TY - JOUR
T1 - Antiretroviral drug use in a cross-sectional population survey in Africa
T2 - NIMH project accept (HPTN 043)
AU - Fogel, Jessica M.
AU - Clarke, William
AU - Kulich, Michal
AU - Piwowar-Manning, Estelle
AU - Breaud, Autumn
AU - Olson, Matthew T.
AU - Marzinke, Mark A.
AU - Laeyendecker, Oliver
AU - Fiamma, Agnès
AU - Donnell, Deborah
AU - Mbwambo, Jessie K.K.
AU - Richter, Linda
AU - Gray, Glenda
AU - Sweat, Michael
AU - Coates, Thomas J.
AU - Eshleman, Susan H.
N1 - Funding Information:
Supported by the following awards: the HIV Prevention Trials Network, sponsored by the National Institute of Allergy and Infectious Diseases (NIAID), the National Institute of Mental Health (NMH), and the National Institute of Drug Abuse (NIDA), Office of AIDS Research, of the National Institutes of Health [NIH, Grants UM1-AI068613 (S.H.E.); UM1-AI068617 (D.D.); and UM1-AI068619 (El-Sadr). Additional support for National Institute of Mental Health (NIMH) Project Accept (HPTN 043) was provided by the NIMH (U01-MH066687, U01-MH066688, U01-MH066701, and U01-MH066702). Additional support provided by the Division of Intramural Research, NIAID.
Publisher Copyright:
© 2016 Wolters Kluwer Health, Inc.
PY - 2017/2/1
Y1 - 2017/2/1
N2 - Background: Antiretroviral (ARV) drug treatment benefits the treated individual and can prevent HIV transmission. We assessed ARV drug use in a community-randomized trial that evaluated the impact of behavioral interventions on HIV incidence. Methods: Samples were collected in a cross-sectional survey after a 3-year intervention period. ARV drug testing was performed using samples from HIV-infected adults at 4 study sites (Zimbabwe; Tanzania; KwaZulu-Natal and Soweto, South Africa; survey period 2009-2011) using an assay that detects 20 ARV drugs (6 nucleoside/nucleotide reverse transcriptase inhibitors, 3 nonnucleoside reverse transcriptase inhibitors, and 9 protease inhibitors; maraviroc; raltegravir). Results: ARV drugs were detected in 2011 (27.4%) of 7347 samples; 88.1% had 1 nonnucleoside reverse transcriptase inhibitors 6 1-2 nucleoside/nucleotide reverse transcriptase inhibitors. ARV drug detection was associated with sex (women>men), pregnancy, older age (>24 years), and study site (P < 0.0001 for all 4 variables). ARV drugs were also more frequently detected in adults who were widowed (P = 0.006) or unemployed (P = 0.02). ARV drug use was more frequent in intervention versus control communities early in the survey (P = 0.01), with a significant increase in control (P = 0.004) but not in intervention communities during the survey period. In KwaZulu-Natal, a 1% increase in ARV drug use was associated with a 0.14% absolute decrease in HIV incidence (P = 0.018). Conclusions: This study used an objective, biomedical approach to assess ARV drug use on a population level. This analysis identified factors associated with ARV drug use and provided information on ARV drug use over time. ARV drug use was associated with lower HIV incidence at 1 study site.
AB - Background: Antiretroviral (ARV) drug treatment benefits the treated individual and can prevent HIV transmission. We assessed ARV drug use in a community-randomized trial that evaluated the impact of behavioral interventions on HIV incidence. Methods: Samples were collected in a cross-sectional survey after a 3-year intervention period. ARV drug testing was performed using samples from HIV-infected adults at 4 study sites (Zimbabwe; Tanzania; KwaZulu-Natal and Soweto, South Africa; survey period 2009-2011) using an assay that detects 20 ARV drugs (6 nucleoside/nucleotide reverse transcriptase inhibitors, 3 nonnucleoside reverse transcriptase inhibitors, and 9 protease inhibitors; maraviroc; raltegravir). Results: ARV drugs were detected in 2011 (27.4%) of 7347 samples; 88.1% had 1 nonnucleoside reverse transcriptase inhibitors 6 1-2 nucleoside/nucleotide reverse transcriptase inhibitors. ARV drug detection was associated with sex (women>men), pregnancy, older age (>24 years), and study site (P < 0.0001 for all 4 variables). ARV drugs were also more frequently detected in adults who were widowed (P = 0.006) or unemployed (P = 0.02). ARV drug use was more frequent in intervention versus control communities early in the survey (P = 0.01), with a significant increase in control (P = 0.004) but not in intervention communities during the survey period. In KwaZulu-Natal, a 1% increase in ARV drug use was associated with a 0.14% absolute decrease in HIV incidence (P = 0.018). Conclusions: This study used an objective, biomedical approach to assess ARV drug use on a population level. This analysis identified factors associated with ARV drug use and provided information on ARV drug use over time. ARV drug use was associated with lower HIV incidence at 1 study site.
KW - Africa
KW - Antiretroviral drug use
KW - HIV
UR - http://www.scopus.com/inward/record.url?scp=84994644681&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84994644681&partnerID=8YFLogxK
U2 - 10.1097/QAI.0000000000001229
DO - 10.1097/QAI.0000000000001229
M3 - Article
C2 - 27828875
AN - SCOPUS:84994644681
VL - 74
SP - 158
EP - 165
JO - Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology
JF - Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology
SN - 1525-4135
IS - 2
ER -