scholarly journals Vulnerability of the Brazilian LGBT population in HIV treatment

2021 ◽  
Vol 15 (10) ◽  
pp. 1481-1488
Author(s):  
Thaisa Fernanda Lourenção Tauyr ◽  
Luciano Garcia Lourenção ◽  
Maria Amélia Zanon Ponce ◽  
Francisco Rosemiro Guimarães Ximenes Neto ◽  
Maria de Lourdes Sperli Geraldes Santos ◽  
...  
Keyword(s):  
High School ◽  
Viral Load ◽  
Hiv Transmission ◽  
Sexual Transmission ◽  
Undetectable Viral Load ◽  
Cross Sectional Study ◽  
Hiv Treatment ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Lgbt People

Introduction: Human immunodeficiency virus (HIV) infection affects the lesbian, gay, bisexual, transvestite, and transsexual (LGBT) population. We aimed to identify the indidual vulnerability profile of the LGBT population ling with H/acquired immunodeficiency syndrome (AIDS) and correlate it with the treatment situation. Methodology: This cross-sectional study included 510 LGBT people living with HIV (PLHIV)/AIDS who attended the Complex of Chronic Communicable Diseases of the municipality of São José do Rio Preto, São Paulo, Brazil, between 2008 and 2015. Results: There was a predominance of indiduals who were white (70.2%), male (98.4%), single (87.1%), aged 25–44 years (70.0%), educated up to high school (47.7%), economically acte (91.2%), under treatment (80.8%), having CD4 > 350 cells/mm3 (77.1%), and having undetectable viral load (53.3%). HIV transmission was mainly sexual (97.0%) and most people used drugs (76.5%). There was a weak correlation between the variables ‘in treatment’ and acte occupation (r = 0.148, p = 0.001), single marital status (r = 0.128, p = 0.004), white race/colour (r = 0.117, p = 0.008), high school education (r = 0.111, p = 0.012), sexual transmission (r = 0.222, p = 0.000), drug use (r = 0.087, p = 0.049), and CD4 > 350 cells/mm3 (r = 0.118, p = 0.008); and strong correlation between the variables ‘in treatment’ and undetectable viral load (r = -0.937, p = 0.113). Conclusions: The characteristics of the indidual vulnerability of LGBT people involve, among other aspects, issues of gender and social exclusion, a situation that is part of the daily life of PLHIV/AIDS in many scenarios and territories. This can be alleviated with a network of social and health support and effecte and efficient, protecte, attitudinal, and behavioural public policies.

Factors associated with HIV care and treatment cascade in Rio Grande do Sul, Brazil, 2014–2017: A cross-sectional study

2021 ◽  
pp. 095646242097594
Author(s):  
Guilherme B Shimocomaqui ◽  
Craig S Meyer ◽  
Maria L Ikeda ◽  
Elson Romeu Farias ◽  
Tonantzin R Gonçalves ◽  
...  
Keyword(s):  
Viral Load ◽  
Rio Grande ◽  
Undetectable Viral Load ◽  
Cross Sectional Study ◽  
Hiv Care ◽  
Rio Grande Do Sul ◽  
Sectional Study ◽  
Cross Sectional ◽  
Treatment Cascade ◽  
Care And Treatment

