Antiretroviral Medication Adherence and Amplified HIV Transmission Risk Among Sexually Active HIV-Infected Individuals in Three Diverse International Settings

Jessica F. Magidson, Xin Li, Matthew J. Mimiaga, Ayana T. Moore, Kriengkrai Srithanaviboonchai, Ruth Khalili Friedman, Mohammad Limbada, James P. Hughes, Vanessa Cummings, Charlotte A. Gaydos, Vanessa Elharrar, David Celentano, Kenneth H. Mayer, Steven A. Safren

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)699-709
Number of pages11
JournalAIDS and Behavior
Volume20
Issue number4
DOIs
StatePublished - Apr 1 2016

Keywords

  • Adherence
  • Alcohol use
  • Amplified risk
  • Biomedical prevention
  • HIV transmission
  • MSM
  • Treatment as prevention

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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