scholarly journals Characterising HIV transmission risk among US patients with HIV in care: a cross-sectional study of sexual risk behaviour among individuals with viral load above 1500 copies/mL

2017 ◽  
Vol 94 (3) ◽  
pp. 206-211 ◽  
Author(s):  
Michael J Stirratt ◽  
Gary Marks ◽  
Christine O’Daniels ◽  
Edward R Cachay ◽  
Meg Sullivan ◽  
...  

ObjectivesViral load and sexual risk behaviour contribute to HIV transmission risk. High HIV viral loads present greater transmission risk than transient viral ‘blips’ above an undetectable level. This paper therefore characterises sexual risk behaviour among patients with HIV in care with viral loads>1500 copies/mL and associated demographic characteristics.MethodsThis cross-sectional study was conducted at six HIV outpatient clinics in USA. The study sample comprises 1315 patients with HIV with a recent viral load >1500 copies/mL. This study sample was drawn from a larger sample of individuals with a recent viral load >1000 copies/mL who completed a computer-assisted self-interview (CASI) regarding sexual risk practices in the last 2 months. The study sample was 32% heterosexual men, 38% men who have sex with men (MSM) and 30% women.ResultsNinety per cent of the sample had their viral load assay within 60 days of the CASI. Thirty-seven per cent reported being sexually active (vaginal or anal intercourse) in the last 2 months. Most of the sexually active participants reported always using condoms (56.9%) or limiting condomless sex to seroconcordant partners (serosorting; 29.2% overall and 42.9% among MSM). Among sexually active participants who reported condomless anal or vaginal sex with an at-risk partner (14%), most had viral loads>10 000 copies/mL (62%).ConclusionsA relatively small number of patients with HIV in care with viral loads above 1500 copies/mL reported concurrent sexual transmission risk behaviours. Most of the individuals in this small group had markedly elevated viral loads, increasing the probability of transmission. Directing interventions to patients in care with high viral loads and concurrent risk behaviour could strengthen HIV prevention and reduce HIV infections.Trial registration numberNCT02044484, completed.

2014 ◽  
Vol 14 (S3) ◽  
Author(s):  
Nik Daliana Nik Farid ◽  
Sulaiman Che' Rus ◽  
Maznah Dahlui ◽  
Nabilla Al-Sadat ◽  
Norlaili Abdul Aziz

2014 ◽  
Vol 90 (6) ◽  
pp. 491-497 ◽  
Author(s):  
Sowmya Ramesh ◽  
Purnima Mehrotra ◽  
Bidhubhusan Mahapatra ◽  
Deepika Ganju ◽  
Karikalan Nagarajan ◽  
...  

Sexual Health ◽  
2007 ◽  
Vol 4 (4) ◽  
pp. 273 ◽  
Author(s):  
Sara K. Head ◽  
Richard A. Crosby ◽  
Lydia A. Shrier ◽  
Gregory R. Moore

Background: This exploratory study investigated young women’s perceptions of sexually transmissible infection (STI) testing received during gynaecological care. Correlates of the incorrect perception that STI testing occurred were assessed. Methods: Cross-sectional study of sexually active young women, age 18–24 years, attending a university healthcare setting for gynaecological care (n = 109). Two hundred and four women were approached and 87 were ineligible; of the remaining 117, 93.2% chose to enrol. Results: Of the women enrolled, 25.7% falsely perceived that they were STI tested (labelled ‘clean and clear’). Only approximately one in seven (14.7%) accurately understood the STI for which they were tested. In multivariate analyses, controlling for race, STI symptoms, depression, number of lifetime visits to the gynaecologist, and suspicion of current STI, three variables were significant: minority race (adjusted odds ratio (AOR) = 4.84, confidence interval (CI) = 1.38–16.96, P = 0.01), earlier age at sexual debut (AOR = 4.67, CI = 1.73–12.57, P = 0.002), and previous STI diagnosis (AOR = 3.38, CI = 1.07–10.66, P = 0.04). Comment: The findings suggest that many young women may have an inaccurate understanding of the STI testing they undergo during gynaecological care and may operate under the misperception they are ‘clean and clear’ of STI. Women with said misperception were more likely to be of minority race and report relatively earlier age of sexual debut and previous STI diagnosis. Further investigation is warranted to determine whether the ‘clean and clear’ misperception influences young women’s sexual risk behaviour.


2010 ◽  
Vol 2 (2) ◽  
pp. 13 ◽  
Author(s):  
John Rubaihayo ◽  
Akib Surat ◽  
Mughusu Ezekiel ◽  
Abaasa Andrew

In Uganda, previous studies have shown a tremendous decline in HIV prevalence over the past two decades due to changes in sexual behavior with a greater awareness of the risks involved. However, studies in Fort-Portal municipality, a rural town in Western Uganda, continued to show a persistent high HIV prevalence despite the various interventions in place. We conducted a study to establish the current magnitude of HIV prevalence and the factors associated with HIV prevalence in this community. This cross-sectional study was conducted between July and November 2008. Participants were residents of Fort-Portal municipality aged 15-49 years. A population-based HIV sero-survey and a clinical review of prevention of mother to child HIV transmission (PMTCT) and voluntary counseling and HIV Testing (VCT) records were used to collect quantitative data. An inteviewer administered structured questionnaire was used to collect qualitative data on social deographics, risk behaviour and community perceptions. Focus group discussions (FGDs) and in-depth interviews provided supplementary data on community perceptions. Logistic regression was used in the analysis. The overall HIV prevalence in the general population was 16.1% [95% CI; 12.5-20.6]. Prevalence was lower among women (14.5%; 95% CI; 10.0-19.7) but not significantly different from that among men (18.7%; 95% CI; 12.5-26.3) (c2=0.76, P=0.38). Having more than 2 sexual partners increased the odds of HIV by almost 2.5 times. None or low education and age over 35 years were independently associated with HIV prevalence (P<0.05). Most participants attributed the high HIV prevalence to promiscuity/multiple sexual partners (32.5%), followed by prostitution (13.6%), alcoholism (10.1%), carelessness (10.1%), poverty (9.7%), ignorance (9.5%)), rape (4.7%), drug abuse (3.6%) and others (malice/malevolence, laziness, etc.) (6.2%). Although there was a slight decline compared to previous reports, the results from this study confirm that HIV prevalence is still high in this community. In order to prevent new infections, the factors mentioned above need to be addressed, and we recommend that education aimed at changing individual behavior should be intensified in this community.


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