Increased antiretroviral therapy prescription and HIV viral suppression among persons receiving clinical care for HIV infection

Bradley, Heather; Mattson, Christine L.; Beer, Linda; Huang, Ping; Shouse, R. Luke

doi:10.1097/qad.0000000000001164

Cited by 48 publications

(41 citation statements)

References 25 publications

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“…Because young PLWH are least likely to be virally suppressed [11], it is possible that providers are more focused on attaining viral suppression than addressing comorbidities, such as hypertension, in this group. With PLWH living longer lives as a result of highly active antiretroviral therapy [12], younger patients with undiagnosed and untreated hypertension potentially have many years to accrue complications of untreated and uncontrolled hypertension and therefore would benefit from early diagnosis and treatment.…”

Section: Discussionmentioning

confidence: 99%

Hypertension Among Persons Living With HIV in Medical Care in the United States—Medical Monitoring Project, 2013–2014

Olaiya

Weiser

Zhou

et al. 2018

Open Forum Infectious Diseases

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Section: Discussionmentioning

confidence: 99%

Hypertension Among Persons Living With HIV in Medical Care in the United States—Medical Monitoring Project, 2013–2014

Olaiya

Weiser

Zhou

et al. 2018

Open Forum Infectious Diseases

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“…With improved antiretroviral therapy, survival among those with HIV has greatly improved (Antiretroviral Therapy Cohort et al, 2009; Bradley et al, 2016). However, substantial disparities remain (Hall et al, 2013) since African-Americans and Hispanics are at greater risk for HIV infection (Giordano et al, 2010; Harrison, Song, & Zhang, 2010; Siddiqi et al, 2015), and for failure to achieve viral suppression once infected (Castel et al, 2016; Xia, Sun, Wiewel, & Torian, 2017).…”

Section: Introductionmentioning

confidence: 99%

HealthCall delivered via smartphone to reduce co-occurring drug and alcohol use in HIV-infected adults: A randomized pilot trial

Aharonovich

Stohl

Cannizzaro

et al. 2017

Journal of Substance Abuse Treatment

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Aims Co-occurrence of drug and alcohol use among people living with HIV is linked to poor medication adherence and lack of viral suppression. HealthCall, a technological enhancement of brief Motivational Interviewing (MI), involves brief daily self-monitoring, positive reinforcement, and personalized feedback. This randomized pilot study among people living with HIV investigated the feasibility and efficacy of reducing non-injection drug and alcohol use with MI + HealthCall as adapted for smartphone technology. Design An urban, largely-minority community sample of adults living with HIV were screened for eligibility: last 30 day use of non-injection drugs (≥4 days of crack/cocaine, methamphetamine, or heroin use) and binge drinking (≥1 day of 4+ standard drinks). Those eligible were randomized to one of two groups: MI-only (n = 21) and MI + HealthCall-S (n = 21). Trained counselors delivered the brief MI at baseline. Drug and alcohol use assessments were completed at baseline, 30 and 60 days (end of treatment). Primary outcomes derived from a Timeline Follow Back (TLFB) of the past 30 days included (1) total number of days used primary drug (NumDU) (2) total quantity of primary drug used (dollar amount spent per day; QuantU), (3) total number of drinking days (NumDD) and (4) mean number of drinks per day (QuantDD). Feasibility was determined by HealthCall use rates, patient satisfaction questionnaire (1–5 scale, 5 being best), and retention. Findings The median daily use rate for HealthCall was 95%, patient satisfaction was excellent (4.5) and retention was high (93%). Both treatment groups reduced drug and alcohol use by end of treatment, with MI+Healthcall-S showing significantly greater reductions than MI-only in QuantU (p=0.01) and NumDU (p=0.046). P-values for reductions in alcohol quantity and frequency in the MI+Healthcall group were 0.09–0.11. Conclusions This proof-of-concept randomized trial indicates that HealthCall on the smartphone is a highly feasible intervention in urban, minority individuals with HIV, and suggests efficacy in reducing co-occurring drug and alcohol use. Results suggest opportunities for brief behavioral intervention that may be enhanced through interactive mobile technology to address complex alcohol and drug use patterns that interfere with HIV care, medication adherence and ultimately, viral suppression. A larger randomized trial is warranted to replicate and extend present results.

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“…The percentages of US patients in HIV primary care who were prescribed ART and who achieved viral suppression have increased in recent years, with ART use rising from 89% to 94% and viral suppression at last test growing from 72% to 80% between 2009 and 2013 1. Sustaining viral suppression over the long term, however, can present challenges.…”

Section: Introductionmentioning

confidence: 99%

Characterising HIV transmission risk among US patients with HIV in care: a cross-sectional study of sexual risk behaviour among individuals with viral load above 1500 copies/mL

Stirratt

Marks

O’Daniels³

et al. 2017

Sex Transm Infect

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Objectives Viral load and sexual risk behaviour contribute to HIV transmission risk. High HIV viral loads present greater transmission risk than transient viral “blips” above an undetectable level. This paper therefore characterises sexual risk behaviour among HIV patients in care with viral loads >1500 copies/ml and associated demographic characteristics. Methods This cross-sectional study was conducted at six HIV outpatient clinics in the United States. The study sample comprises 1315 HIV patients with a recent viral load >1500 copies/ml. This study sample was drawn from a larger sample of individuals with a recent viral load >1000 copies/ml who completed a computer-assisted self-interview (CASI) regarding sexual risk practices in the last two months. The study sample was 32% heterosexual men, 38% men who have sex with men (MSM), and 30% women. Results Ninety percent of the sample had their viral load assay within 60 days of the CASI. Thirty-seven percent reported being sexually active (vaginal or anal intercourse) in the last two months. Most of the sexually active participants reported always using condoms (56.9%) or limiting condomless sex to seroconcordant partners (serosorting; 29.2% overall and 42.9% among MSM). Among sexually active participants who reported condomless anal or vaginal sex with an at-risk partner (14%), most had viral loads >10,000 copies/ml (62%). Conclusions A relatively small number of HIV patients in care with viral loads above 1500 copies/ml reported concurrent sexual transmission risk behaviours. Most of the individuals in this small group had markedly elevated viral loads, increasing the probability of transmission. Directing interventions to patients in care with high viral loads and concurrent risk behaviour could strengthen HIV prevention and reduce HIV infections.

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Increased antiretroviral therapy prescription and HIV viral suppression among persons receiving clinical care for HIV infection

Cited by 48 publications

References 25 publications

Hypertension Among Persons Living With HIV in Medical Care in the United States—Medical Monitoring Project, 2013–2014

Hypertension Among Persons Living With HIV in Medical Care in the United States—Medical Monitoring Project, 2013–2014

HealthCall delivered via smartphone to reduce co-occurring drug and alcohol use in HIV-infected adults: A randomized pilot trial

Characterising HIV transmission risk among US patients with HIV in care: a cross-sectional study of sexual risk behaviour among individuals with viral load above 1500 copies/mL

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