Sexual risk behaviour and viral suppression among HIV-infected adults receiving medical care in the United States

• Type of Material: Article
• Authors: Christine L. Mattson, Centers for Disease Control and Prevention (CDC); Mark Freedman, Centers for Disease Control and Prevention (CDC); Jennifer L. Fagan, Centers for Disease Control and Prevention (CDC); Emma L. Frazier, Centers for Disease Control and Prevention (CDC); Linda Beer, Centers for Disease Control and Prevention (CDC); Ping Huang, Centers for Disease Control and Prevention (CDC); Eduardo E. Valverde, Centers for Disease Control and Prevention (CDC); Christopher Johnson, Centers for Disease Control and Prevention (CDC); Catherine Sanders, Centers for Disease Control and Prevention (CDC); A.D. McNaghten, Emory University; Patrick Sullivan, Emory University; Amy Lansky, Centers for Disease Control and Prevention (CDC); Jonathan Mermin, Centers for Disease Control and Prevention (CDC); James Heffelfinger, Centers for Disease Control and Prevention (CDC); Jacek Skarbinski, Centers for Disease Control and Prevention (CDC)
• Language: English
• Date: 2014-05-15
• Publisher: Lippincott, Williams & Wilkins
• Publication Version: Final Published Version
• Copyright Statement: © 2014 Wolters Kluwer Health - Lippincott Williams & Wilkins.
• License: Creative Commons Attribution-NonCommerical-NoDerivs 3.0 Unported
• Final Published Version (URL): http://dx.doi.org/10.1097/QAD.0000000000000273
• Title of Journal or Parent Work: AIDS
• ISSN: 0269-9370
• Volume: 28
• Issue: 8
• Start Page: 1203
• End Page: 1211
• Grant/Funding Information: Funding for the MMP is provided by the CDC.
• Keywords: Life Sciences & Biomedicine; SAMPLE; antiretroviral therapy; Immunology; ACTIVE ANTIRETROVIRAL TREATMENT; HIV-infected persons; IMPACT; sexual behaviour; SAN-FRANCISCO; TRANSMISSION; PREVENTION; METAANALYSIS; Science & Technology; INFECTIOUS DISEASES; IMMUNOLOGY; viral load; THERAPY; VIROLOGY; VIRUS; Virology; Infectious Diseases; MEN; unsafe sex
• Research Categories: Health Sciences, General

Abstract

Objective: To describe the prevalence and association of sexual risk behaviours and viral suppression among HIV-infected adults in the United States. Design: Cross-sectional analysis of weighted data from a probability sample of HIVinfected adults receiving outpatient medical care. The facility and patient response rates were 76 and 51%, respectively. Methods: We analysed 2009 interview and medical record data. Sexual behaviours were self-reported in the past 12 months. Viral suppression was defined as all viral load measurements in the medical record during the past 12 months less than 200 copies/ml. Results: An estimated 98 022 (24%) HIV-infected adults engaged in unprotected vaginal or anal sex; 50 953 (12%) engaged in unprotected vaginal or anal sex with at least one partner of negative or unknown HIV status; 23 933 (6%) did so while not virally suppressed. Persons who were virally suppressed were less likely than persons who were not suppressed to engage in vaginal or anal sex [prevalence ratio, 0.88; 95% confidence interval (CI), 0.82-0.93]; unprotected vaginal or anal sex (prevalence ratio, 0.85; 95% CI, 0.73-0.98); and unprotected vaginal or anal sex with a partner of negative or unknown HIV status (prevalence ratio, 0.79; 95% CI, 0.64-0.99). Conclusion: The majority of HIV-infected adults receiving medical care in the U.S. did not engage in sexual risk behaviours that have the potential to transmit HIV, and of the 12% who did, approximately half were not virally suppressed. Persons who were virally suppressed were less likely than persons who were not suppressed to engage in sexual risk behaviours.