Amplified HIV Transmission Risk Among People Living With HIV in Southeast Brazil.
Renata Karina Reis, Marcela Antonini, Laelson Rochelle Milanês Sousa and 4 others
PMID 37565984WHAT IT FOUND
68.6% of people living with HIV had at least one factor linked to greater HIV transmission risk.
Younger age, alcohol or drug use before sex, and no professional HIV counseling were linked to higher risk.
Key findings
01206 participants (68.6%) had one or more factors of amplified HIV transmission risk; STI diagnosis was most common (34.3%), then condomless intercourse (31.0%), detectable viral load (25.3%), and STI symptoms (14.7%).
02In the final model, age was associated with higher amplified risk (OR=0.96; 95% CI 0.94-0.98), with younger participants at higher risk; alcohol use before sex (OR=1.84; 95% CI 1.12-3.02), illicit drug use before sex (OR=2.40; 95% CI 1.27-4.55), and lack of professional counseling (OR=1.82; 95% CI 1.05-3.15) also remained associated with higher amplified risk.
03Participants who believed a person living with HIV could transmit HIV to a serodiscordant partner had lower odds of higher amplified risk (OR=0.54; 95% CI 0.30-0.97).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was cross-sectional, so it cannot show that counseling, substance use, beliefs, or age caused higher amplified risk. Sexual behavior and drug use were self-reported, so answers may be biased by what participants wanted to report. Participants were recruited from infectious-disease referral units and most were on ART, so findings may not apply to people living with HIV who are not in care or not taking ART. 97 of 397 interviewed were excluded for missing clinical or outcome data, leaving 300 analysed. The study was done in a city in Brazil, so generalization to other settings is uncertain.
Declared interests
The authors declared no conflicts of interest. Funding came from the São Paulo Research Foundation (FAPESP), grant 2015/23008-2; the authors state the content is solely their responsibility.
The easy way to misread this
Do not conclude that professional HIV counseling reduces transmission risk. This study found that lack of counseling was associated with higher amplified risk in a cross-sectional sample, and it did not test counseling as an intervention.