Condomless Sex With Virologically Suppressed HIV-Infected Individuals

Daar, Eric S.; Corado, Katya

doi:10.1001/jama.2016.5636

Cited by 8 publications

(4 citation statements)

References 11 publications

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“…These reductions are slightly higher than the mean reduction of 88% in our 100 model runs. Adherence is likely to be higher in research study cohorts than in the general population however [ 20 ], and therefore our lower simulated mean reduction may be more realistic for Uganda as a whole.…”

Section: Discussionmentioning

confidence: 99%

Improving ART programme retention and viral suppression are key to maximising impact of treatment as prevention – a modelling study

et al. 2017

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BackgroundUNAIDS calls for fewer than 500,000 new HIV infections/year by 2020, with treatment-as-prevention being a key part of their strategy for achieving the target. A better understanding of the contribution to transmission of people at different stages of the care pathway can help focus intervention services at populations where they may have the greatest effect. We investigate this using Uganda as a case study.MethodsAn individual-based HIV/ART model was fitted using history matching. 100 model fits were generated to account for uncertainties in sexual behaviour, HIV epidemiology, and ART coverage up to 2015 in Uganda. A number of different ART scale-up intervention scenarios were simulated between 2016 and 2030. The incidence and proportion of transmission over time from people with primary infection, post-primary ART-naïve infection, and people currently or previously on ART was calculated.ResultsIn all scenarios, the proportion of transmission by ART-naïve people decreases, from 70% (61%–79%) in 2015 to between 23% (15%–40%) and 47% (35%–61%) in 2030. The proportion of transmission by people on ART increases from 7.8% (3.5%–13%) to between 14% (7.0%–24%) and 38% (21%–55%). The proportion of transmission by ART dropouts increases from 22% (15%–33%) to between 31% (23%–43%) and 56% (43%–70%).ConclusionsPeople who are currently or previously on ART are likely to play an increasingly large role in transmission as ART coverage increases in Uganda. Improving retention on ART, and ensuring that people on ART remain virally suppressed, will be key in reducing HIV incidence in Uganda.

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Section: Discussionmentioning

confidence: 99%

Improving ART programme retention and viral suppression are key to maximising impact of treatment as prevention – a modelling study

et al. 2017

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“…The burden of sexually transmitted infections (STIs) and crack cocaine use is higher in low and middleincome countries than in high-income ones and the great challenge is to find strategies to reduce the impact of inequality and discrimination and to develop policies to protect individuals living with or at risk of infections. [1][2][3][4] Approximately 47% of all human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/ AIDS) cases in Latin America 5 are in Brazil, which is also the country with the highest rate of crack cocaine use, affecting 0.8% of the total population. 6 Although no significant reductions in supply or demand for crack cocaine have occurred recently, HIV/AIDS prevention and treatment initiatives have reduced the incidence of new HIV/AIDS cases significantly all over the globe, 5 from 3.1 million in 2000 to 2.1 million in 2015.…”

Section: Introductionmentioning

confidence: 99%

HIV and syphilis infections and associated factors among patients in treatment at a Specialist Alcohol, Tobacco, and Drugs Center in São Paulo’s “Cracolândia”

Ribeiro

Trevizol

Oluwoye

et al. 2020

Trends Psychiatry Psychother.

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Introduction: This study describes the epidemiological scenario of human immunodeficiency virus (HIV) and syphilis at the biggest specialist drug addiction center in Brazil. The great challenge is to find strategies to reduce the impact of inequality and discrimination and develop policies to protect individuals living with-or at risk of-infections. Methods: During the period from January 1 to May 31, 2016, a cross-sectional study was conducted on which all patients (N = 806) seeking inpatient treatment were enrolled. A structured diagnostic interview and rapid tests were conducted initially, and diagnoses were confirmed by tests conducted at a venereal disease research laboratory (VDRL). Results: HIV and syphilis rates were 5.86% and 21.9%, respectively. Women were nearly 2.5 times more likely to have syphilis. HIV infection was associated with unprotected sex (odds ratio [OR]: 3.27, p = 0.003, 95% confidence interval [95%CI]: 1.51-7.11), and suicidal ideation (OR: 6.63, p = 0.001, 95%CI: 3.37-14.0). Although only 1.86% reported injecting drugs at any point during their lifetimes, this variable was associated with both HIV and syphilis. Elevated rates of HIV and syphilis were observed in the context of this severe social vulnerability scenario. Conclusion: The risk factors identified as associated with HIV and syphilis should be taken into consideration for implementation of specific prevention strategies including early diagnosis and treatment of sexually transmitted infections (STI) to tackle the rapid spread of STIs in this population.

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“…Such strategies have been noted elsewhere. [45][46][47][48] Use of PrEP, known to be highly effective against HIV transmission, [49][50][51] may also influence condom use. While condom use remains the gold standard beyond abstinence for HIV/STI protection, interviews suggested that assessment of condom use without accounting for these factors would be less informative of true risk behavior in the current ART era.…”

Section: Discussionmentioning

confidence: 99%

Development and Content Validation of a Patient-Reported Sexual Risk Measure for Use in Primary Care

et al. 2018

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Condomless Sex With Virologically Suppressed HIV-Infected Individuals

Cited by 8 publications

References 11 publications

Improving ART programme retention and viral suppression are key to maximising impact of treatment as prevention – a modelling study

Improving ART programme retention and viral suppression are key to maximising impact of treatment as prevention – a modelling study

HIV and syphilis infections and associated factors among patients in treatment at a Specialist Alcohol, Tobacco, and Drugs Center in São Paulo’s “Cracolândia”

Development and Content Validation of a Patient-Reported Sexual Risk Measure for Use in Primary Care

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