In 2018, Rio Grande do Sul (RS) had some of the highest HIV/AIDS rates in Brazil, and we did not find any studies about the HIV care and treatment cascade (HCTC) related to this state. We aimed to estimate the indicators of HCTC of RS, Brazil, and associated factors. A cross-sectional study with all people living with HIV (PLWH) in RS between 1 January 2014 and 31 December 2017 was conducted using a national database which registers all HIV notifications, CD4 and viral load laboratory data and antiretroviral therapy (ART) usage in the public health system. We considered sex, age, education, race, year of HIV diagnosis, and health region as predictor factors, and defined linkage to care, retention to care, being on ART, and having undetectable viral load as the HCTC indicators. Descriptive analysis and multivariable logistic regression were performed using Stata 15.2. A total of 116,121 PLWH were diagnosed, 79,959 were linked to care, 72,117 retained in care, 69,219 on ART, and 54,857 had undetectable viral load from 2014 to 2017. We observed greatest attrition for younger age, non-white, and lower education in all HCTC indicators. Women are more likely to have undetectable viral load (OR = 1.04, 95% CI: 1.01–1.07), even though they are less likely to be retained to care (OR = 0.92; 95% CI: 0.89–0.96) and on ART (OR = 0.82; 95% CI: 0.78–0.86). Although all HCTC indicators have increased over the period and the “test and treat” policy indicates improvements in ART and in undetectable viral load outcomes, evidence suggests specific attrition and disparities such as those related to HIV healthcare facilities should be addressed. These findings may be used by researchers, health professionals, and policymakers in order to investigate and implement interventions to better engage PLWH across the HCTC.

scholarly journals Demographic Features of Identified PLWHA Infected through Commercial and Nonmarital Noncommercial Heterosexual Contact in China from 2015 – 2018: A Retrospective Cross-Sectional Study

2020 ◽  
Author(s):  
Zhilong Dong ◽  
Liying Ma ◽  
Chang Cai ◽  
George Fu Gao ◽  
Fan Lyu
Keyword(s):  
Marital Status ◽  
Educational Level ◽  
Hiv Transmission ◽  
Cross Sectional Study ◽  
Demographic Characteristics ◽  
Heterosexual Transmission ◽  
People Living With Hiv ◽  
Heterosexual Contact ◽  
Cross Sectional ◽  
Hiv Aids

Abstract Background:Understanding the demographic characteristics of people living with HIV/AIDS (PLWHA) infected through commercial heterosexual contact (CHC) or nonmarital noncommercial heterosexual contact (NMNCHC) is important for HIV/AIDS prevention and control.Methods:Cases reported through the Chinese HIV/AIDS Case Reporting System (CRS) from 2015 to 2018 were analyzed. A descriptive and preliminary inferential analysis were performed for those demographic characteristics deemed of interest.Results:Overall, 523,121 identified PLWHA between 2015 and 2018 in the CRS were analyzed. The constituent ratio of heterosexual transmission increased from 66.25% in 2015 to 71.48% in 2018. The proportion of CHC heterosexual transmission decreased from 40.18% in 2015 to 37.99% in 2018, while that of NMNCHC increased from 46.33% in 2015 to 49.02% in 2018. PLWHA infected through NMNCHC were significantly younger than those who were infected through CHC (Student’s t test, P<0.0001), with an average age gap ranging from 5.63 (2015) to 7.46 (2018) years, and the average age of both groups increased annually. The frequency of newly identified PLWHA who were infected through CHC had a remarkable increase among the ages of 65 and above. Gender distribution was significantly different between CHC and NMNCHC (χ2 = 8909.00(2015), 9941.90(2016), 11004.00 (2017), 12836.00(2018), all P < 0.0001), and the ratio of men to women in the NMCHC group was 1.50:1 (2015), 1.51:1 (2016), 1.54:1 (2017), and 1.52:1 (2018), while in the commercial heterosexual contact (CHC) group, these ratios were 11.45:1 (2015), 12.08:1 (2016), 12.53:1 (2017), and 13.28:1 (2018). Marital status was significantly different between CHC and NMNCHC (χ2 = 94.67 (2015), 109.88(2016), 58.18(2017), 152.38(2018), all P < 0.0001). As the educational level improved, the proportion of NMNCHC also increased (Cochran - Armitage test, P<0.0001).Conclusions:We found that heterosexual transmission was the primary mode of HIV transmission in China from 2015 to 2018. PLWHA infected through CHC and NMNCHC had different characteristics in age, gender, marital status, and educational level. The frequency of PLWHA infected through CHC increased substantially in the age group of 65 and above. This study provides useful baseline data for future studies on the heterosexual transmission of HIV in China.

