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Letters
JAMA. 2004;292(19):2336. doi: 10.1001/jama.292.19.2336-a

HAART and Sexual Risk Behavior—Reply

  1. Nicole Crepaz, PhD
  1. ncrepaz@cdc.gov
  1. Gary Marks, PhD
  1. Division of HIV/AIDS Prevention
    Centers for Disease Control and Prevention
    Atlanta, Ga
  1. Trevor A. Hart, PhD
  1. Department of Psychology
    York University
    Toronto, Ontario

Since this article does not have an abstract, we have provided the first 150 words of the full text.

In Reply: Dr Diamond and colleagues provide analyses that examine whether CD4 cell counts and the duration of HIV infection are associated with unprotected sex in a heterogeneous sample of HIV-positive patients. As discussed in our meta-analytic review, analyses like these are informative for obtaining a better understanding of how medical factors may affect the relationship between receipt of HAART and sexual risk behavior among persons infected with HIV. Although Diamond and colleagues did not find any association between CD4 cell counts, an indicator of disease stage, and sexual risk behavior in their cross-sectional study, a recent longitudinal study1 conducted survival analyses of 190 HIV-infected injection drug users who initiated HAART during 1996-2000 and found that an increase in CD4 cell count after HAART initiation was significantly associated with engaging in unprotected sexual intercourse, a finding that is consistent with our discussion. However, given that potentially conflicting conclusions may …

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