Modeling HIV Transmission from Sexually Active Alcohol-Consuming Men in ART Programs to Seronegative Wives

Overview

Journal J Int Assoc Provid AIDS Care

Publisher Sage Publications

Specialty Infectious Diseases

Date 2020 Aug 28

PMID 32851898

Authors

Kevin D Dieckhaus

Toan H Ha

Stephen L Schensul

Avina Sarna

Affiliations

Soon will be listed here.

Abstract

Background: The rollout of antiviral therapy in Low and Middle Income Countries (LMICs) has reduced HIV transmission rates at the potential risk of resistant HIV transmission. We sought to predict the risk of wild type and antiviral resistance transmissions in these settings.

Methods: A predictive model utilizing viral load, ART adherence, genital ulcer disease, condom use, and sexual event histories was developed to predict risks of HIV transmission to wives of 233 HIV+ men in 4 antiretroviral treatment centers in Maharashtra, India.

Results: ARV Therapy predicted a 5.71-fold reduction in transmissions compared to a model of using condoms alone, with 79.9%, of remaining transmissions resulting in primary ART-resistance.

Conclusions: ART programs reduce transmission of HIV to susceptible partners at a substantial increased risk for transmission of resistant virus. Enhanced vigilance in monitoring adherence, use of barrier protections, and viral load may reduce risks of resistant HIV transmissions in LMIC settings.

References

Stolte I, Dukers N, de Wit J, Fennema J, Coutinho R . Increase in sexually transmitted infections among homosexual men in Amsterdam in relation to HAART. Sex Transm Infect. 2001; 77(3):184-6. PMC: 1744315. DOI: 10.1136/sti.77.3.184. View

Sun X, Xiao Y, Peng Z . Modelling HIV superinfection among men who have sex with men. Math Biosci Eng. 2016; 13(1):171-91. DOI: 10.3934/mbe.2016.13.171. View

Gupta R, Jordan M, Sultan B, Hill A, Davis D, Gregson J . Global trends in antiretroviral resistance in treatment-naive individuals with HIV after rollout of antiretroviral treatment in resource-limited settings: a global collaborative study and meta-regression analysis. Lancet. 2012; 380(9849):1250-8. PMC: 3790969. DOI: 10.1016/S0140-6736(12)61038-1. View

Hugonnet S, Mosha F, Todd J, Mugeye K, Klokke A, Ndeki L . Incidence of HIV infection in stable sexual partnerships: a retrospective cohort study of 1802 couples in Mwanza Region, Tanzania. J Acquir Immune Defic Syndr. 2002; 30(1):73-80. DOI: 10.1097/00042560-200205010-00010. View

Pedraza M, Del Romero J, Roldan F, Garcia S, Ayerbe M, NORIEGA A . Heterosexual transmission of HIV-1 is associated with high plasma viral load levels and a positive viral isolation in the infected partner. J Acquir Immune Defic Syndr. 1999; 21(2):120-5. View

Kamenga M, Ryder R, Jingu M, Mbuyi N, Mbu L, Behets F . Evidence of marked sexual behavior change associated with low HIV-1 seroconversion in 149 married couples with discordant HIV-1 serostatus: experience at an HIV counselling center in Zaire. AIDS. 1991; 5(1):61-7. DOI: 10.1097/00002030-199101000-00009. View

Toure S, Kouadio B, Seyler C, Traore M, Dakoury-Dogbo N, Duvignac J . Rapid scaling-up of antiretroviral therapy in 10,000 adults in Côte d'Ivoire: 2-year outcomes and determinants. AIDS. 2008; 22(7):873-82. PMC: 3921665. DOI: 10.1097/QAD.0b013e3282f768f8. View

Quinn T, Wawer M, Sewankambo N, Serwadda D, Li C, Wabwire-Mangen F . Viral load and heterosexual transmission of human immunodeficiency virus type 1. Rakai Project Study Group. N Engl J Med. 2000; 342(13):921-9. DOI: 10.1056/NEJM200003303421303. View

Chakraborty H, Sen P, HELMS R, Vernazza P, Fiscus S, Eron J . Viral burden in genital secretions determines male-to-female sexual transmission of HIV-1: a probabilistic empiric model. AIDS. 2001; 15(5):621-7. DOI: 10.1097/00002030-200103300-00012. View

10.

