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

• Main Authors: Jessica F. Magidson, Xin Li, Matthew J. Mimiaga, Ayana T. Moore, Kriengkrai Srithanaviboonchai, Ruth Khalili Friedman, Mohammad Limbada, James P. Hughes, Vanessa Cummings, Charlotte A. Gaydos, Vanessa Elharrar, David Celentano, Kenneth H. Mayer, Steven A. Safren
• Format: Journal
• Published: 2018
• Subjects: Medicine; Psychology
• Online Access: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84938703946&origin=inward; http://cmuir.cmu.ac.th/jspui/handle/6653943832/56176
• Institution: Chiang Mai University

© 2015, Springer Science+Business Media New York. 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.