HIV Community Viral Load and Factors Associated With Elevated Viremia Among a Community-Based Sample of Men Who Have Sex With Men in Vancouver, Canada
Date
2016
Authors
Moore, David M.
Cui, Zishan
Lachowsky, Nathan J.
Raymond, Henry F.
Roth, Eric
Rich, Ashleigh
Sereda, Paul
Howard, Terry
McFarland, Willi
Lal, Allan
Journal Title
Journal ISSN
Volume Title
Publisher
Journal of Acquired Immune Deficiency Syndromes
Abstract
Background—We developed estimates of community viral load (VL) and risk factors for
unsuppressed VL from a cross-sectional study of men who have sex with men (MSM) in
Vancouver, Canada.
Methods—MSM were recruited from February 25, 2012 – February 28, 2014 using Respondent-
Driven Sampling (RDS). Participants completed a computer assisted self-interview questionnaire
and a nurse-administered point-of-care HIV test. For HIV positive participants, we conducted VL
and CD4 cell counts. We used RDS-weighted analysis to obtain population estimates of key
variables and multivariable logistic regression to examine factors associated with having a VL
≥200 copies/mL among HIV-positive participants.
Results—We recruited 719 participants, of whom 119 (16.6%) were seeds. Our estimate of the
population HIV prevalence was 23.4% (95% CI 15.8 – 31.0%) after RDS-adjustments. We
estimated that 18.6% (95% confidence interval [CI] 8.8 – 30.4%) of HIV-positive MSM in
Vancouver had a VL ≥200 copies/mL. Having an unsuppressed VL was associated with non-
Caucasian ethnicity (adjusted odds ratio [AOR]= 4.34; 95% CI 1.67 – 11.1); an annual income of
<$15,000 CAD (AOR=6.43; 95%CI 2.08–19.9); using GHB in the previous six months (AOR=4.85; 95%CI 1.79–13.2); unprotected anal intercourse with a known HIV negative or
unknown serostatus partner (AOR=3.13; 95%CI 1.10–8.90); and disclosing one’s HIV serostatus
≥50% of the time (AOR=7.04; 95%CI 1.01–49.1).
Conclusion—Despite a high prevalence of HIV, we estimated that a small proportion of HIV
positive MSM have undiagnosed HIV and unsuppressed VL. Our results highlight the importance
of continued work to address health inequities using a social determinants of health framework.
Description
The authors would like to thank the Momentum Study participants, office staff and community advisory board, as
well as our community partner agencies, the Health Initiative for Men, YouthCo HIV and Hep C Society, and the
Positive Living Society of BC.
Keywords
men who have sex with men (MSM), community viral load, treatment as prevention, risky sex
Citation
Moore, D. M., Cui, Z., Lachowsky, N., Raymond, H. F., Roth, E., Rich, A., Sereda, P., Howard, T., McFarland, W., Lal, A., Montaner, J., Corneil, T., & Hogg, R. S. (2016). “HIV Community Viral Load and Factors Associated With Elevated Viremia Among a Community-Based Sample of Men Who Have Sex With Men in Vancouver, Canada.” Journal of Acquired Immune Deficiency Syndromes, 72(1), 87-95. https://doi.org/10.1097/QAI.0000000000000934