Transactional Sex Among Women Accessing Antiretroviral Care in Sagamu, Nigeria: A Descriptive Survey

2018 ◽  
Vol 39 (4) ◽  
pp. 225-231 ◽  
Author(s):  
Victor Jide Animasahun ◽  
Oluwafolahan O. Sholeye ◽  
Bankole K. Oyewole
Keyword(s):  
Hiv Transmission ◽  
Cross Sectional Study ◽  
Transactional Sex ◽  
Health Concern ◽  
Treatment Center ◽  
People Living With Hiv ◽  
Food Ration ◽  
Cross Sectional ◽  
Assistance Programs ◽  
Ogun State

HIV prevalence and transmission is still of public health concern in low-resource climes like Nigeria. Transactional sex is a well-known risk factor for HIV transmission. This study therefore assessed the prevalence of transactional sex and associated factors among women attending the antiretroviral clinic in Sagamu, Nigeria. A cross-sectional study was carried out among 204 women attending antiretroviral treatment center in Sagamu, Ogun State, Nigeria, selected via total population recruitment. Data were collected using a validated, semistructured questionnaire. Respondents’ written informed consent was obtained. The mean age of respondents was 38.3 ± 9.0 years. Two thirds (66%) were in monogamous marriages. About two thirds (64.2%) had at least secondary education. Almost 50% spent more than half of their income on food. About 90% had commenced antiretroviral therapy. The prevalence of transactional sex was 7.4%. Household size ( p = .031), marital status ( p = .015), reduction of food ration ( p = .010), skipping of medication ( p = .001), and starving for a whole day ( p = .044) were associated with transactional sex. Food assistance programs, socioeconomic empowerment schemes, and targeted counseling should be given to people living with HIV to halt HIV transmission.

scholarly journals 2528. Inflammation and Plasma Selenium and Chromium in Ugandan Children Living with HIV

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S879-S879
Author(s):  
Sahera Dirajlal-Fargo ◽  
Abdus Sattar ◽  
Lingpeng Shan ◽  
Emily Bowman ◽  
Rashida Nazzinda ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Viral Load ◽  
Systemic Inflammation ◽  
Plasma Concentrations ◽  
Selenium Deficiency ◽  
Undetectable Viral Load ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Plasma Selenium ◽  
Selenium Supplements

Abstract Background Selenium deficiency has been reported to be associated with HIV disease progression and chromium deficiency with insulin resistance and hyperlipidemia. Here, we assessed selenium and chromium status in a cohort of Ugandan HIV+, HIV exposed uninfected (HEU) and HIV negative (HIV−) children and their associations with markers of systemic inflammation, immune activation, and gut integrity. Methods This is a cross-sectional study in HIV+, HEU and HIV unexposed uninfected (HIV-) children aged 2–10 years old enrolled in Uganda. HIV+ children were on stable ART with undetectable viral load. We measured plasma concentrations of selenium and chromium as well as markers of systemic inflammation, monocyte activation, gut integrity and insulin resistance (HOMA-IR). Results Among HIV+ children (n = 57), 93% had viral load ≤ 20 copies/mL, mean CD4 was 34% and 77% were receiving a non-nucleotide reserve transcriptase regimen. Mean age of all participants was 7 years and 55% were girls. Mean selenium concentrations were higher in the HIV+ group (106 µg/L) compared with the HEU (84 µg/L) and HIV− (98 µg/L) groups (p . Mean chromium concentrations were 1 µg/L; 1 HIV+ child and 6 HEU children had chromium levels > 1 µg/L (p. Conclusion In this cohort of HIV+ children on ART in Uganda, plasma selenium and chromium concentrations appear sufficient. Higher plasma selenium concentrations were associated with lower systemic inflammation and higher gut integrity markers. Although our findings do not support the use of selenium supplementation broadly for HIV-infected children in Uganda, further studies are warranted to assess the role of selenium supplements in attenuating heightened inflammation. Disclosures All authors: No reported disclosures.

scholarly journals Thrombocytopenia according to antiretroviral drug combinations, viremia and CD4 lymphocytes among HIV-infected patients in Cameroon: a snapshot from the City of Yaoundé

