HIV transmission risk behavior and its relation to antiretroviral treatment adherence.
BACKGROUND
Rising rates of antiretroviral drug resistance among recently infected persons are evidence of high-risk behavior among persons in HIV care.


OBJECTIVE
The goal was to determine HIV transmission risk behavior among persons in HIV care and evaluate its association with treatment adherence.


METHODS
The study involved a structured interview of a random sample of patients in HIV care in an urban public clinic. Participants were categorized by transmission risk: high risk = unprotected anal/vaginal sex and/or needle sharing; low risk = protected anal/vaginal sex, unprotected and/or protected oral sex, no needle sharing; no risk = no sex or needle sharing.


RESULTS
Of the 95 participants, 21 (22%) reported high-risk behavior, 36 (38%) reported low-risk behavior, and 38 (40%) reported no transmission risk in the past 3 months. Younger, more educated persons and those with an active substance abuse diagnosis were more likely to have high transmission risk (P < or = 0.05). Patients who engaged in high-risk behavior had equivalent use of antiretroviral therapy (P = 0.80) but lower adherence (P < or = 0.01) and higher median plasma viral loads (P = 0.05).


CONCLUSIONS
There was a wide spectrum of transmission risk behavior among persons in HIV care. Persons reporting high-risk behavior were less adherent to antiretroviral therapy, providing a behavioral basis for transmission of drug-resistant HIV.
Flaks
Rachel C
RC
Department of Public Health, Denver Health and Hospital Authority, University of Colorado Health Sciences Center, Denver, Colorado, USA.
Burman
William J
WJ
Gourley
Patrick J
PJ
Rietmeijer
Cornelis A
CA
Cohn
David L
DL
D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D003120:Colorado; D003430:Cross-Sectional Studies; D018562:Disease Transmission, Infectious; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000635:transmission*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D012307:Risk Factors; D012309:Risk-Taking; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014505:Urban Population
D019380:Anti-HIV Agents