Association between knowledge of HIV-positive status or use of antiretroviral therapy and high-risk transmission behaviors: Systematic review

Abstract

To systematically review the evidence on the association between knowledge of HIV-positive status or use of antiretroviral therapy (ART) and high-risk transmission behaviors, we searched Ovid MEDLINE from 2004 to February 2012 and the Cochrane Library Database through the first quarter of 2012. Four observational studies meeting inclusion criteria addressed HIV-positive status and seven addressed the use of ART and effects on behavior. Studies including both average and high-risk populations were conducted in developed countries and were rated at least fair quality. Overall, knowledge of HIV-positive status was associated with less engagement in high-risk transmission behaviors, and the use of ART was not found to increase participation in high-risk transmission behaviors by HIV-positive individuals.

Keywords:

• systematic review
• HIV
• knowledge of HIV status
• antiretroviral therapy
• transmission risk behavior

Acknowledgements

The authors thank Tracy Dana, MLS; Christina Bougatsos, MPH; Shelley Selph, MD, MPH; and P. Todd Korthuis, MD, MPH. This study was funded by the Agency for Healthcare Research and Quality (AHRQ) under a contract to support the work of the United States Preventive Services Task Force (USPSTF). Staff at AHRQ and USPSTF members helped develop the scope of this work and reviewed drafts. The drafts were reviewed by external peer reviewers not affiliated with the USPSTF, then revised for the final version. Approval from AHRQ was required before this manuscript could be submitted for publication, but the authors are solely responsible for the content and the decision to submit.