Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2016 Apr;20(4):699-709.
doi: 10.1007/s10461-015-1142-7.

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

Jessica F Magidson  1 , Xin Li  2 , Matthew J Mimiaga  3   4   5 , Ayana T Moore  6 , Kriengkrai Srithanaviboonchai  7   8 , Ruth Khalili Friedman  9 , Mohammad Limbada  10 , James P Hughes  2   11 , Vanessa Cummings  12 , Charlotte A Gaydos  12 , Vanessa Elharrar  13 , David Celentano  14 , Kenneth H Mayer  5   15 , Steven A Safren  5   16
Affiliations
Observational Study

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

Jessica F Magidson et al. AIDS Behav. 2016 Apr.

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.

Keywords: Adherence; Alcohol use; Amplified risk; Biomedical prevention; HIV transmission; MSM; Treatment as prevention.

PubMed Disclaimer

References

    1. Cohen MS, Chen YQ, McCauley M, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365:493–505. - PMC - PubMed
    1. Rodger A, Bruun T, Cambiano V, et al. HIV transmission risk through condomless sex if HIV ? partner on suppressive ART: PARTNER Study; Presented at the 21st Conference on Retroviruses and Opportunistic Infections (CROI); 2014.
    1. Mayer KH, Venkatesh KK. Interactions of HIV, other sexually transmitted diseases, and genital tract inflammation facilitating local pathogen transmission and acquisition. Am J Reprod Immunol. 2011;65:308–316. - PMC - PubMed
    1. Kalichman SC, Pellowski J, Turner C. Prevalence of sexually transmitted co-infections in people living with HIV/AIDS: systematic review with implications for using HIV treatments for prevention. Sex Transm Infect. 2011;87:183–190. - PMC - PubMed
    1. Vernazza P, Hirschel B, Bernasconi E, Flepp M. HIV-positive individuals without additional sexually transmitted diseases (STD) and on effective anti-retroviral therapy are sexually non-infectious. Bull Médecins Suisses. 2008;89:165–169.

Publication types

MeSH terms

Substances