Abstract
Suppressing HIV viral load through daily antiretroviral therapy (ART) substantially reduces the risk of HIV transmission, however, the potential population impact of treatment as prevention (TasP) is mitigated due to challenges with sustained care engagement and ART adherence. For an undetectable viral load (VL) to inform decision making about transmission risk, individuals must be able to accurately classify their VL as detectable or undetectable. Participants were 205 HIV-infected young men who have sex with men (YMSM) and transgender women (TGW) from a large cohort study in the Chicago area. Analyses examined correspondence among self-reported undetectable VL, study-specific VL, and most recent medical record VL. Among HIV-positive YMSM/TGW, 54% had an undetectable VL (< 200 copies/mL) via study-specific laboratory testing. Concordance between self-report and medical record VL values was 80% and between self-report and study-specific laboratory testing was 73%; 34% of participants with a detectable study-specific VL self-reported an undetectable VL at last medical visit, and another 28% reported not knowing their VL status. Periods of lapsed viral suppression between medical visits may represent a particular risk for the TasP strategy among YMSM/TGW. Strategies for frequent viral load monitoring, that are not burdensome to patients, may be necessary to optimize TasP.
| Original language | English (US) |
|---|---|
| Pages (from-to) | :2360-2367 |
| Journal | AIDS and behavior |
| Volume | 22 |
| Issue number | 7 |
| DOIs | |
| State | Published - Jul 2018 |
Funding
We acknowledge the contributions of the RADAR study staff, particularly Antonia Clifford, Justin Franz, Roky Truong, Peter Cleary, and Hannah Hudson. Laboratory tests were performed by the Ann & Robert H. Lurie Children’s Hospital Special Infectious Diseases Laboratory in Chicago, Illinois. Viral load data was obtained from some participants from the Chicago Department of Public Health (CDPH), and we thank them for providing these data with the consent of participants under the terms of our data use agreement. CDPH disclaims responsibility for any analysis, interpretations, or conclusions. B.M., R.D., and M.N. conceptualized the study. D.T.R, T.A.R., and E.M. obtained and extracted medical record data. R.T.D. supervised collection of laboratory data. D.T.R. performed statistical analyses. B.M. and D.T.R. drafted the article. All authors reviewed and approved the final article. Funding This study was funded by the National Institute on Drug Abuse (U01DA036939). We acknowledge the support of the Third Coast Center for AIDS Research (P30AI117943) and the Northwestern University Clinical and Translational Sciences Institute (UL1TR001422). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Drug Abuse or the National Institutes of Health. Funding This study was funded by the National Institute on Drug Abuse (U01DA036939). We acknowledge the support of the Third Coast Center for AIDS Research (P30AI117943) and the North-western University Clinical and Translational Sciences Institute (UL1TR001422). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Drug Abuse or the National Institutes of Health.
Keywords
- Medical records
- Treatment as prevention
- Undetectable
- Viral load
- Young msm
ASJC Scopus subject areas
- Public Health, Environmental and Occupational Health
- Infectious Diseases
- Social Psychology
