- NEW YORK -- HIV-positive patients who take a potent class of antiretroviral
drugs called protease inhibitors are more likely to have unprotected sex
than patients who do not take the drugs, U.S. researchers reported at the
American Public Health Association's annual meeting in Washington, DC,
- Protease inhibitors reduce levels of
the human immunodeficiency virus (HIV) - the virus that causes AIDS - in
the blood. But they do not cure the disease or prevent transmission of
the virus from HIV-positive patients to their sexual partners.
- "Given that many HIV-infected individuals
will be treated with protease inhibitors, these unanticipated consequences
are disturbing," the lead researcher, Dr. Ralph DiClemente, of Emory
University's Rollins School of Public Health in Atlanta, Ga., said in a
statement to the press.
- The findings suggest that many people
taking the drugs have misconceptions about the medications. This may be
due in part to the fact that initial press reports about the drugs were
overly optimistic, he said. When the drugs were introduced a few years
ago, he added, a major news magazine ran an article with the headline,
- In light of the findings, healthcare
workers need to ensure that patients taking antiretroviral drugs realize
that the drugs are not a cure, that they can still infect sexual partners
with the virus, and that they must take precautions during sex, DiClemente
told Reuters Health in an interview.
- DiClemente and colleagues interviewed
190 sexually active HIV-positive patients at six clinics in rural Alabama,
asking them about their sexual practices over the preceding 30 days. Roughly
15.8% of the patients were taking protease inhibitors.
- These patients were 2.5 times more likely
to report that they did not use condoms regularly than were patients who
were not taking protease inhibitors, the researchers found. Patients taking
protease inhibitors were also more likely to say that they never used condoms
during the preceding 30 days than were those not taking the drugs.
- Among patients taking protease inhibitors,
men who were having sex with other men were "markedly more likely"
to say they did not use condoms regularly than were women or men having
sex with women, DiClemente and colleagues report.
- And among men having sex with men, those
taking protease inhibitors were four times more likely to report that they
did not use condoms regularly - and 5.4 times more likely to report never
using condoms - than were men who were not taking the drugs.
- "Men having sex with men may have
had more exposure to (initial media reports about the drugs) and been more
aware and attuned to medical progress," DiClemente suggested as a
reason for the pronounced difference in sexual behavior among the groups.
"So when the first words came down about how effective these drugs
were, this may have affected these men more than (it affected) men having
sex with women, or than women in these rural areas."
- Given the potential consequences of these
findings, more study is warranted, he added.