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Which HIV-Infected Men Who Have Sex with Men (MSM) in Care are Most Likely to Transmit?

Which HIV-Infected Men Who Have Sex with Men (MSM) in Care are Most Likely to Transmit?. KH Mayer, C O’Cleirigh, M Skeer, C Covahey, E Leidolf, R VanDerwarker, SA Safren. Methods. 201 HIV-infected MSM who received their primary care at Fenway Community Health

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Which HIV-Infected Men Who Have Sex with Men (MSM) in Care are Most Likely to Transmit?

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  1. Which HIV-Infected Men Who Have Sex with Men (MSM) in Care are Most Likely to Transmit? KH Mayer, C O’Cleirigh, M Skeer, C Covahey, E Leidolf, R VanDerwarker,SA Safren

  2. Methods • 201 HIV-infected MSM who received their primary care at Fenway Community Health • HIV transmission risk reduction behavioral intervention between August 2004 and May 2007 • Computer self-administered risk assessment • STIs were collected through study procedures and through medical record extraction, including urine and rectal NAAT for GC, CT and syphilis serology • CD4/Viral Load data were obtained through electronic medial record extraction

  3. Dependent Variable • Being a high-risk transmitter (HRT), defined as: • Engaging in unprotected insertive or receptive anal intercourse with HIV-negative or unknown status partners within the past 6 months, and • Either having a detectable viral load (HIV RNA >75 copies/ml), or • Having an STI diagnosis (gonorrhea, syphilis, or chlamydia) within the past year

  4. Cohort • Mean age: 40.7, range 24-67 • 74.6% White • 54.7% College education • Mean time since testing positive: 7.2 years • CD4: Mean: 537, Median 485 • Viral Load: 49.8% undetectable (mean: 18,425) • 57.0% were currently on HAART

  5. Results • 23.4% had >/= 5 alcoholic drinks per day • 64.7% used other substances • 30.3% used Methamphetamine • 11.9% had an STI • 69.3% engaged in unprotected anal sex • 50.2% had a detectable PVL • 45.0% were high risk transmitters

  6. Results Multivariable Associations • All variables found to have unique, significant associations with reported risk taking were included in a single logistic regression analysis. • In the final model, the following variables were found to be significantly associated with being a high-risk transmitter

  7. Conclusions • Prevention programs for HIV-infected MSM should focus on more recently diagnosed, and substance-using patients, especially those who binge drink and use Methamphetamine.

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