Author:
King Caroline,Giang Le Minh,Bart Gavin,Kunkel Lynn,Korthuis P. Todd
Abstract
Abstract
Background
Little is known about patient characteristics that contribute to initiating antiretroviral therapy (ART) and achieving viral suppression among HIV people with opioid use disorder in Vietnam. The primary objective of this analysis was to evaluate associations between participant characteristics and the critical steps in the HIV care continuum of ART initiation and HIV viral suppression among people with opioid use disorder and HIV in Vietnam.
Methods
We assessed baseline participant characteristics, ART status, and HIV viral suppression (HIV RNA PCR < 200 copies/mL) enrolled in a clinical trial of HIV clinic-based buprenorphine versus referral for methadone among people with opioid use disorder in Vietnam. We developed logistic regression models to identify characteristics associated with ART status and HIV viral suppression.
Results
Among 283 study participants, 191 (67.5%) were prescribed ART at baseline, and 168 of those on ART (90%) were virally suppressed. Years since HIV diagnosis (aOR = 1.12, 95% CI 1.06, 1.19) and being married (aOR = 2.83, 95% CI 1.51, 5.34) were associated with an increased likelihood of current prescription for ART at baseline. Greater depression symptoms were negatively associated with receipt of ART (aOR = 0.97, 95% CI = (0.94, 0.9963)). In the HIV suppression model, once adjusting for all included covariates, only receipt of ART was associated with viral suppression (aOR = 25.9, 95% CI = (12.5, 53.8). In bivariate analyses, methamphetamine was negatively correlated with ART prescription (p = 0.07) and viral suppression (p = 0.08).
Conclusion
While fewer than 90% of participants had received ART, 90% of those on ART had achieved HIV viral suppression at baseline, suggesting that interventions to improve uptake of ART in Vietnam are essential for achieving UNAIDS 90–90-90 goals in people who use heroin in Vietnam. Social determinants of health associated with ART and HIV viral suppression suggest that social support may be a key to facilitating both of these steps in the HIV care continuum.
Funder
National Institute on Drug Abuse
National Center for Advancing Translational Sciences
Publisher
Springer Science and Business Media LLC
Subject
Public Health, Environmental and Occupational Health
Reference46 articles.
1. AMFAR. The twin epidemics of HIV and drug use: innovative strategies for healthy communitiesAMFAR Meeting Report; 2012.
2. Fiellin D, G.T.H.R. Combating the twin epidemics of hiv/aids and drug addiction: opportunities for Progress and gaps in scale: CSIS Task Force; 2008.
3. DECISION OF THE PRIME MINISTER approving the National Strategy on HIV/AIDS prevention and control in Viet Nam till 2010 with a vision to 2020, S.R.o. Vietnam, Editor. 2004.
4. HIV/AIDS, T.J.U.N.P.o., 90–90-90 An ambitious treatment target to help end the AIDS epidemic. 2014.
5. Nguyen VT, et al. Expenditure analysis of HIV testing and counseling services using the Cascade framework in Vietnam. PLoS One. 2015;10(5):e0126659.
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