TY - JOUR
T1 - Antiretroviral Medication Adherence and Amplified HIV Transmission Risk Among Sexually Active HIV-Infected Individuals in Three Diverse International Settings
AU - Magidson, Jessica F.
AU - Li, Xin
AU - Mimiaga, Matthew J.
AU - Moore, Ayana T.
AU - Srithanaviboonchai, Kriengkrai
AU - Friedman, Ruth Khalili
AU - Limbada, Mohammad
AU - Hughes, James P.
AU - Cummings, Vanessa
AU - Gaydos, Charlotte A.
AU - Elharrar, Vanessa
AU - Celentano, David
AU - Mayer, Kenneth H.
AU - Safren, Steven A.
N1 - Funding Information:
HPTN 063 was funded by the Division of AIDS (DAIDS), National Institute of Allergy and Infectious Disease (NIAID), National Institute on Drug Abuse (NIDA), and the National Institute of Mental Health (NIMH) under Cooperative Agreement # UM1AI068619. The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or The HIV Prevention Trials Network. The authors would also like to acknowledge the staff at the HPTN 063 study sites for their contributions to the study. Additionally, Dr. Magidson’s work on this manuscript was supported by NIH Grant T32MH093310, and Dr. Safren was supported by NIH Grant K24MH094214. Dr. Mayer and Dr. Safren were also supported by the Harvard University Center for AIDS Research (HU CFAR) NIH P30AI060354. This manuscript was supported by consultation from other members of the HU CFAR Social and Behavioral Sciences Core.
Publisher Copyright:
© 2015, Springer Science+Business Media New York.
PY - 2016/4/1
Y1 - 2016/4/1
N2 - Successful biomedical prevention/treatment-as-prevention (TasP) requires identifying individuals at greatest risk for transmitting HIV, including those with antiretroviral therapy (ART) nonadherence and/or ‘amplified HIV transmission risk,’ defined as condomless sex with HIV-uninfected/unknown-status partners when infectious (i.e., with detectable viremia or STI diagnosis according to Swiss criteria for infectiousness). This study recruited sexually-active, HIV-infected patients in Brazil, Thailand, and Zambia to examine correlates of ART nonadherence and ‘amplified HIV transmission risk’. Lower alcohol use (OR = .71, p < .01) and higher health-related quality of life (OR = 1.10, p < .01) were associated with greater odds of ART adherence over and above region. Of those with viral load data available (in Brazil and Thailand only), 40 % met Swiss criteria for infectiousness, and 29 % had ‘amplified HIV transmission risk.’ MSM had almost three-fold (OR = 2.89, p < .001) increased odds of ‘amplified HIV transmission risk’ (vs. heterosexual men) over and above region. TasP efforts should consider psychosocial and contextual needs, particularly among MSM with detectable viremia.
AB - Successful biomedical prevention/treatment-as-prevention (TasP) requires identifying individuals at greatest risk for transmitting HIV, including those with antiretroviral therapy (ART) nonadherence and/or ‘amplified HIV transmission risk,’ defined as condomless sex with HIV-uninfected/unknown-status partners when infectious (i.e., with detectable viremia or STI diagnosis according to Swiss criteria for infectiousness). This study recruited sexually-active, HIV-infected patients in Brazil, Thailand, and Zambia to examine correlates of ART nonadherence and ‘amplified HIV transmission risk’. Lower alcohol use (OR = .71, p < .01) and higher health-related quality of life (OR = 1.10, p < .01) were associated with greater odds of ART adherence over and above region. Of those with viral load data available (in Brazil and Thailand only), 40 % met Swiss criteria for infectiousness, and 29 % had ‘amplified HIV transmission risk.’ MSM had almost three-fold (OR = 2.89, p < .001) increased odds of ‘amplified HIV transmission risk’ (vs. heterosexual men) over and above region. TasP efforts should consider psychosocial and contextual needs, particularly among MSM with detectable viremia.
KW - Adherence
KW - Alcohol use
KW - Amplified risk
KW - Biomedical prevention
KW - HIV transmission
KW - MSM
KW - Treatment as prevention
UR - http://www.scopus.com/inward/record.url?scp=84938703946&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84938703946&partnerID=8YFLogxK
U2 - 10.1007/s10461-015-1142-7
DO - 10.1007/s10461-015-1142-7
M3 - Article
C2 - 26246068
AN - SCOPUS:84938703946
SN - 1090-7165
VL - 20
SP - 699
EP - 709
JO - AIDS and Behavior
JF - AIDS and Behavior
IS - 4
ER -