Use of Antiretroviral Drug Testing to Assess the Accuracy of Self-reported Data from HIV-Infected People Who Inject Drugs

Abstract

We used antiretroviral (ARV) drug testing to evaluate the accuracy of self-reported data for HIV status and antiretroviral treatment (ART) among people who inject drugs enrolled in an HIV prevention trial. ARV drugs were detected in enrollment samples from 72/482 = 14.9% HIV-infected participants (39/52 = 75.0% who reported being on ART; 33/430 = 7.7% who reported not being on ART). Overall, 213/482 = 44.2% participants indicated that they were not aware of their HIV-positive status prior to study entry; of those, 30 had ARV drugs detected at enrollment, including 15 who also had ARV drugs detected at the screening visit. These participants were likely aware of their HIV-positive status at study entry but did not report this to study staff. This study shows that self-reported data on HIV testing history and ART may not be accurate and that ARV drug testing can help identify persons who are aware of their HIV-positive status and are on ART.

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References

  1. 1.

    UNAIDS. The gap report 2014. http://files.unaids.org/en/media/unaids/contentassets/documents/unaidspublication/2014/UNAIDS_Gap_report_en.pdf. Accessed 1 Feb 2018.

  2. 2.

    Degenhardt L, Peacock A, Colledge S, Leung J, Grebely J, Vickerman P, et al. Global prevalence of injecting drug use and sociodemographic characteristics and prevalence of HIV, HBV, and HCV in people who inject drugs: a multistage systematic review. Lancet Glob Health. 2017;5(12):e1192–207.

    Article  PubMed  PubMed Central  Google Scholar 

  3. 3.

    World Health Organization. Global health observatiory (GHO) data. http://www.who.int/gho/hiv/en/. Accessed 1 Feb 2018.

  4. 4.

    Habecker P, Abadie R, Welch-Lazoritz M, Reyes JC, Khan B, Dombrowski K. Injection partners, HCV, and HIV status among rural persons who inject drugs in Puerto Rico. Subst Use Misuse. 2017;53:1128–38.

    Article  PubMed  PubMed Central  Google Scholar 

  5. 5.

    Pares-Badell O, Espelt A, Folch C, Majo X, Gonzalez V, Casabona J, et al. Undiagnosed HIV and Hepatitis C infection in people who inject drugs: From new evidence to better practice. J Subst Abuse Treat. 2017;77:13–20.

    Article  PubMed  Google Scholar 

  6. 6.

    Zelaya CE, Le Minh N, Lau B, Latkin CA, Viet Ha T, Minh Quan V, et al. The effect of a multi-level intervention on the initiation of antiretroviral therapy (ART) among HIV-Infected men who inject drugs and were diagnosed late in Thai Nguyen, Vietnam. PLoS ONE. 2016;11(8):e0161718.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. 7.

    Fogel JM, Wang L, Parsons TL, Ou SS, Piwowar-Manning E, Chen Y, et al. Undisclosed antiretroviral drug use in a multinational clinical trial (HIV Prevention Trials Network 052). J Infect Dis. 2013;208(10):1624–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. 8.

    Grabowski MK, Reynolds SJ, Kagaayi J, Gray RH, Clarke W, Chang LW, et al. The validity of self-reported antiretroviral use in persons living with HIV: a population-based study. AIDS. 2018;32(3):363–9.

    PubMed  PubMed Central  Google Scholar 

  9. 9.

    Kim AA, Mukui I, Young PW, Mirjahangir J, Mwanyumba S, Wamicwe J, et al. Undisclosed HIV infection and antiretroviral therapy use in the Kenya AIDS indicator survey 2012: relevance to national targets for HIV diagnosis and treatment. AIDS. 2016;30(17):2685–95.

    Article  PubMed  PubMed Central  Google Scholar 

  10. 10.

    Sullivan AK, Savage EJ, Lowndes CM, Paul G, Murphy G, Carne S, et al. Non-disclosure of HIV status in UK sexual health clinics–a pilot study to identify non-disclosure within a national unlinked anonymous seroprevalence survey. Sex Transm Infect. 2013;89(2):120–1.

    Article  PubMed  Google Scholar 

  11. 11.

    Savage EJ, Lowndes CM, Sullivan AK, Back DJ, Else LJ, Murphy G, et al. Effect of nondisclosure of HIV status in sexual health clinics on unlinked anonymous HIV prevalence estimates in England, 2005-2009. AIDS. 2016;30(1):145–9.

    PubMed  Google Scholar 

  12. 12.

    Marzinke MA, Clarke W, Wang L, Cummings V, Liu TY, Piwowar-Manning E, et al. Nondisclosure of HIV status in a clinical trial setting: antiretroviral drug screening can help distinguish between newly diagnosed and previously diagnosed HIV infection. Clin Infect Dis. 2014;58(1):117–20.

    Article  PubMed  Google Scholar 

  13. 13.

