Portal de Periódicos da CAPES

HIV Transmission Risk Behavior and Its Relation to Antiretroviral Treatment Adherence

2003; Lippincott Williams & Wilkins; Volume: 30; Issue: 5 Linguagem: Inglês

10.1097/00007435-200305000-00005

1537-4521

RACHEL C. FLAKS, William J. Burman, Patrick J. Gourley, Cornelis A. Rietmeijer, David L. Cohn,

HIV, Drug Use, Sexual Risk

In Brief Background Rising rates of antiretroviral drug resistance among recently infected persons are evidence of high-risk behavior among persons in HIV care. Goal The goal was to determine HIV transmission risk behavior among persons in HIV care and evaluate its association with treatment adherence. Study Design The study involved a structured interview of a random sample of patients in HIV care in an urban public clinic. Participants were categorized by transmission risk: high risk = unprotected anal/vaginal sex and/or needle sharing; low risk = protected anal/vaginal sex, unprotected and/or protected oral sex, no needle sharing; no risk = no sex or needle sharing. Results Of the 95 participants, 21 (22%) reported high-risk behavior, 36 (38%) reported low-risk behavior, and 38 (40%) reported no transmission risk in the past 3 months. Younger, more educated persons and those with an active substance abuse diagnosis were more likely to have high transmission risk (P ≤ 0.05). Patients who engaged in high-risk behavior had equivalent use of antiretroviral therapy (P = 0.80) but lower adherence (P ≤ 0.01) and higher median plasma viral loads (P = 0.05). Conclusions There was a wide spectrum of transmission risk behavior among persons in HIV care. Persons reporting high-risk behavior were less adherent to antiretroviral therapy, providing a behavioral basis for transmission of drug-resistant HIV. Of 95 randomly selected patients in HIV care, 22% reported unprotected anal or vaginal sex in the past 3 months. Adherence to antiretroviral therapy was lower among patients who reported high-risk sexual behavior.