Details:

Alternative Title:
J Acquir Immune Defic Syndr
Personal Author:
Novitsky, Vlad ; Gaolathe, Tendani ; Mmalane, Mompati ; Moyo, Sikhulile ; Chakalisa, Unoda ; ... More +
Novitsky, Vlad ; Gaolathe, Tendani ; Mmalane, Mompati ; Moyo, Sikhulile ; Chakalisa, Unoda ; Yankinda, Etienne Kadima ; Marukutira, Tafireyi ; Holme, Molly Pretorius ; Sekoto, Tumalano ; Gaseitsiwe, Simani ; Musonda, Rosemary ; van Widenfelt, Erik ; Powis, Kathleen M. ; Khan, Nealia ; Dryden-Peterson, Scott ; Bennett, Kara ; Wirth, Kathleen E. ; Tchetgen, Eric Tchetgen ; Bachanas, Pam ; Mills, Lisa A. ; Lebelonyane, Refeletswe ; el-Halabi, Shenaaz ; Makhema, Joseph ; Lockman, Shahin ; Essex, M. ; Less -
Description:
Background: HIV-1 RNA load is the best biological predictor of HIV transmission and treatment response. The rate of virologic suppression among key sub-populations can guide HIV prevention programs. Methods: The Botswana Combination Prevention Project performed a population-based household survey among adults in 30 communities in Botswana. Data collected included knowledge of HIV-positive status, ART coverage and virologic suppression (HIV-1 RNA ≤400 copies/mL). Individuals aged 16–29 years were considered young adults. Results: Among 552 young people living with HIV (PLHIV) enrolled with RNA load data and ART status available, 51% (n=279) had undetectable HIV-1 RNA, including 54% of young women and 32% of young men (gender PR: 0.53; 95% CI: 0.43–0.80; p<0.001). Compared with older adults (30–64 years old), young HIV-infected adults were significantly less likely to have undetectable HIV-1 RNA (PR: 0.65; 95%CI: 0.59–0.70; p<0.0001), including both men (PR: 0.43; 95%CI: 0.34–0.56; p<0.0001) and women (PR: 0.67; 95%CI: 0.62–0.74; p<0.0001). Among a subset of PLHIV receiving ART, young adults also were less likely to have undetectable HIV-1 RNA load than older adults (PR: 0.93; 95%CI: 0.90–0.95; p=<0.0001). Analysis of the care continuum revealed that inferior HIV diagnosis and sub-optimal linkage to care are the primary reasons for low virologic suppression among young adults. Conclusions: Young adults in Botswana are significantly less likely to have undetectable HIV-1 RNA load compared with older adults. In the era of broad scale-up of ART, interventions able to diagnose young adults living with HIV and link them to effective therapy are urgently needed.
Subject:
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Article
HIV-1C Epidemic
HIV Suppression
Receiving ART
Virologically Suppressed
Young Adults

Source:
J Acquir Immune Defic Syndr. 78(5):557-565
Pubmed ID:
29771781
Pubmed Central ID:
PMC6069598
Document Type:
Journal Article ;
Funding:
U01 GH000447/GH/CGH CDC HHS/United States ; U2G GH001911/GH/CGH CDC HHS/United States ;
U01 GH000447/GH/CGH CDC HHS/United States ; U2G GH001911/GH/CGH CDC HHS/United States ; Less -
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:6a899200c3ac7695278745bf043023f2b5011548839f19e5567ad5a1bd6e748e
File Type:

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