Milken Institute School of Public Health Poster Presentations (Marvin Center & Video)

Title

Preliminary Analysis of Risk Behaviors and Risk Reduction Strategies among Newly Diagnosed and Viremic Persons Living with HIV (PLWH) in Washington, DC

Document Type

Poster

Status

Graduate Student - Doctoral

Abstract Category

Epidemiology and Biostatistics

Keywords

HIV; Risk behaviors; Risk reduction

Publication Date

4-2017

Abstract

Background: While high risk behaviors among PLWH contribute to onward transmission of HIV, it is well-documented that knowing one’s HIV status can lead to risk reduction behaviors including disclosure, reducing the number of sexual partners, sero-sorting, and consistent condom use. Washington, DC has a high HIV prevalence of 2%, thus understanding the sexual risk behaviors of PLWH may help inform future interventions to interrupt transmission.

Objective: To describe the sexual risk behaviors and risk reduction strategies of recently diagnosed PLWH in DC compared to those chronically infected but with detectable virus.

Methods: The DC Cohort is a longitudinal observational cohort study of PLWH receiving care at 14 clinical sites in DC. As part of a Molecular Epidemiology sub-study, Cohort participants who were either diagnosed in the 12 months prior to their enrollment or viremic (gt;1500 copies/mL) as of their most recent viral load test were eligible. This analysis focused on data from the sub-study cross-sectional behavioral survey. Univariate analyses using chi-square and Wilcoxon rank sum tests were conducted to describe participants and examine differences between recently diagnosed and viremic participants.

Results: Of the 91 participants enrolled to date, 33% (N=30) were recently diagnosed; 67% (N=61) were viremic. Viremic participants were diagnosed a median of 15 years, were more likely to be older (51 vs. 34 years), heterosexual (62% vs. 27%), Black (92% vs. 60%), and have acquired HIV through heterosexual contact (46% vs. 17%); (plt;.05 for all). Overall, 63% of participants were sexually active in the past 12 months (mean number of partners: 6). Over half (54%) had disclosed to their most recent partner, 24% of whom were also HIV+, and 25% of whom were reportedly taking pre-exposure prophylaxis (PrEP). More recently diagnosed participants had unprotected sex during their last sexual encounter (47% vs. 23%, p=0.02) and more recently diagnosed MSM used condoms inconsistently during anal sex with their most recent partner (91% vs. 50%, p=0.05) compared to viremic participants. More viremic participants reported always using condoms with each sexual partner (53% vs. 30%, p=.04), and refraining from anal sex (33% vs. 20%, p=.01) as risk reduction strategies compared to recently diagnosed participants.

Conclusions: Despite a relatively high number of sexual partners, modest disclosure rates, and inconsistent condom use, differences in risk behaviors and risk reduction strategies between recently diagnosed and viremic participants were observed. Primary and secondary prevention interventions focused on consistent condom use and PrEP should be emphasized.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Open Access

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Poster to be presented at GW Annual Research Days 2017.

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Preliminary Analysis of Risk Behaviors and Risk Reduction Strategies among Newly Diagnosed and Viremic Persons Living with HIV (PLWH) in Washington, DC

Background: While high risk behaviors among PLWH contribute to onward transmission of HIV, it is well-documented that knowing one’s HIV status can lead to risk reduction behaviors including disclosure, reducing the number of sexual partners, sero-sorting, and consistent condom use. Washington, DC has a high HIV prevalence of 2%, thus understanding the sexual risk behaviors of PLWH may help inform future interventions to interrupt transmission.

Objective: To describe the sexual risk behaviors and risk reduction strategies of recently diagnosed PLWH in DC compared to those chronically infected but with detectable virus.

Methods: The DC Cohort is a longitudinal observational cohort study of PLWH receiving care at 14 clinical sites in DC. As part of a Molecular Epidemiology sub-study, Cohort participants who were either diagnosed in the 12 months prior to their enrollment or viremic (gt;1500 copies/mL) as of their most recent viral load test were eligible. This analysis focused on data from the sub-study cross-sectional behavioral survey. Univariate analyses using chi-square and Wilcoxon rank sum tests were conducted to describe participants and examine differences between recently diagnosed and viremic participants.

Results: Of the 91 participants enrolled to date, 33% (N=30) were recently diagnosed; 67% (N=61) were viremic. Viremic participants were diagnosed a median of 15 years, were more likely to be older (51 vs. 34 years), heterosexual (62% vs. 27%), Black (92% vs. 60%), and have acquired HIV through heterosexual contact (46% vs. 17%); (plt;.05 for all). Overall, 63% of participants were sexually active in the past 12 months (mean number of partners: 6). Over half (54%) had disclosed to their most recent partner, 24% of whom were also HIV+, and 25% of whom were reportedly taking pre-exposure prophylaxis (PrEP). More recently diagnosed participants had unprotected sex during their last sexual encounter (47% vs. 23%, p=0.02) and more recently diagnosed MSM used condoms inconsistently during anal sex with their most recent partner (91% vs. 50%, p=0.05) compared to viremic participants. More viremic participants reported always using condoms with each sexual partner (53% vs. 30%, p=.04), and refraining from anal sex (33% vs. 20%, p=.01) as risk reduction strategies compared to recently diagnosed participants.

Conclusions: Despite a relatively high number of sexual partners, modest disclosure rates, and inconsistent condom use, differences in risk behaviors and risk reduction strategies between recently diagnosed and viremic participants were observed. Primary and secondary prevention interventions focused on consistent condom use and PrEP should be emphasized.