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Trends in time spent viremic among persons newly diagnosed with HIV in San Francisco
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10 1 2023
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Source: J Acquir Immune Defic Syndr. 94(2):107-115
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Details:
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Alternative Title:J Acquir Immune Defic Syndr
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Personal Author:
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Description:Objective:
To examine trends in time spent viremic and initiation into ART among persons newly diagnosed with HIV in San Francisco.
Methods:
Using HIV surveillance data we included persons diagnosed with HIV during 2012–2020, a San Francisco resident at HIV diagnosis, alive 12 months after HIV diagnosis, and had ≥2 viral load tests within 12 months after diagnosis. Percent person-time spent (pPT) >200, pPT>1,500 , and pPT>10,000 copies/ml was calculated during the 12 months after HIV diagnosis. Multivariate regression models assessed year of diagnosis and time spent above each viral threshold and year of diagnosis and ART initiation within 0–7 days (rapid), 8–365 days (delayed), or no ART initiation.
Results:
Of 2,471 new HIV diagnoses in San Francisco from 2012–2020, 1,921 (72%) were included. Newly diagnosed persons spent a mean of 40.4% pPT>200, 32.4% pPT>1,500, and 23.4% pPT>10,000 copies/ml; 33.8% had rapid ART initiation, 57.3% delayed, and 9% had no ART initiation. After adjustment, persons diagnosed in years 2014–2015, 2016–2017, 2018–2019, and 2020 were associated with less time spent above all viral thresholds and lower risk of delayed or no ART initiation compared to those diagnosed in 2012–2013. Greater time above thresholds correlated with injection drug use, ages 25–29 and 30–39 years, and homelessness.
Conclusions:
Percent time spent above each viremic level decreased significantly, while rapid ART initiation increased among newly diagnosed persons from 2014 through 2020 compared to 2012–2013. Population differences in time spent unsuppressed highlight the need for targeted interventions to reduce new HIV infections and improve health.
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Pubmed ID:37707298
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Pubmed Central ID:PMC10497196
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Funding:
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Volume:94
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Issue:2
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