Objectives The aim of this study was to evaluate the effect of antiretroviral therapy (ART) with or without condom use on the risk of sexual transmission of HIV. Methods A search of the literature was conducted in the PubMed, Web of Science, Cochrane, SCOPUS and EMBASE databases for studies dating back to 2008. The results were summarized as relative risks and incidence rates with 95% confidence intervals (CIs). The effect sizes were pooled using random‐effects models and heterogeneity was evaluated using the Cochrane Q test and I2. Results Of the 1424 studies retrieved in the initial search, 10 met the eligibility requirements. ART was associated with a 52% reduction in transmission risk compared to no ART, with a relative risk of 0.48 (95% CI 0.439–0.525) (Q = 0.524; I2 = 0.0%; overall effect Z = 15.99, P < 0.0001). ART vs. no ART caused a reduction in the risk from 5.6 person‐years (95% CI 3.26–9.62 person‐years) (Q = 0.771; I2 = 0.0%; overall effect Z = 6.25, P < 0.0001) in the untreated group to 0.85 person‐years (95% CI 0.28–2.99 person‐years) (Q = 0.038; I2 = 76.7%; overall effect Z = 0.11, P = 0.772) in the treated group, but not significantly so, which is equivalent to an 84% reduction in the risk of sexual transmission. In accordance with the Swiss National AIDS Commission declaration, ART with suppressed viral loads was associated with a minimal risk of transmission, with a median time at risk of 0.00 person‐years (95% CI 0.00–0.00 person‐years) (Q = 1.00; I2 = 0.0%; overall effect Z = 6.80, P < 0.0001). Conclusions ART and condom use were found to cause a significant reduction in the risk of sexual transmission of HIV in both homosexual and heterosexual populations, based on previous systematic reviews and meta‐analyses.

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Background Patients suffering from an out‐of‐hospital cardiac arrest are often transported to the closest hospital. Although it has been suggested that these patients be transported to cardiac resuscitation centers, few jurisdictions have acted on this recommendation. To better evaluate the evidence on this subject, a systematic review and meta‐analysis of the currently available literature evaluating the association between the destination hospital's capability (cardiac resuscitation center or not) and resuscitation outcomes for adult patients suffering from an out‐of‐hospital cardiac arrest was performed. Methods and Results PubMed, EMBASE , and the Cochrane Library databases were first searched using a specifically designed search strategy. Both original randomized controlled trials and observational studies were considered for inclusion. Cardiac resuscitation centers were defined as having on‐site percutaneous coronary intervention and targeted temperature management capability at all times. The primary outcome measure was survival. Twelve nonrandomized observational studies were retained in this review. A total of 61 240 patients were included in the 10 studies that could be included in the meta‐analysis regarding the survival outcome. Being transported to a cardiac resuscitation center was associated with an increase in survival (odds ratio=1.95 [95% confidence interval 1.47‐2.59], P <0.001). Conclusions Adult patients suffering from an out‐of‐hospital cardiac arrest transported to cardiac resuscitation centers have better outcomes than their counterparts. When possible, it is reasonable to transport these patients directly to cardiac resuscitation centers (class II a, level of evidence B, nonrandomized). Clinical Trial Registration URL : http://www.crd.york.ac.uk/PROSPERO/ . Unique identifier: CRD 42018086608.