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Alex Durand Nka ◽  
Samuel Martin Sosso ◽  
Joseph Fokam ◽  
Yagai Bouba ◽  
Georges Teto ◽  
...  
Keyword(s):  
Viral Load ◽  
Blood Platelets ◽  
Undetectable Viral Load ◽  
Drug Combinations ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Viral Loads ◽  
Reference Centre ◽  
Antiretroviral Drug ◽  
Load Rate

Abstract Objective Thrombocytopenia is an abnormal decrease in blood platelets, which can affect the prognosis of people living with HIV (PLHIV). In order to assess the burden of this haematological disorder, we evaluated the frequency of thrombocytopenia according to antiretroviral drug combinations, viremia and the immune status of PLHIV. Results A cross-sectional and analytical study was conducted from June to November 2016 among 310 PLHIV at the “Chantal BIYA” International Reference Centre, Yaoundé, Cameroon. Overall rate of thrombocytopenia was 19.0% (59/310). The rate of thrombocytopenia was 64.6% (42/65) versus 6.9% (17/245) in ART-naïve versus ART-treated patients respectively, p < 0.0001. Following viral load, rate of thrombocytopenia was 15.8% (20/130) in those with undetectable viral load, and 34.1% (27/79) with viral loads > 3 log10 RNA/ml (p = 0.03). As concerns CD4-count, rate of thrombocytopenia was 16.2% (42/259) in those with ≥ 200 CD4/mm3 versus 33.3% (17/51) with < 200 CD4/mm3 (p = 0.0003). After adjusting for sex, ART, viral load and CD4, Viral load and ART exposure were significantly associated with decreased risk of thrombocytopenia (p < 0.05). Thrombocytopenia occurs especially among ART-naïve, high viremia and severe immune-compromised patients. Interestingly, ART coverage appears as an independent factor in preventing the occurrence of thrombocytopenia.

scholarly journals Non-uptake of viral load testing among people receiving HIV treatment in Gomba district, rural Uganda

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Rita Nakalega ◽  
Nelson Mukiza ◽  
George Kiwanuka ◽  
Ronald Makanga-Kakumba ◽  
Robert Menge ◽  
...  
Keyword(s):  
Viral Load ◽  
Virologic Failure ◽  
Treatment Success ◽  
Cross Sectional Study ◽  
Hiv Treatment ◽  
Virologic Suppression ◽  
Load Testing ◽  
Duration Of Treatment ◽  
Cross Sectional ◽  
Art Initiation

Abstract Background Viral load (VL) testing is the gold-standard approach for monitoring human immunodeficiency virus (HIV) treatment success and virologic failure, but uptake is suboptimal in resource-limited and rural settings. We conducted a cross-sectional study of risk factors for non-uptake of VL testing in rural Uganda. Methods We conducted a cross-sectional analysis of uptake of VL testing among randomly selected people with HIV (PWH) receiving anti-retroviral treatment (ART) for at least 6 months at all eight primary health centers in Gomba district, rural Uganda. Socio-demographic and clinical data were extracted from medical records for the period January to December 2017. VL testing was routinely performed 6 months after ART initiation and 12 months thereafter for PWH stable on ART. We used descriptive statistics and multivariable logistic regression to evaluate factors associated with non-uptake of VL testing (the primary outcome). Results Of 414 PWH, 60% were female, and the median age was 40 years (interquartile range [IQR] 31–48). Most (62.3%) had been on ART > 2 years, and the median duration of treatment was 34 months (IQR 14–55). Thirty three percent did not receive VL testing: 36% of women and 30% of men. Shorter duration of ART (≤2 years) (adjusted odds ratio [AOR] 2.38; 95% CI:1.37–4.12; p = 0.002), younger age 16–30 years (AOR 2.74; 95% CI:1.44–5.24; p = 0.002) and 31–45 years (AOR 1.92; 95% CI 1.12–3.27; p = 0.017), and receipt of ART at Health Center IV (AOR 2.85; 95% CI: 1.78–4.56; p < 0.001) were significantly associated with non-uptake of VL testing. Conclusions One-in-three PWH on ART missed VL testing in rural Uganda. Strategies to improve coverage of VL testing, such as VL focal persons to flag missed tests, patient education and demand creation for VL testing are needed, particularly for recent ART initiates and younger persons on treatment, in order to attain the third Joint United Nations Program on HIV/AIDS (UNAIDS) 95–95-95 target – virologic suppression for 95% of PWH on ART.

