Please use this identifier to cite or link to this item:
https://www.arca.fiocruz.br/handle/icict/29427
Type
ArticleCopyright
Restricted access
Embargo date
2028-08-30
Collections
- INI - Artigos de Periódicos [3466]
Metadata
Show full item record
ANTIRETROVIRAL MEDICATION ADHERENCE AND AMPLIFIED HIV TRANSMISSION RISK AMONG SEXUALLY ACTIVE HIV-INFECTED INDIVIDUALS IN THREE DIVERSE INTERNATIONAL SETTINGS
Treatment as prevention
HIV transmission
Amplified risk
Alcohol use
MSM
Biomedical prevention
Author
Affilliation
Department of Psychiatry. Harvard Medical School/Massachusetts General Hospital. Boston, MA, USA.
Fred Hutchinson Cancer Research Center. Seattle, WA, USA.
Department of Psychiatry. Harvard Medical School/Massachusetts General Hospital. Boston, MA, USA./ Harvard School of Public Health. Boston, MA, USA./ The Fenway Institute, Fenway Health. Boston, MA, USA.
FHI360, Durham, NC, USA.
Research Institute for Health Sciences. Chiang Mai University. Chiang Mai, Thailand./ Faculty of Medicine. Chiang Mai Universit., Chiang Mai, Thailand.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.
Centre for Infectious Disease Research in Zambia. Lusaka, Zambia.
Fred Hutchinson Cancer Research Center. Seattle, WA, USA./ University of Washington. Seattle, WA, USA.
Division of Infectious Diseases. Departments of Pathology and Medicine. Johns Hopkins School of Medicine. Baltimore, MD, USA.
Division of Infectious Diseases. Departments of Pathology and Medicine. Johns Hopkins School of Medicine. Baltimore, MD, USA.
National Institute of Allergy and Infectious Disease (NIAID), Bethesda, MD, USA.
Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
The Fenway Institute. Fenway Health. Boston, MA, USA./ Harvard Medical School/Beth Israel Deaconess Medical Center. Boston, MA, USA.
The Fenway Institute. Fenway Health. Boston, MA, USA./ Department of Psychology. University of Miami. Coral Gables, FL, USA.
Fred Hutchinson Cancer Research Center. Seattle, WA, USA.
Department of Psychiatry. Harvard Medical School/Massachusetts General Hospital. Boston, MA, USA./ Harvard School of Public Health. Boston, MA, USA./ The Fenway Institute, Fenway Health. Boston, MA, USA.
FHI360, Durham, NC, USA.
Research Institute for Health Sciences. Chiang Mai University. Chiang Mai, Thailand./ Faculty of Medicine. Chiang Mai Universit., Chiang Mai, Thailand.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.
Centre for Infectious Disease Research in Zambia. Lusaka, Zambia.
Fred Hutchinson Cancer Research Center. Seattle, WA, USA./ University of Washington. Seattle, WA, USA.
Division of Infectious Diseases. Departments of Pathology and Medicine. Johns Hopkins School of Medicine. Baltimore, MD, USA.
Division of Infectious Diseases. Departments of Pathology and Medicine. Johns Hopkins School of Medicine. Baltimore, MD, USA.
National Institute of Allergy and Infectious Disease (NIAID), Bethesda, MD, USA.
Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
The Fenway Institute. Fenway Health. Boston, MA, USA./ Harvard Medical School/Beth Israel Deaconess Medical Center. Boston, MA, USA.
The Fenway Institute. Fenway Health. Boston, MA, USA./ Department of Psychology. University of Miami. Coral Gables, FL, USA.
Abstract
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.
Keywords
AdherenceTreatment as prevention
HIV transmission
Amplified risk
Alcohol use
MSM
Biomedical prevention
Share