Time Spent with HIV Viral Load > 1500 Copies/mL Among Persons Engaged in Continuity HIV Care in an Urban Clinic in the United States, 2010–2015

Background. To evaluate the effects of HIV viral load, measured cross-sectionally and cumulatively, on the risk of miscarriage or stillbirth (pregnancy loss) among HIV-infected women enrolled in the Women’s Interagency HIV Study between 1994 and 2013.Methods. We assessed three exposures: most recent viral load measure before the pregnancy ended, log10copy-years viremia from initiation of antiretroviral therapy (ART) to conception, and log10copy-years viremia in the two years before conception.Results. The risk of pregnancy loss for those with log10viral load >4.00 before pregnancy ended was 1.59 (95% confidence interval (CI): 0.99, 2.56) times as high as the risk for women whose log10viral load was ≤1.60. There was not a meaningful impact of log10copy-years viremia since ART or log10copy-years viremia in the two years before conception on pregnancy loss (adjusted risk ratios (aRRs): 0.80 (95% CI: 0.69, 0.92) and 1.00 (95% CI: 0.90, 1.11), resp.).Conclusions. Cumulative viral load burden does not appear to be an informative measure for pregnancy loss risk, but the extent of HIV replication during pregnancy, as represented by plasma HIV RNA viral load, predicted loss versus live birth in this ethnically diverse cohort of HIV-infected US women.

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Moderating effects of social support on the relationship between substance use disorders and HIV viral load and medication adherence among Black women living with HIV in the United States

AIDS Care ◽

10.1080/09540121.2021.2001415 ◽

2021 ◽

pp. 1-10

Author(s):

Rachelle Reid ◽

Sannisha K. Dale

Keyword(s):

United States ◽

Social Support ◽

Viral Load ◽

Black Women ◽

The United States ◽

Moderating Effects ◽

Hiv Viral Load ◽

Women Living With Hiv ◽

Living With Hiv ◽

The Relationship

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Factors associated with severity of COVID-19 disease in a multicenter cohort of people with HIV in the United States, March-December 2020

10.1101/2021.10.15.21265063 ◽

2021 ◽

Author(s):

Adrienne E Shapiro ◽

Rachel A Bender Ignacio ◽

Bridget M Whitney ◽

Joseph CA Delaney ◽

Robin M Nance ◽

...

Keyword(s):

United States ◽

Case Fatality ◽

The United States ◽

Cd4 Count ◽

Hiv Care ◽

Risk Scores ◽

Chronic Obstructive ◽

Viral Load Suppression ◽

Hiv Viral Load ◽

Obstructive Pulmonary Disease

Background: Understanding the spectrum of SARS-CoV-2 infection and COVID-19 disease in people with HIV (PWH) is critical to provide clinical guidance and implement risk-reduction strategies. Objective: To characterize COVID-19 in PWH in the United States and identify predictors of disease severity. Design: Observational cohort study. Setting: Geographically diverse clinical sites in the CFAR Network of Integrated Clinical Systems (CNICS) Participants: Adults receiving HIV care through December 31, 2020. Measurements: COVID-19 cases and severity (hospitalization, intensive care, death). Results: Of 16,056 PWH in care, 649 were diagnosed with COVID-19 between March-December 2020. Case fatality was 2%; 106 (16.3%) were hospitalized and 12 died. PWH with current CD4 count <350 cells/mm3 (aRR 2.68; 95%CI 1.93-3.71; P<.001) or lowest recorded CD4 count <200 (aRR 1.67; 95%CI 1.18-2.36; P<.005) had greater risk of hospitalization. HIV viral load suppression and antiretroviral therapy (ART) status were not associated with hospitalization, although the majority of PWH were suppressed (86%). Black PWH were 51% more likely to be hospitalized with COVID-19 compared to other racial/ethnic groups (aRR 1.51; 95%CI 1.04-2.19, P=.03). Chronic kidney disease (CKD), chronic obstructive pulmonary disease, diabetes, hypertension, obesity, and increased cardiovascular and hepatic fibrosis risk scores were associated with higher risk of hospitalization. PWH who were older, not on ART, with current CD4 <350, diabetes, and CKD were overrepresented amongst PWH who required intubation or died. Limitations: Unable to compare directly to persons without HIV; underestimate of total COVID-19 cases. Conclusions: PWH with CD4 <350 cells/mm3, low CD4/CD8 ratio, and history of CD4 <200, have a clear excess risk of severe COVID-19, after accounting for comorbidities also associated with severe outcomes. PWH with these risk factors should be prioritized for COVID-19 vaccination, early treatment, and monitored closely for worsening illness.

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Correlates of High HIV Viral Load and Antiretroviral Therapy Adherence Among Viremic Youth in the United States Enrolled in an Adherence Improvement Intervention

AIDS Patient Care and STDs ◽

10.1089/apc.2021.0005 ◽

2021 ◽

Vol 35 (5) ◽

pp. 145-157

Author(s):

K. Rivet Amico ◽

Jessica Crawford ◽

Ini Ubong ◽

Jane C. Lindsey ◽

Aditya H. Gaur ◽

...

Keyword(s):

United States ◽

Viral Load ◽

Antiretroviral Therapy ◽

The United States ◽

Hiv Viral Load ◽

Therapy Adherence ◽

Antiretroviral Therapy Adherence ◽

Improvement Intervention

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Abuse and Resilience in Relation to HAART Medication Adherence and HIV Viral Load Among Women with HIV in the United States

AIDS Patient Care and STDs ◽

10.1089/apc.2013.0329 ◽

2014 ◽

Vol 28 (3) ◽

pp. 136-143 ◽

Cited By ~ 59

Author(s):

Sannisha Dale ◽

Mardge Cohen ◽

Kathleen Weber ◽

Ruth Cruise ◽

Gwendolyn Kelso ◽

...

Keyword(s):

United States ◽

Viral Load ◽

Medication Adherence ◽

The United States ◽

Hiv Viral Load ◽

Women With Hiv

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Shifting the Paradigm in HIV Prevention and Treatment Service Delivery Toward Differentiated Care for Youth

NAM Perspectives ◽

10.31478/201903a ◽

2019 ◽

Author(s):

Vincent Guilamo-Ramos ◽

Marco Thimm-Kaiser ◽

Adam Benzekri ◽

Donna Futterman

Keyword(s):

United States ◽

Hiv Prevention ◽

Service Delivery ◽

The United States ◽

Hiv Care ◽

Health Concern ◽

Service Needs ◽

Minority Adolescents ◽

Prevention And Treatment ◽

Differentiated Care

Despite significant progress in the fight against HIV/AIDS in the United States, HIV prevention and treatment disparities among key populations remain a national public health concern. While new HIV diagnoses are increasing among people under age 30—in particular among racial, ethnic, and sexual minority adolescents and young adults (AYA)—dominant prevention and treatment paradigms too often inadequately consider the unique HIV service needs of AYA. To address this gap, we characterize persistent and largely overlooked AYA disparities across the HIV prevention and treatment continuum, identify AYA-specific limitations in extant resources for improving HIV service delivery in the United States, and propose a novel AYA-centered differentiated care framework adapted to the unique ecological and developmental factors shaping engagement, adherence, and retention in HIV services among AYA. Shifting the paradigm for AYA to differentiated HIV care is a promising approach that warrants implementation and evaluation as part of reinforced national efforts to end the HIV epidemic in the United States by 2030.

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