HIV Community Viral Load & Factors Associated with Elevated Viremia among Men Who Have Sex with Men (MSM) in Vancouver, Canada
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.
By: Moore DM1, Cui Z, Lachowsky N, Raymond HF, Roth E, Rich A, Sereda P, Howard T, McFarland W, Lal A, Montaner J, Corneil T, Hogg RS; Momentum Health Study team.
- 1Department of Medicine, University of British Columbia, Vancouver, Canada
- 2 BC Centre for Excellence in HIV/AIDS, Vancouver, Canada
- 3 University of California - San Francisco, San Francisco, United States
- 4 University of Victoria, Victoria, Canada
- 5 Positive Living Society of BC, Vancouver, Canada 6Interior Health, Kelowna, Canada 7Simon Fraser University, Burnaby, Canada.
- J Acquir Immune Defic Syndr. 2016 Jan 27.
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