TY - JOUR
T1 - Variation in antiretroviral treatment (ART) coverage and virological suppression among three HIV key populations
AU - EuroSIDA Study Group
AU - Laut, Kamilla Grønborg
AU - Shepherd, Leah
AU - Gottfredsson, Magnus
AU - Sedlacek, Dalibor
AU - Knysz, Brygida
AU - Begovac, Josip
AU - Radoi, Roxana
AU - Schmied, Brigitte
AU - Chkhartishvili, Nikoloz
AU - Florence, Eric
AU - Ristola, Matti
AU - Fätkenheuer, Gerd
AU - Mulcahy, Fiona
AU - Schmid, Patrick
AU - Kuzovatova, Elena
AU - Paduta, Dzmitry
AU - Smidt, Jelena
AU - Domingo, Pere
AU - Szlávik, Janos
AU - Lundgren, Jens
AU - Mocroft, Amanda
AU - Kirk, Ole
N1 - NPP
PY - 2018
Y1 - 2018
N2 - 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.
AB - 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.
KW - antiretroviral therapy
KW - HIV
KW - HIV care continuum
KW - key and vulnerable populations
KW - public health
KW - viral suppression
KW - INJECTING DRUG-USERS
KW - HEPATITIS-C VIRUS
KW - EASTERN-EUROPE
KW - CARE
KW - INFECTION
KW - CASCADE
KW - SEX
KW - CONTINUUM
KW - BARRIERS
KW - RUSSIA
U2 - 10.1097/QAD.0000000000002035
DO - 10.1097/QAD.0000000000002035
M3 - A1: Web of Science-article
C2 - 30289816
SN - 0269-9370
VL - 32
SP - 2807
EP - 2819
JO - AIDS
JF - AIDS
IS - 18
ER -