Bao, Y., Jing, J., Zhang, Y., et al. Chinese Medical Journal (English), (December 2014), Vol. 127, Issue 24, pp. 4177–4183.
This cohort study examined differences in the risk of sexual HIV transmission between people who knew their HIV status and those who did not. The study comprised two surveys of newly diagnosed HIV-positive participants in Shanghai, Chongqing, and Kunming, China. The first survey of 823 HIV-positive participants took place before participants learned their status. The second study, with 650 participants, was conducted six months after HIV status notification. Both surveys asked questions about sexual behaviors in the past six months, including unsafe sex practices (unprotected anal and vaginal sex with partners of positive or unknown HIV status), number of unsafe sexual partners, and frequency of unsafe sexual behaviors. Comparison of the behavior of participants with known versus unknown HIV status showed a large reduction (84.65 percent) in reports of unsafe sex (from 58.25 percent before HIV status notification to 8.94 percent after notification). Moreover, the average number of partners in unsafe sex practices dropped by over 35 percent (from 2.33 partners to 1.51 partners pre- and post-notification, respectively). The average frequency of unsafe sex dropped from 9.02 percent of all encounters before HIV status notification to 7.85 percent after notification. The authors concluded that HIV status notification can reduce the incidence of unsafe sexual practices, leading to reduced sexual transmission of HIV.