Publication
Variation in antiretroviral treatment (ART) coverage and virological suppression among three HIV key populations
Journal Paper/Review - Oct 4, 2018
Laut Kamilla Grønborg, Schmid Patrick, Kuzovatova Elena, Paduta Dzmitry, Smidt Jelena, Domingo Pere, Szlávik Janos, Lundgren Jens, Mocroft Amanda, Kirk Ole, Mulcahy Fiona, Fätkenheuer Gerd, Ristola Matti, Shepherd Leah, Gottfredsson Magnus, Sedlacek Dalibor, Knysz Brygida, Begovac Josip, Radoi Roxana, Schmied Brigitte, Chkhartishvili Nikoloz, Florence Eric, EuroSIDA Study Group
Units
PubMed
Doi
Citation
Type
Journal
Publication Date
Issn Electronic
Brief description/objective
OBJECTIVES
We assessed differences in antiretroviral treatment (ART) coverage and virological suppression across three HIV key populations, as defined by self-reported HIV transmission category: sex between men, injection drug use [IDU] and heterosexual transmission.
DESIGN
Multinational cohort study.
METHODS
Within the EuroSIDA study, we assessed region-specific percentages of ART-coverage among those in care and virological suppression (<500 copies/mL) among those on ART,, and analyzed differences between transmission categories using logistic regression.
RESULTS
Among 12,872 participants followed 01/07/2014 - 30/06/2016, the percentages of ART-coverage and virological suppression varied between transmission categories, depending on geographical region (global p for interaction: p = 0.0148 for ART-coverage, p = 0.0006 for virological suppression). In Western (adjusted odds ratio [aOR] 1.41 [95% confidence interval 1.14-1.75]) and Northern Europe (aOR 1.68 [1.25-2.26]) heterosexuals were more likely to receive ART than men who have sex with men (MSM), while in Eastern Europe there was some evidence that infection through IDU (aOR 0.60 [0.31-1.14]) or heterosexual contact (aOR 0.58 [0.30-1.10]) was associated with lower odds of receiving ART. In terms of virological suppression, people infected through IDU or heterosexual contact in East Central and Eastern Europe were around half as likely as MSM to have a suppressed viral load on ART, while we observed no differences in virological suppression across transmission categories in Western and Northern Europe.
CONCLUSIONS
In our cohort, patterns of ART-coverage and virological suppression among key populations varied by geographical region, emphasizing the importance of tailoring HIV programmes to the local epidemic.