Modeling HIV Transmission from Sexually Active Alcohol-Consuming Men in ART Programs to Seronegative Wives

Autor: Kevin D. Dieckhaus MD, Toan H. Ha MD, DrPh, Stephen L. Schensul PhD, Avina Sarna MD
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: Journal of the International Association of Providers of AIDS Care, Vol 19 (2020)
Druh dokumentu: article
ISSN: 2325-9582
23259582
DOI: 10.1177/2325958220952287
Popis: Background: The rollout of antiviral therapy in Low and Middle Income Countries (LMICs) has reduced HIV transmission rates at the potential risk of resistant HIV transmission. We sought to predict the risk of wild type and antiviral resistance transmissions in these settings. Methods: A predictive model utilizing viral load, ART adherence, genital ulcer disease, condom use, and sexual event histories was developed to predict risks of HIV transmission to wives of 233 HIV+ men in 4 antiretroviral treatment centers in Maharashtra, India. Results: ARV Therapy predicted a 5.71-fold reduction in transmissions compared to a model of using condoms alone, with 79.9%, of remaining transmissions resulting in primary ART-resistance. Conclusions: ART programs reduce transmission of HIV to susceptible partners at a substantial increased risk for transmission of resistant virus. Enhanced vigilance in monitoring adherence, use of barrier protections, and viral load may reduce risks of resistant HIV transmissions in LMIC settings.
Databáze: Directory of Open Access Journals