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. 2016 May 1;72(1):87-95.
doi: 10.1097/QAI.0000000000000934.

HIV Community Viral Load and Factors Associated With Elevated Viremia Among a Community-Based Sample of Men Who Have Sex With Men in Vancouver, Canada

David M Moore  1 , Zishan Cui, Nathan Lachowsky, Henry F Raymond, Eric Roth, Ashleigh Rich, Paul Sereda, Terry Howard, Willi McFarland, Allan Lal, Julio Montaner, Trevor Corneil, Robert S Hogg; Momentum Health Study team
Affiliations

HIV Community Viral Load and Factors Associated With Elevated Viremia Among a Community-Based Sample of Men Who Have Sex With Men in Vancouver, Canada

David M Moore et al. J Acquir Immune Defic Syndr. .

Abstract

Background: We developed estimates of community viral load (VL) and risk factors for unsuppressed VL from a cross-sectional study of men who have sex with men (MSM) in Vancouver, Canada.

Methods: MSM were recruited from February 25, 2012 to February 28, 2014 using respondent-driven sampling (RDS). Participants completed a computer-assisted self-interview questionnaire and a nurse-administered point-of-care HIV test. For HIV-positive participants, we conducted VL and CD4 cell counts. We used RDS-weighted analysis to obtain population estimates of key variables and multivariable logistic regression to examine factors associated with having a VL of ≥200 copies per milliliter among HIV-positive participants.

Results: We recruited 719 participants, of whom 119 (16.6%) were seeds. Our estimate of the population prevalence of HIV was 23.4% [95% confidence interval (CI): 15.8% to 31.0%] after RDS adjustments. We estimated that 18.6% (95% CI: 8.8% to 30.4%) of HIV-positive MSM in Vancouver had a VL of ≥200 copies per milliliter. Having an unsuppressed VL was associated with non-white ethnicity [adjusted odds ratio (AOR) = 4.34; 95% CI: 1.67 to 11.1], an annual income of <$15,000 CAD (AOR = 6.43; 95% CI: 2.08 to 19.9), using gamma-hydroxy butyrate in the previous 6 months (AOR = 4.85; 95% CI: 1.79 to 13.2), unprotected anal intercourse with a known HIV-negative or an unknown serostatus partner (AOR = 3.13; 95% CI: 1.10 to 8.90), and disclosing one's HIV serostatus ≥50% of the time (AOR = 7.04; 95% CI: 1.01 to 49.1).

Conclusion: Despite a high prevalence of HIV, we estimated that a small proportion of HIV-positive MSM have undiagnosed HIV and unsuppressed VL. Our results highlight the importance of continued work to address health inequities using a framework based on social determinants of health.

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Conflict of interest statement

Conflicts of interest: For the remaining authors no conflicts of interest were declared

Figures

Figure 1
Figure 1. Recruitment chains for the Momentum Study
White = self-reported HIV negative; black = self-reported HIV positive; grey = other Circle = 16–24 years; Square = 25–39 years, Triangle = 40+ years
See this image and copyright information in PMC

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