Factors associated with sex differences in viral non‐suppression in the Swedish InfCareHIV cohort: An observational real‐world study

Author:

Lindh Maria123ORCID,Brännström Johanna45,Reepalu Anton67ORCID,Svedhem Veronica48,Mellgren Åsa19

Affiliation:

1. Department of Infectious Diseases Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg Gothenburg Sweden

2. Region Västra Götaland, Södra Älvsborg Hospital, Department of Research, Education and Innovation Borås Sweden

3. Department of Infectious Diseases Södra Älvsborg Hospital Borås Sweden

4. Division of Infection and Dermatology, Department of Medicine Huddinge Karolinska Institute Stockholm Sweden

5. Department of Infectious Diseases/Venhälsan South Hospital Stockholm Sweden

6. Clinical Infection Medicine, Department of Translational Medicine Lund University Lund Sweden

7. Department of Infectious Diseases Skåne University Hospital Malmö Sweden

8. Department of Infectious Diseases Karolinska University Hospital Huddinge Sweden

9. Department of Infectious Diseases Region Västra Götaland, Sahlgrenska University Hospital Gothenburg Sweden

Abstract

AbstractObjectivesWomen living with HIV are underrepresented in clinical trials assessing outcomes of antiretroviral treatment (ART), justifying the need for observational studies. We investigated differences in viral non‐suppression between women and men in the Swedish InfCareHIV cohort and analysed results in relation to biological and socio‐demographic variables and patient‐reported outcome measures (PROMs).MethodsThe study included people living with HIV (PLWH) aged ≥18 years, who initiated ART at least 6 months prior to inclusion. Data from the InfCareHIV registry 2011–2018 were collected. Associations between variables and HIV RNA ≥50 copies/mL were investigated in uni‐ and multivariable analyses using generalized estimating equations, providing relative risks (RRs) as effect size.ResultsThe study included 38% (n = 2981) women. Women were more likely to have HIV RNA ≥50 copies/mL than were men [RR = 1.20, 95% confidence interval (CI): 1.10–1.31]. After adjusting for origin and route of transmission, sex at birth was no longer associated with viral non‐suppression. PROMs were available in 52.4% of PLWH, and items associated with viral non‐suppression were impaired adherence in women (RR = 2.38, 95% CI: 1.79–3.17) and men (RR 1.84, 95% CI: 1.40–2.42), and experience of side effects in women (RR = 1.49, 95% CI: 1.10–2.02).ConclusionsThis observational study found a 20% higher relative risk of viral non‐suppression in women than in men and the difference was associated with socio‐demographic factors. The associations between PROMs and viral non‐suppression varied between women and men. PROMs are important health outcomes that may identify PLWH in need of support to achieve viral non‐suppression.

Publisher

Wiley

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