TY - JOUR

T1 - Variation in antiretroviral treatment coverage and virological suppression among three HIV key populations

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

AU - Eurosida Study Group

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: A 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 analysed differences between transmission categories using logistic regression.RESULTS: Among 12 872 participants followed from 1 July 2014 to 30 June 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 (95% confidence interval 1.25-2.26)], heterosexuals were more likely to receive ART than MSM, while in Eastern Europe, there was some evidence that infection through IDU [aOR 0.60 (95% confidence interval 0.31-1.14)] or heterosexual contact [aOR 0.58 (95% confidence interval 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.CONCLUSION: 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: A 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 analysed differences between transmission categories using logistic regression.RESULTS: Among 12 872 participants followed from 1 July 2014 to 30 June 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 (95% confidence interval 1.25-2.26)], heterosexuals were more likely to receive ART than MSM, while in Eastern Europe, there was some evidence that infection through IDU [aOR 0.60 (95% confidence interval 0.31-1.14)] or heterosexual contact [aOR 0.58 (95% confidence interval 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.CONCLUSION: 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.

U2 - 10.1097/QAD.0000000000002035

DO - 10.1097/QAD.0000000000002035

M3 - Journal article

C2 - 30289816

VL - 32

SP - 2807

EP - 2819

JO - AIDS

JF - AIDS

SN - 1350-2840

IS - 18

ER -