Paying the price in an era of HIV treatment as prevention: a retrospective study of the cost burden of HIV treatment for people living with HIV in Victoria, Australia

Sexual Health ◽  
2015 ◽  
Vol 12 (1) ◽  
pp. 34 ◽  
Author(s):  
Anna L. Wilkinson ◽  
James McMahon ◽  
Yik-Siang Cheah ◽  
Catriona S. Bradshaw ◽  
Carol El-Hayek ◽  
...  
Keyword(s):  
Financial Burden ◽  
Cross Sectional Study ◽  
Hiv Treatment ◽  
Health Clinic ◽  
Treatment As Prevention ◽  
People Living With Hiv ◽  
Prevention Strategies ◽  
Cross Sectional ◽  
Patient Costs ◽  
Hiv Prevention Strategies

Background An estimated 25 700 people live with diagnosed HIV (PLWH) in Australia and ~1200 newly diagnosed cases were notified in 2012. New HIV prevention strategies focus on individual uptake of treatment; however, a potential barrier is the financial burden of antiretroviral treatment (ART). We describe HIV ART dispensed and the estimated associated costs for PLWH in Victoria. Methods: A retrospective cross-sectional study of pharmacy data on ART dispensed between January 2012 and November 2013 from a hospital network, including Victoria’s largest sexual health clinic was conducted. Estimated annual patient costs of ART were calculated by the number of items dispensed per year, concession status, dispensing site and applicable co-payment. Results: A total of 60 225 dispensing records from 3903 individuals were included; this represented 83.8% of pharmaceutical benefits scheme-recorded ART dispensed in Victoria over this period. The estimated annual co-payment costs for patients without a concession card and who were collecting two medications was $433.20. One-fifth of patients (21.3%) collected four or more items, equating to an estimated annual cost of at least $866.40 without a concession card and $141.60 with a concession card. Of those dispensed four or more items, 40.4% were concession card holders. Conclusions: There may be meaningful patient costs associated with accessing ART for some PLWH. New HIV treatment-based prevention strategies need to consider financial vulnerabilities and appropriately targeted initiatives to alleviate patient costs associated with ART, ensuring they do not act as a barrier to commencement of and adherence to HIV treatment.

scholarly journals Thrombocytopenia according to Antiretroviral Drug Combinations, Viremia and CD4 Lymphocytes among HIV-Infected Patients in Cameroon A Snapshot from the City of Yaoundé

2019 ◽  
Author(s):  
Alex Durand NKA ◽  
Samuel Martin Sosso ◽  
Joseph Fokam ◽  
Bouba Yagai ◽  
Georges Teto ◽  
...  
Keyword(s):  
Viral Load ◽  
Blood Platelets ◽  
Undetectable Viral Load ◽  
Drug Combinations ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Viral Loads ◽  
Reference Centre ◽  
Antiretroviral Drug ◽  
Living With Hiv

