Impact of viral suppression among persons with HIV upon estimated HIV incidence between 2010 and 2015 in the United States
| العنوان: | Impact of viral suppression among persons with HIV upon estimated HIV incidence between 2010 and 2015 in the United States |
|---|---|
| المؤلفون: | Jeffrey Wiener, Karen W. Hoover, Ya-Lin A Huang, Azfar-e. Alam Siddiqi, Taraz Samandari |
| المصدر: | PLoS ONE PLoS ONE, Vol 15, Iss 10, p e0240727 (2020) |
| بيانات النشر: | Public Library of Science, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | 0301 basic medicine, RNA viruses, Sustained Virologic Response, Epidemiology, HIV Infections, Rate ratio, Pathology and Laboratory Medicine, Geographical locations, Men who have sex with men, 0302 clinical medicine, Immunodeficiency Viruses, Medicine, 030212 general & internal medicine, education.field_of_study, Multidisciplinary, Incidence (epidemiology), Incidence, HIV diagnosis and management, Viral Load, Annual Percent Change, Socioeconomic Aspects of Health, HIV epidemiology, Medical Microbiology, Viral Pathogens, Viruses, symbols, Pathogens, Research Article, Science, Population, HIV prevention, Men WHO Have Sex with Men, Viremia, Microbiology, 03 medical and health sciences, symbols.namesake, Virology, Retroviruses, Humans, Poisson regression, education, Microbial Pathogens, Medicine and health sciences, Preventive medicine, business.industry, Lentivirus, Organisms, Biology and Life Sciences, HIV, medicine.disease, 030112 virology, Confidence interval, Diagnostic medicine, United States, Health Care, Public and occupational health, North America, Population Groupings, People and places, business, Viral Transmission and Infection, Demography, Sexuality Groupings |
| الوصف: | BackgroundThe suppression of viremia among persons with HIV (PWH) using antiretroviral therapy has been hypothesized to reduce HIV incidence at the population level. We investigated the impact of state level viral suppression among PWH in the United States on estimated HIV incidence between 2010 and 2015.MethodsViral suppression data and HIV incidence estimates from the National HIV Surveillance System were available from 29 states and the District of Columbia. We assumed a one year delay for viral suppression to impact incidence. Poisson regression models were used to calculate the estimated annual percent change (EAPC) in incidence rate. We employed a multivariable mixed-effects Poisson regression model to assess the effects of state level race/ethnicity, socioeconomic status, percent men who have sex with men (MSM) and hepatitis C virus prevalence as a proxy for injection drug use on HIV incidence.FindingsFitted HIV incidence for 30 jurisdictions declined from 11.5 in 2010 to 10.0 per 100,000 population by 2015 corresponding with an EAPC of -2.67 (95% confidence interval [95%CI] -2.95, -2.38). Southern states experienced the highest estimated incidence by far throughout this period but upon adjustment for viral suppression and demographics there was a 36% lower incidence rate than Northeast states (adjusted rate ratio [aRR] 0.64; 95%CI 0.42, 0.99). For every 10 percentage point (pp) increase in viral suppression there was an adjusted 4% decline in HIV incidence rate in the subsequent year (aRR 0.96; 95%CI 0.93, 0.99). While controlling for viral suppression, HIV incidence rate increased by 42% (aRR 1.42 95%CI 1.31, 1.54) for every 5 pp increase in percent Black race and by 27% (aRR 1.27 95%CI 1.10, 1.48) for every 1 pp increase in percent MSM in states.InterpretationA decline in estimated HIV incidence from 2010 to 2015 was associated with increasing viral suppression in the United States. Race and sexual orientation were important HIV acquisition risk factors. |
| اللغة: | English |
| تدمد: | 1932-6203 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::3261a942bd6bae9c1a68689d8aec3160 http://europepmc.org/articles/PMC7567380 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....3261a942bd6bae9c1a68689d8aec3160 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 19326203 |
|---|