HIV community viral load and factors associated with elevated viremia among a community-based sample of men who have sex with men (MSM) in Vancouver, Canada.

2016 | J Acquir Immune Defic Syndr

Program(s): Epidemiology and Population Health |
Initiative(s): Momentum |
Topic(s): Treatment as Prevention® |

Abstract:

BACKGROUND:

We developed estimates of community viral load (VL) and risk factors for unsuppressed VL from a cross-sectional study of men who have sex with men (MSM) in Vancouver, Canada.

METHODS:

MSM were recruited from February 25, 2012 - February 28, 2014 using Respondent-Driven Sampling (RDS). Participants completed a computer assisted self-interview questionnaire and a nurse-administered point-of-care HIV test. For HIV positive participants, we conducted VL and CD4 cell counts. We used RDS-weighted analysis to obtain population estimates of key variables and multivariable logistic regression to examine factors associated with having a VL ≥200 copies/mL among HIV-positive participants.

RESULTS:

We recruited 719 participants, of whom 119 (16.6%) were seeds. Our estimate of the population HIV prevalence was 23.4% (95% CI 15.8 - 31.0%) after RDS-adjustments. We estimated that 18.6% (95% confidence interval [CI] 8.8 - 30.4%) of HIV-positive MSM in Vancouver had a VL ≥200 copies/mL. Having an unsuppressed VL was associated with non-Caucasian ethnicity (adjusted odds ratio [AOR]= 4.34; 95% CI 1.67- 11.1); an annual income of <$15,000 CAD (AOR=6.43; 95%CI 2.08-19.9); using GHB in the previous six months (AOR=4.85; 95%CI 1.79-13.2); unprotected anal intercourse with a known HIV negative or unknown serostatus partner (AOR=3.13; 95%CI 1.10-8.90); and disclosing one's HIV serostatus ≥50% of the time (AOR=7.04; 95%CI 1.01-49.1).

CONCLUSION:

Despite a high prevalence of HIV, we estimated that a small proportion of HIV positive MSM have undiagnosed HIV and unsuppressed VL. Our results highlight the importance of continued work to address health inequities using a social determinants of health framework.

BC Centre for Excellence in HIV/AIDS

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HIV community viral load and factors associated with elevated viremia among a community-based sample of men who have sex with men (MSM) in Vancouver, Canada.

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