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

• Published in: International journal of STD & AIDS 2019-08, Vol.30 (9), p.891-901
• Main Authors: Pan, Yue, Metsch, Lisa R, Gooden, Lauren K, Philbin, Morgan M, Daar, Eric S, Douaihy, Antoine, Jacobs, Petra, del Rio, Carlos, Rodriguez, Allan E, Feaster, Daniel J
• Format: Article
• Language: English
• Subjects: Adult; AIDS/HIV; Anti-HIV Agents - therapeutic use; Cross-Sectional Studies; Female; HIV Infections - diagnosis; HIV Infections - drug therapy; HIV Infections - transmission; HIV Infections - virology; Humans; Inpatients - statistics & numerical data; Male; Risk-Taking; Sexual Behavior - psychology; Sexual Partners; Substance Abuse, Intravenous - epidemiology; Substance Abuse, Intravenous - psychology; Sustained Virologic Response; United States - epidemiology; Unsafe Sex - psychology; Viral Load - statistics & numerical data
• ISSN: 0956-4624; 1758-1052
• DOI: 10.1177/0956462419846726

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.