Improvements in Virologic Control Among PWH Over Time: Narrowing the Gap Between Those With and Without STIs

Authors

Hana Akselrod, Division of Infectious Diseases, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Morgan Byrne, Department of Epidemiology, George Washington University Milken Institute School of Public Health, Washington, DC, USA. byrne410@gwu.edu.
Jeannette Lundberg, Infectious Diseases Section, DC Veterans Administration Medical Center, Washington, DC, USA.
Jonathan Mamber Czeresnia, Department of Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Jose Lucar, Division of Infectious Diseases, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Alessandra Secco, Division of Infectious Diseases, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Matt Levy, Department of Epidemiology, George Washington University Milken Institute School of Public Health, Washington, DC, USA.
Anne Monroe, Department of Epidemiology, George Washington University Milken Institute School of Public Health, Washington, DC, USA.
Amanda Castel, Department of Epidemiology, George Washington University Milken Institute School of Public Health, Washington, DC, USA.
Michael Horberg, Kaiser Permanente Mid-Atlantic Permanente Research Institute, Rockville, MD, USA.
Rupali Doshi, DC Department of Health, HIV/AIDS, Hepatitis, STD, and TB Administration, Washington, DC, USA.
Heather Rivasplata, Infectious Diseases Section, DC Veterans Administration Medical Center, Washington, DC, USA.
Leah Squires, Department of Psychology, DC Veterans Affairs Medical Center, Washington, DC, USA.
David Parenti, Division of Infectious Diseases, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Debra Benator, Division of Infectious Diseases, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.

Document Type

Journal Article

Publication Date

8-19-2022

Journal

AIDS and behavior

DOI

10.1007/s10461-022-03802-6

Keywords

Ending the HIV Epidemic; HIV; HIV transmission; Sexually transmitted infection; Viral load

Abstract

Using the incidence of bacterial sexually transmitted infection (STI) as a surrogate for condomless sexual behavior, we assessed the association between STI and uncontrolled HIV replication among in-care persons with HIV (PWH) enrolled in a longitudinal HIV cohort study in the District of Columbia (the DC Cohort). Although STI occurrence initially correlated with higher HIV viral load (VL), this difference became more attenuated over time (2012-2016). This was true overall and among those with the greatest number of STIs [age 18-34, men who have sex with men (MSM)]. This likely reflects gains in population-wide virologic control through improved antiretroviral therapy and access to care, which helps mitigate the risk of HIV transmission.

Department

Medicine

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