Viral suppression and HIV transmission behaviors among hospitalized patients living with HIV

• Type of Material: Article
• Authors: Yue Pan, University of Miami; Lisa R. Metsch, Columbia University; Lauren K. Gooden, Columbia University; Morgan M. Philbin, Columbia University; Eric S. Daar, University of California Los Angeles; Antoine Douaihy, University of Pittsburgh; Petra Jacobs, National Institute on Drug Abuse; Carlos del Rio, Emory University; Allan E. Rodriguez, University of Miami; Daniel J. Feaster, University of Miami
• Language: English
• Date: 2019-08-01
• Publisher: SAGE Publications Ltd.
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2022 by SAGE Publications.
• Final Published Version (URL): http://dx.doi.org/10.1177/0956462419846726
• Title of Journal or Parent Work: International Journal of STD & AIDS
• Volume: 30
• Issue: 9
• Start Page: 891
• End Page: 901
• Grant/Funding Information: None declared
• Keywords: Care; viral suppression; Infectious Diseases; Immunology; African Americans; Life Sciences & Biomedicine; Active antiretroviral therapy; Adolescents; sexual risk behaviors; Science & Technology; antiretroviral therapy; Interventions; injection drug use; Drug-users; HIV; Sexual risk behaviors; Men; Prevention; United States
• Research Categories: Health Sciences, Public Health; Health Sciences, Immunology; Health Sciences, Rehabilitation and Therapy

Abstract

From July 2012 to January 2014, the CTN0049 study, Project HOPE (Hospital Visit as Opportunity for Prevention and Engagement for HIV-infected Drug Users) interviewed 1227 people with HIV infection from 11 hospitals in the US to determine eligibility for participation in a randomized trial. Using these screening interviews, we conducted a cross-sectional study with multivariable analysis to examine groups that are at highest risk for having a detectable viral load (VL) and engaging in HIV transmission behaviors. Viral suppression was 42.8%. Persons with a detectable VL were more likely to have sex partners who were HIV-negative or of unknown status (OR = 1.72, 95% CI = 1.22–2.38), report not cleaning needles after injecting drugs (OR = 3.13, 95% CI = 1.33–7.14), and to engage in sex acts while high on drugs or alcohol (OR = 1.85, 95% CI = 1.28–2.7) compared to their counterparts. Many hospitalized people with HIV infection are unsuppressed and more likely to engage in HIV transmission behaviors than those with viral suppression. Developing behavioral interventions targeting HIV transmission behaviors toward patients with unsuppressed HIV VLs in the hospital setting has the potential to prevent HIV transmission.