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Safren SA, Hughes JP, Mimiaga MJ, et al. Frequency and predictors of estimated HIV transmissions and bacterial STI acquisition among HIV-positive patients in HIV care across three continents. J Int AIDS Soc. 2016;19(1):21096doi: 10.7448/IAS.19.1.21096.
Safren, S. A., Hughes, J. P., Mimiaga, M. J., Moore, A. T., Friedman, R. K., Srithanaviboonchai, K., Limbada, M., Williamson, B. D., Elharrar, V., Cummings, V., Magidson, J. F., Gaydos, C. A., Celentano, D. D., Mayer, K. H. (2016). Frequency and predictors of estimated HIV transmissions and bacterial STI acquisition among HIV-positive patients in HIV care across three continents. Journal of the International AIDS Society, 19(1), 21096. https://doi.org/10.7448/IAS.19.1.21096
Safren, Steven A, et al. "Frequency and predictors of estimated HIV transmissions and bacterial STI acquisition among HIV-positive patients in HIV care across three continents." Journal of the International AIDS Society vol. 19,1 (2016): 21096. doi: https://doi.org/10.7448/IAS.19.1.21096
Safren SA, Hughes JP, Mimiaga MJ, Moore AT, Friedman RK, Srithanaviboonchai K, Limbada M, Williamson BD, Elharrar V, Cummings V, Magidson JF, Gaydos CA, Celentano DD, Mayer KH. Frequency and predictors of estimated HIV transmissions and bacterial STI acquisition among HIV-positive patients in HIV care across three continents. J Int AIDS Soc. 2016 Sep 28;19(1):21096. doi: 10.7448/IAS.19.1.21096. eCollection 2016. PMID: 27687145; PMCID: PMC5043092.
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J Int AIDS Soc. 2016 Sep 28;19(1):21096. doi: 10.7448/IAS.19.1.21096. eCollection 2016.

Frequency and predictors of estimated HIV transmissions and bacterial STI acquisition among HIV-positive patients in HIV care across three continents.

Journal of the International AIDS Society

Steven A Safren, James P Hughes, Matthew J Mimiaga, Ayana T Moore, Ruth Khalili Friedman, Kriengkrai Srithanaviboonchai, Mohammed Limbada, Brian D Williamson, Vanessa Elharrar, Vanessa Cummings, Jessica F Magidson, Charlotte A Gaydos, David D Celentano, Kenneth H Mayer,

Affiliations

  1. The Fenway Institute, Fenway Health, Boston, MA, USA.
  2. Department of Psychology, University of Miami, Coral Gables, FL, USA; [email protected].
  3. Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
  4. School of Public Health, University of Washington, Seattle, WA, USA.
  5. Institute for Community Health Promotion, Brown University, Providence RI, USA.
  6. FHI360, Durham, NC, USA.
  7. Instituto Nacional de Infectologia Evandro Chagas, FIOCRUZ, Rio de Janeiro, Brazil.
  8. Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand.
  9. Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
  10. Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.
  11. National Institute of Allergy and Infectious Disease (NIAID), Bethesda, MD, USA.
  12. Department of Pathology, Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, MD, USA.
  13. Department of Medicine, Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, MD, USA.
  14. Behavioral Medicine Service, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
  15. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
  16. Department of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA.

PMID: 27687145 PMCID: PMC5043092 DOI: 10.7448/IAS.19.1.21096

Abstract

INTRODUCTION: Successful global treatment as prevention (TasP) requires identifying HIV-positive individuals at high risk for transmitting HIV, and having impact via potential infections averted. This study estimated the frequency and predictors of numbers of HIV transmissions and bacterial sexually transmitted infection (STI) acquisition among sexually active HIV-positive individuals in care from three representative global settings.

METHODS: HIV-positive individuals (

RESULTS: An estimated 3.81 (standard error, (SE)=0.63) HIV transmissions occurred for every 100 participants over the 15 months, which decreased over time. The highest rate was 19.50 (SE=1.68) for every 100 MSM in Brazil. In a multivariable model, country×risk group interactions emerged: in Brazil, MSM had 2.85 (95% CI=1.45, 4.25,

CONCLUSIONS: These data help to estimate the potential number of HIV infections transmitted and bacterial STIs acquired over time in patients established in care, a group typically considered at lower transmission risk, and found substantial numbers of estimated HIV transmissions. These findings provide an approach for evaluating the impact (in phase 2 studies) and potentially cost-effectiveness of global TasP efforts.

Keywords: MSM; global HIV prevention; global HIV transmission; secondary prevention; treatment as prevention

Conflict of interest statement

The authors have no competing interests to declare.

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