Attia S, Egger M, Muller M, Zwahlen M, Low N . Sexual transmission of HIV according to viral load and antiretroviral therapy: systematic review and meta-analysis. AIDS. 2009; 23(11):1397-404. DOI: 10.1097/QAD.0b013e32832b7dca. View

11.

Bertagnolio S, De Luca A, Vitoria M, Essajee S, Penazzato M, Hong S . Determinants of HIV drug resistance and public health implications in low- and middle-income countries. Antivir Ther. 2012; 17(6):941-53. DOI: 10.3851/IMP2320. View

12.

Vernazza P, Troiani L, Flepp M, Cone R, Schock J, Roth F . Potent antiretroviral treatment of HIV-infection results in suppression of the seminal shedding of HIV. The Swiss HIV Cohort Study. AIDS. 2000; 14(2):117-21. DOI: 10.1097/00002030-200001280-00006. View

13.

Nash D, Katyal M, Brinkhof M, Keiser O, May M, Hughes R . Long-term immunologic response to antiretroviral therapy in low-income countries: a collaborative analysis of prospective studies. AIDS. 2008; 22(17):2291-302. PMC: 2794130. DOI: 10.1097/QAD.0b013e3283121ca9. View

14.

Lasry A, Sansom S, Wolitski R, Green T, Borkowf C, Patel P . HIV sexual transmission risk among serodiscordant couples: assessing the effects of combining prevention strategies. AIDS. 2014; 28(10):1521-9. PMC: 7797164. DOI: 10.1097/QAD.0000000000000307. View

15.

Zheng Z, Li Y, Jiang Y, Liang X, Qin S, Nehl E . Population HIV transmission risk for serodiscordant couples in Guangxi, Southern China: A cohort study. Medicine (Baltimore). 2018; 97(36):e12077. PMC: 6133537. DOI: 10.1097/MD.0000000000012077. View

16.

Chesney M, Ickovics J, Chambers D, Gifford A, Neidig J, Zwickl B . Self-reported adherence to antiretroviral medications among participants in HIV clinical trials: the AACTG adherence instruments. Patient Care Committee & Adherence Working Group of the Outcomes Committee of the Adult AIDS Clinical Trials Group.... AIDS Care. 2000; 12(3):255-66. DOI: 10.1080/09540120050042891. View

17.

Rowland-Jones S, Sutton J, Ariyoshi K, Dong T, Gotch F, McAdam S . HIV-specific cytotoxic T-cells in HIV-exposed but uninfected Gambian women. Nat Med. 1995; 1(1):59-64. DOI: 10.1038/nm0195-59. View

18.

Donnell D, Baeten J, Kiarie J, Thomas K, Stevens W, Cohen C . Heterosexual HIV-1 transmission after initiation of antiretroviral therapy: a prospective cohort analysis. Lancet. 2010; 375(9731):2092-8. PMC: 2922041. DOI: 10.1016/S0140-6736(10)60705-2. View

19.

Cohen M, Chen Y, McCauley M, Gamble T, Hosseinipour M, Kumarasamy N . Antiretroviral Therapy for the Prevention of HIV-1 Transmission. N Engl J Med. 2016; 375(9):830-9. PMC: 5049503. DOI: 10.1056/NEJMoa1600693. View

20.

Sturmer M, Doerr H, Berger A, Gute P . Is transmission of HIV-1 in non-viraemic serodiscordant couples possible?. Antivir Ther. 2008; 13(5):729-32. View