1. Does per‐act HIV‐1 transmission risk through anal sex vary by gender? An updated systematic review and meta‐analysis
- Author
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Baggaley, Rebecca F, Owen, Branwen N, Silhol, Romain, Elmes, Jocelyn, Anton, Peter, McGowan, Ian, van der Straten, Ariane, Shacklett, Barbara, Dang, Que, Swann, Edith M, Bolton, Diane L, and Boily, Marie‐Claude
- Subjects
Biomedical and Clinical Sciences ,Clinical Sciences ,HIV/AIDS ,Prevention ,Infection ,Gender Equality ,Good Health and Well Being ,Female ,HIV Infections ,HIV-1 ,Heterosexuality ,Humans ,Male ,Risk ,Sex Factors ,Sexual Behavior ,Sexual and Gender Minorities ,anal intercourse ,antiretroviral therapy ,heterosexual ,HIV ,infectivity ,meta-analysis ,MSM ,review ,transmission probability - Abstract
Quantifying HIV-1 transmission risk per-act of anal intercourse (AI) is important for HIV-1 prevention. We updated previous reviews by searching Medline and Embase to 02/2018. We derived pooled estimates of receptive AI (URAI) and insertive AI (UIAI) risk unprotected by condoms using random-effects models. Subgroup analyses were conducted by gender, study design, and whether antiretroviral treatment (ART) had been introduced by the time of the study. Two new relevant studies were identified, one of which met inclusion criteria, adding three new cohorts and increasing number of individuals/partnerships included from 1869 to 14 277. Four studies, all from high-income countries, were included. Pooled HIV-1 risk was higher for URAI (1.25%, 95% CI 0.55%-2.23%, N = 5, I2 = 87%) than UIAI (0.17%, 95 % CI 0.09%-0.26%, N = 3, I2 = 0%). The sole heterosexual URAI estimate (3.38%, 95% CI 1.85%-4.91%), from a study of 72 women published in a peer-reviewed journal, was significantly higher than the men-who-have-sex-with-men (MSM) pooled estimate (0.75%, 95% CI 0.56%-0.98%, N = 4, P
- Published
- 2018