","sequence":"first","affiliation":[{"name":"Research Department of Infection and Population Health University College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"FC","family":"Lampe","sequence":"additional","affiliation":[{"name":"Research Department of Infection and Population Health University College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AE","family":"Grulich","sequence":"additional","affiliation":[{"name":"The Kirby Institute University of New South Wales Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Fisher","sequence":"additional","affiliation":[{"name":"Brighton and Sussex Medical School Brighton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G","family":"Friedland","sequence":"additional","affiliation":[{"name":"Departments of Medicine and Epidemiology Yale School of Medicine New Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N","family":"Phanuphak","sequence":"additional","affiliation":[{"name":"Thai Red Cross AIDS Research Centre Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JR","family":"Bogner","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Med IV University Hospital of Munich Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"LC","family":"Pereira","sequence":"additional","affiliation":[{"name":"Emilio Ribas Institute of Infectious Diseases S\u00e3o Paulo SP Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Rietmeijer","sequence":"additional","affiliation":[{"name":"Colorado School of Public Health University of Colorado Denver CO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W","family":"Burman","sequence":"additional","affiliation":[{"name":"University of Colorado Health Sciences Center Denver CO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AN","family":"Phillips","sequence":"additional","affiliation":[{"name":"Research Department of Infection and Population Health University College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"International Network for Strategic Initiatives in Global HIV Trials (INSIGHT) START Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,2,25]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e32832effae"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e318183a9ad"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1105243"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e32832b7dca"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e3283437c2b"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200003303421303"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1089\/088922201750290023"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102458\u201012\u2010296"},{"key":"e_1_2_8_10_1","unstructured":"US Department of Health and Human Services.Guidelines for the use of antiretroviral agents in HIV\u20101\u2010infected adults and adolescents. Available athttp:\/\/aidsinfo.nih.gov\/guidelines(accessed 5 May 2014)."},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.7961"},{"key":"e_1_2_8_12_1","unstructured":"EACS (European AIDS Clinical Society) guidelines. Version 7.1 \u2013 November 2014. Available athttp:\/\/www.eacsociety.org\/guidelines\/eacs\u2010guidelines\/eacs\u2010guidelines.html(accessed 14 July 2013)."},{"key":"e_1_2_8_13_1","first-page":"1","article-title":"The next generation of the World Health Organization's global antiretroviral guidance","volume":"30","author":"Hirnschall G","year":"2013","journal-title":"J Int AIDS Soc"},{"issue":"1","key":"e_1_2_8_14_1","first-page":"1","article-title":"British HIV Association Guidelines for the Treatment of HIV\u20101\u2010positive adults with antiretroviral therapy 2012 (Updated November 2013)","volume":"15","author":"Williams I","year":"2014","journal-title":"HIV Med"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/1740774512440342"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1080\/09540120208629666"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.292.2.224"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/sti.79.1.7"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-200501280-00010"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.aids.0000167348.15750.9a"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e32831fb51a"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0b013e3182401a2f"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwh090"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-013-0426-z"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/COH.0b013e32832c3bb3"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1258\/ijsa.2007.007131"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007435-200307000-00006"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.7448\/IAS.15.6.18143"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10508-008-9365-6"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1293.2009.00708.x"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e32834f9d7c"},{"key":"e_1_2_8_32_1","unstructured":"World Health Organization.Guidance on Couples HIV Testing and Counseling including antiretroviral therapy for treatment and prevention in serodiscordant couples. Recommendations for a public health approach.2012. Available athttp:\/\/www.who.int\/hiv\/pub\/guidelines\/9789241501972\/en\/(accessed 5 May 2014)."},{"key":"e_1_2_8_33_1","unstructured":"Department of Health.BHIVA and EAGA position statement on the use of antiretroviral therapy to reduce HIV transmission. Available athttps:\/\/www.gov.uk\/government\/publications\/bhiva\u2010and\u2010eaga\u2010position\u2010statement\u2010on\u2010the\u2010use\u2010of\u2010antiretroviral\u2010therapy\u2010to\u2010reduce\u2010hiv\u2010transmission(accessed 5 May 2014)."},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11524-011-9578-1"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/hiv.12227"}],"container-title":["HIV Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fhiv.12235","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hiv.12235","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T04:24:11Z","timestamp":1694492651000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hiv.12235"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,2,25]]},"references-count":34,"journal-issue":{"issue":"S1","published-print":{"date-parts":[[2015,4]]}},"alternative-id":["10.1111\/hiv.12235"],"URL":"https:\/\/doi.org\/10.1111\/hiv.12235","archive":["Portico"],"relation":{},"ISSN":["1464-2662","1468-1293"],"issn-type":[{"value":"1464-2662","type":"print"},{"value":"1468-1293","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,2,25]]}}}