Population prevalence of antiretroviral therapy sharing and its association with HIV viremia in rural Uganda: a cross-sectional population-based study.
Population prevalence of antiretroviral therapy sharing and its association with HIV viremia in rural Uganda: a cross-sectional population-based study.
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DOI：
10.1002/jia2.26135
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发表时间：
2023-09
影响因子：
6
通讯作者：
中科院分区：
文献类型：
--
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据报道，乌干达和南非的渔民和性工作者共享抗逆转录病毒治疗（ART）。然而，尚无基于人群的研究记录了非洲艾滋病毒感染者中抗逆转录病毒治疗的转移流行率（包括分享[给予/接受]、购买和销售）或其与病毒血症的关系。 2018 年至 2020 年，我们在 Rakai 社区队列研究（乌干达中南部基于人群的队列）中对 41 个社区中 15 至 49 岁的艾滋病毒感染者进行了调查。我们评估了自我报告的一生和过去一年的 ART 转移的患病率和相关性，按年龄和性别进行分层，并记录转移药物的来源。我们使用对数二项式回归来量化转移模式和病毒血症（病毒载量>40拷贝/毫升）之间的关系，报告为未调整和调整后的患病率（aPR），置信区间（CI）为95％。在 2852 名 HIV 感染者和自我报告当前 ART 使用情况的患者中，266 人 (9.3%) 报告终生接受 ART 转移。给予/接受毒品最为常见；很少有参与者报告买入，也没有参与者报告卖出。男性 (12.9%) 比女性 (7.4%) 更有可能报告一生的娱乐活动，其中 25-34 岁的男性报告分享程度较高 (18.9%)。朋友是最常见的共用毒品来源，其次是配偶/性伴侣。一生和过去一年的转移模式相似。在获得病毒载量结果的参与者中，8.6% 患有病毒血症。在调整分析中，报告仅接受 ART 的患者出现病毒血症的可能性几乎是报告未转移患者的两倍（aPR：1.94，95% CI：1.10−3.44），而报告仅接受 ART 的患者出现病毒血症的可能性较小（aPR：0.46，95% CI：0.12−1.79），尽管后者没有统计学意义。报告给予和接受 ART 与病毒血症无关（aPR：0.79，95% CI：0.43−1.46）。报告购买抗逆转录病毒治疗虽然很少见，但也与较高的病毒血症发生率相关，但这种关系并不具有统计学意义（aPR：1.98，95％CI：0.72−5.45）。在乌干达农村地区，报告使用抗逆转录病毒治疗的人中，尤其是男性中，分享抗逆转录病毒治疗很常见。共用抗逆转录病毒治疗与病毒血症有关，接受抗逆转录病毒治疗可能有助于抑制病毒。 HIV 项目可能会受益于在咨询信息中考虑 ART 共享。
Antiretroviral treatment (ART) sharing has been reported among fishermen and sex workers in Uganda and South Africa. However, no population‐based studies have documented ART diversion prevalence (including sharing [giving/receiving], buying and selling) or its relationship with viremia among men and women living with HIV in Africa. In 2018–2020, we surveyed people living with HIV aged 15–49 years in 41 communities in the Rakai Community Cohort Study, a population‐based cohort in south‐central Uganda. We assessed the prevalence and correlates of self‐reported lifetime and past‐year ART diversion, stratifying by age and gender and documenting sources of diverted drugs. We used log‐binomial regression to quantify the relationship between diversion patterns and viremia (viral load >40 copies/ml), reported as unadjusted and adjusted prevalence ratios (aPR) with 95% confidence intervals (CI). Of 2852 people living with HIV and self‐reporting current ART use, 266 (9.3%) reported lifetime ART diversion. Giving/receiving drugs were most common; few participants reported buying, and none reported selling. Men (12.9%) were more likely to report lifetime diversion than women (7.4%), with men aged 25–34 reporting high levels of sharing (18.9%). Friends were the most common sources of shared drugs, followed by spouses/sexual partners. Patterns of lifetime and past‐year diversion were similar. Among participants with viral load results, 8.6% were viraemic. In adjusted analyses, people who reported only giving ART were nearly twice as likely to be viraemic than those who reported no diversion (aPR: 1.94, 95% CI: 1.10−3.44), and those reporting only receiving ART were less likely to exhibit viremia (aPR: 0.46, 95% CI: 0.12−1.79), although the latter was not statistically significant. Reporting both giving and receiving ART was not associated with viremia (aPR: 0.79, 95% CI: 0.43−1.46). Reporting buying ART, though rare, was also correlated with higher rates of viremia, but this relationship was not statistically significant (aPR: 1.98, 95% CI: 0.72−5.45). ART sharing is common among persons reporting ART use in rural Uganda, particularly among men. Sharing ART was associated with viremia, and receiving ART may facilitate viral suppression. HIV programmes may benefit from considering ART sharing in counselling messages.
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影响因子：
4.4
作者：
Tsuyuki, Kiyomi;Surratt, Hilary L.
通讯作者：
Surratt, Hilary L.
影响因子：
4.4
作者：
Tsuyuki, Kiyomi;Surratt, Hilary L.;Levi-Minzi, Maria A.;O'Grady, Catherine L.;Kurtz, Steven P.
通讯作者：
Kurtz, Steven P.
DOI：
10.1177/23259582221110820
发表时间：
2022-01
影响因子：
--
作者：
Rock, Amelia;Comins, Carly;Mulumba, Ntambue;Young, Katherine;Mcingana, Mfezi;Guddera, Vijayanand;Hausler, Harry;Phetlhu, Rene;Baral, Stefan;Schwartz, Sheree
通讯作者：
Schwartz, Sheree
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影响因子：
1.7
作者：
Kurtz SP;Buttram ME;Surratt HL
通讯作者：
Surratt HL