Abstract Background Thrombocytopenia is an abnormal decrease in blood platelets, which can affect the prognosis of people living with HIV (PLHIV). In order to limit the occurrence of this haematological disorder, we evaluated the frequency of thrombocytopenia according to antiretroviral drug combinations, viremia and the immune status of PLHIV. Methods A cross-sectional and analytical study was conducted from June-November 2016 among 310 PLHIV at the “Chantal BIYA” International Reference Centre for research on HIV/AIDS prevention and management (CIRCB), Yaoundé, Cameroon. Thrombocytopenia was assessed by blood count on Mindray BC 3000 plus, then categorized as mild (50,000-149,999 platelets/μL), moderate (20,000-49,999) and severe <20,000; HIV-1 viremia was measured by Abbott m2000RT and CD4 by BD Facs Calibur; treatment history was retrieved from medical records. Data were analysed using Graph Pad Prism.6, with p<0.05 considered statistically significant. Results Median age was 40 [IQR: 33-49] years with, and 60.9% of participants being female. Up to 79.0% (245) were receiving antiretroviral therapy (ART); 54.5% had CD4 counts <500 cells/mm3 and 25.4% had viremia >3log10 RNA/ml. Overall rate of thrombocytopenia was 19.0% (59/310), with 17.4% (54/310) mild, 1.6% (5/310) moderate and 0.0% severe. Following ART-exposure, rate of thrombocytopenia was 64.6% (42/65) versus 6.9% (17/245) in naïve versus treated patients respectively, p<0.0001. Following ART regimens, rate of thrombocytopenia was 64.7% (11/17) versus 35.3% (6/17) among AZT-containing versus AZT-sparing regimens, p=0.02. Following viral load ranges, rate of thrombocytopenia was 15.8% (20/130) in those with undetectable viral load, 11.0% (12/101) with viral loads 1.60-3.0 log10 RNA/ml and 34.1% (27/79) with viral loads >3 log10 RNA/ml (p=0.03; r=-0.12). As concerns CD4-count, rate of thrombocytopenia was 16.2% (42/259) in those with ≥200 CD4/mm3 versus 33.3% (17/51) with <200 CD4/mm3 (p=0.0003; r=0.21). After adjusting for age, sex, ART, viral load and CD4, only ART exposure was significantly associated with decreased risk of thrombopenia (p<0.0001). Conclusions Thrombocytopenia occurs generally at mild-level among PLHIV in Cameroon, especially among ART-naïve, AZT-treated, high viremia and severe immune-compromised patients. Interestingly, ART coverage appears as an independent factor in preventing the occurrence of thrombocytopenia, especially for AZT-sparing treatment combinations in countries with similar features like Cameroon.

scholarly journals Stigmatization among People Living with HIV/AIDS at the Kumba Health District, Cameroon

2020 ◽  
Vol 19 ◽  
pp. 232595821989930 ◽  
Author(s):  
Thomas Obinchemti Egbe ◽  
Cynthia Adanze Nge ◽  
Hermann Ngouekam ◽  
Etienne Asonganyi ◽  
Dickson Shey Nsagha
Keyword(s):  
Cross Sectional Study ◽  
Hiv Treatment ◽  
Health District ◽  
People Living With Hiv ◽  
Group Discussions ◽  
Cross Sectional ◽  
Stigma Reduction ◽  
Related Stigma ◽  
Living With Hiv ◽  
Hiv Aids

We determined the level, type of stigma, and risk factors associated with stigmatization of people living with HIV/AIDS (PLWHA) by conducting a cross-sectional study from April to June 2018 in 3 HIV treatment centers in the Kumba Health District (KHD), Cameroon. We reviewed hospital registers, conducted focus group discussions, and administered structured questionnaires. For data analysis, we used the Statistical Package for Social Sciences version 20.0. We recorded a total stigma index score of 59.1. Internal stigma (odds ratio [OR] 2.91; 95% confidence interval [CI]: 1.74-4.98) was common in PLWHA. Also, younger age <30 years (adjusted OR [AOR]: 0.39; 95% CI: 0.17-0.94) was linked with stigma reduction while low level of education (AOR: 1.74; 95% CI: 1.02-2.97) increased the stigma level. HIV-related stigma is pervasive in the lives of PLWHA, with most of them having internal stigmatization. Appropriate health education on HIV will be crucial in reducing stigmatization in the KHD.

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 ◽  
...  
Keyword(s):  
Viral Load ◽  
Sexual Risk ◽  
Hiv Transmission ◽  
Risk Behaviour ◽  
Cross Sectional Study ◽  
Transmission Risk ◽  
Sexual Risk Behaviour ◽  
Sexually Active ◽  
Cross Sectional ◽  
Viral Loads

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.

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