Abstract
Objective: We examined HIV transmission potential of patients in care by analyzing the amount of person-Time spent above a viral load threshold that increases risk for transmission. Design: Observational cohort and supplemental data. Methods: The cohort included HIV patients who received care at six HIV clinics in the United States, from 1 April 2009 to 31 March 2013, and had two or more viral load tests during this interval. Person-Time (in days) above a viral load of 1500 copies/ml out of the total observation time was determined by inspecting consecutive pairs of viral load results and the time intervals between those pairs. The person-Time rate ratios comparing demographic and clinical subgroups were estimated with Poisson regression. Results: The cohort included 14 532 patients observed for a median of 1073 days with a median of nine viral load records. Ninety percent of the patients had been prescribed antiretroviral therapy. On average, viral load exceeded 1500 copies/ml during 23% of the patients observation time (average of 84 days per year, per patient). Percentage of person-Time above the threshold was higher among patients who had more than a fourth of their viral load pairs exceeding a 6-month interval (34% of observation time), patients not on antiretroviral therapy (58% of time), new/re-engaging patients (34% of time), patients 16 39 years of age (32% of time), and patients of black race (26% of time). Conclusion: HIV patients in care spent an average of nearly a quarter of their time with viral loads above 1500 copies/ml, higher among some subgroups, placing them at risk for potentially transmitting HIV to others.
Original language | English (US) |
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Pages (from-to) | 947-954 |
Number of pages | 8 |
Journal | AIDS |
Volume | 29 |
Issue number | 8 |
DOIs | |
State | Published - 2015 |
Keywords
- HIV
- Person-Time
- Transmission
- Viral load
- cohort study
ASJC Scopus subject areas
- Immunology and Allergy
- Immunology
- Infectious Diseases