HIV viral load trajectories of women living with HIV in Metro Vancouver, Canada

Abstract

This study describes long-term viral load (VL) trajectories and their predictors among women living with HIV (WLWH), using data from Sexual Health and HIV/AIDS: Women’s Longitudinal Needs Assessment (SHAWNA), an open prospective cohort study with linkages to the HIV/AIDS Drug Treatment Program. Using Latent Class Growth Analysis (LCGA) on a sample of 153 WLWH (1088 observations), three distinct trajectories of detectable VL (≥50 copies/ml) were identified: ‘sustained low probability of detectable VL’, characterized by high probability of long-term VL undetectability (51% of participants); ‘ high probability of delayed viral undetectability’, characterized by a high probability VL detectability at baseline that decreases over time (43% of participants); and ‘ high probability of detectable VL’, characterized by a high probability of long-term VL detectability (7% of participants). In multivariable analysis, incarceration (adjusted odds ratio (AOR) = 3.24; 95%CI:1.34–7.82), younger age (AOR = 0.96; 95%CI:0.92–1.00), and lower CD4 count (AOR = 0.82; 95%CI:0.72–0.93) were associated with ‘ high probability of delayed viral undetectability’ compared to ‘sustained low probability of detectable VL.’ This study reveals the dynamic and heterogeneous nature of WLWH’s long-term VL patterns, and highlights the need for early engagement in HIV care among young WLWH and programs to mitigate the destabilizing impact of incarceration on WLWH’s HIV treatment outcomes.

HIV Viral Load Patterns and Risk Factors Among Women in Prevention of Mother-To-Child Transmission Programs to Inform Differentiated Service Delivery

“…28 GBTM has been used to evaluate virologic outcomes in high-income countries. [29][30][31][32][33][34][35] One study in Zambia reported 6 engagement trajectories in medication possession ratio and retention in care among new ART starters, 36 but overall evidence on viral trajectories in resource-limited settings is limited because of lack of sufficient longitudinal VL data.…”

“…The 3 distinct group-based VL trajectory patterns identified using GBTM yielded comparable patterns to those described in a study of women living with HIV in Canada. 29 Achieving and maintaining viral suppression is the key to minimize vertical HIV transmission and to optimize women's health outcomes. 50 Our study provided supportive evidence for inclusion of PWLH in DSD models.…”

The prevalence and social-structural correlates of housing status among women living with HIV in Vancouver, Canada

“…SHAWNA is an ongoing community-based study of WLWH (2014-present) which aims to understand the social and structural factors that shape access to health services among WLWH, including access to HIV treatment and care. Founded on extensive consultation with community, clinical, and policy experts, SHAWNA is [17].…”

Optimization Algorithm for Urban Rail Transit Operation Scheduling based on Linear Programming

“…The power consumption of URT system mainly includes traction, ventilation, air conditioning, and lighting; Traction and ventilation and air conditioning account for 3/4 of the TEC, but there are still difficulties in studying energy conservation and emission reduction in some areas, such as ventilation and air conditioning systems [3]. It relies on developing efficient equipment and reducing working hours [4]. The energy consumption of traction power supply is closely related to the operating time under traction conditions.…”