Adherence to Antiretroviral Therapy and HIV Transmission Risks: Implications for Test-and-Treat Approaches to HIV Prevention
Adherence to Antiretroviral Therapy and HIV Transmission Risks: Implications for Test-and-Treat Approaches to HIV Prevention
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DOI：
10.1089/apc.2009.0309
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发表时间：
2010-05-01
影响因子：
4.9
通讯作者：
Kalichman, Moira O.
中科院分区：
文献类型：
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作者：
Kalichman, Seth C.;Cherry, Chauncey;Kalichman, Moira O.
通过抗逆转录病毒疗法（ART）有效抑制病毒复制，可以预防艾滋病毒传播。然而，坚持对ART的成功至关重要，包括减少艾滋病毒传播风险行为。本研究探讨了不依从性与依从性与艾滋病毒传播风险的关系。男性（n = 226）艾滋病毒/艾滋病感染者和接受抗逆转录病毒治疗完成了保密的计算机化访谈和电话为基础的突击药丸计数抗逆转录病毒治疗依从性监测。数据收集于2008年1月至2009年6月。结果表明，不遵守ART与更多的性伴侣和从事无保护和保护肛交。这些关联并不受物质使用的影响。认为检测不到病毒载量会导致较低的传染性与更多的伴侣（包括非阳性伴侣）和较少使用避孕套有关。那些病毒载量检测不到的男性，并认为病毒载量检测不到会降低他们的传染性，他们最近感染性病的可能性更大。旨在检测和治疗艾滋病毒/艾滋病感染者以预防艾滋病的方案需要注意依从性和性行为。
HIV transmission may be prevented by effectively suppressing viral replication with antiretroviral therapy (ART). However, adherence is essential to the success of ART, including for reducing HIV transmission risk behaviors. This study examined the association of nonadherence versus adherence with HIV transmission risks. Men (n = 226) living with HIV/AIDS and receiving ART completed confidential computerized interviews and telephone-based unannounced pill counts for ART adherence monitoring. Data were collected between January 2008 and June 2009. Results showed that nonadherence to ART was associated with greater number of sex partners and engaging in unprotected and protected anal intercourse. These associations were not moderated by substance use. The belief that having an undetectable viral load leads to lower infectiousness was associated with greater number of partners, including nonpositive partners, and less condom use. Men who had an undetectable viral load and believed that having an undetectable viral load reduces their infectiousness, were significantly more likely to have contracted a recent STI. Programs aimed at testing and treating people living with HIV/AIDS for prevention require attention to adherence and sexual behaviors.