    Fogel JM, Zhang Y, Guo X, Clarke W, Breaud A, Cummings V, et al. Accuracy of self-reported HIV status among African men and transgender women who have sex with men who were screened for participation in a research study: HPTN 075. AIDS Behav. 2018; Epub ahead of print.

  14. 14.

    Hoots B, Wejnert C, Martin A, Haaland R, Masciotra S, Sionean C, et al. Undisclosed HIV infection among MSM in national HIV behavioral surveillance. 25th Conference on Retroviruses and Opportunistic Infections, Boston, MA, March 4–7, 2018. Abstract #910.

  15. 15.

    Fogel JM, Clarke W, Kulich M, Piwowar-Manning E, Breaud A, Olson MT, et al. Antiretroviral drug use in a cross-sectional population survey in Africa: NIMH Project Accept (HPTN 043). J Acquir Immune Defic Syndr. 2017;74(2):158–65.

    Article  PubMed  PubMed Central  Google Scholar 

  16. 16.

    Chen I, Connor MB, Clarke W, Marzinke MA, Cummings V, Breaud A, et al. Antiretroviral drug use and HIV drug resistance among HIV-infected Black men who have sex with men: HIV Prevention Trials Network 061. J Acquir Immune Defic Syndr. 2015;69(4):446–52.

    Article  PubMed  PubMed Central  Google Scholar 

  17. 17.

    Castillo-Mancilla JR, Haberer JE. Adherence measurements in HIV: new advancements in pharmacologic methods and real-time monitoring. Curr HIV/AIDS Rep. 2018;15(1):49–59.

    Article  PubMed  PubMed Central  Google Scholar 

  18. 18.

    Lancaster KE, Hoffman IF, Hanscom B, Ha TV, Dumchev K, Susami H, et al. Regional differences between people who inject drugs in an HIV prevention trial integrating treatment and prevention: HPTN 074. J Int AIDS Soc. 2018;21(10):e25195.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. 19.

    Miller WC, Hoffman IF, Hanscom BS, Ha TV, Dumchev K, Djoerban Z, et al. A scalable, integrated intervention to engage people who inject drugs in HIV care and medication-assisted treatment: a randomized, controlled vanguard trial (HPTN 074). Lancet. 2018;392:747–59.

    Article  PubMed  Google Scholar 

  20. 20.

    Marzinke MA, Breaud A, Parsons TL, Cohen MS, Piwowar-Manning E, Eshleman SH, et al. The development and validation of a method using high-resolution mass spectrometry (HRMS) for the qualitative detection of antiretroviral agents in human blood. Clin Chim Acta. 2014;433:157–68.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. 21.

    Zhang Y, Clarke W, Marzinke MA, Piwowar-Manning E, Beauchamp G, Breaud A, et al. Evaluation of a multidrug assay for monitoring adherence to a regimen for HIV preexposure prophylaxis in a clinical study, HIV Prevention Trials Network 073. Antimicrob Agents Chemother. 2017;61(7):e02743–16

  22. 22.

    Davis GP, Surratt HL, Levin FR, Blanco C. Antiretroviral medication: an emerging category of prescription drug misuse. Am J Addict. 2014;23(6):519–25.

    Article  PubMed  Google Scholar 

  23. 23.

    Grelotti DJ, Closson EF, Smit JA, Mabude Z, Matthews LT, Safren SA, et al. Whoonga: potential recreational use of HIV antiretroviral medication in South Africa. AIDS Behav. 2014;18(3):511–8.

    Article  PubMed  PubMed Central  Google Scholar 

  24. 24.

    Larney S, Peacock A, Leung J, Colledge S, Hickman M, Vickerman P, et al. Global, regional, and country-level coverage of interventions to prevent and manage HIV and hepatitis C among people who inject drugs: a systematic review. Lancet Glob Health. 2017;5(12):e1208–20.

    Article  PubMed  PubMed Central  Google Scholar 

  25. 25.

    Iskandar S, de Jong CA, Hidayat T, Siregar IM, Achmad TH, van Crevel R, et al. Successful testing and treating of HIV/AIDS in Indonesia depends on the addiction treatment modality. J Multidiscip Healthc. 2012;5:329–36.

    Article  PubMed  PubMed Central  Google Scholar 

  26. 26.

    Lim TW, Davis WW, Quan VM, Frangakis C, Viet T, Minh NL, et al. Association between HIV knowledge and risk behavior in persons who inject drugs in Thai Nguyen, Vietnam. Southeast Asian J Trop Med Public Health. 2014;45(6):1425–36.

    PubMed  PubMed Central  Google Scholar 

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Acknowledgements

The authors thank the HPTN 074 study team and participants for providing the samples and data used in this study. We also thank the laboratory staff who helped with sample management and testing. This work was supported by the HIV Prevention Trials Network (HPTN) sponsored by the National Institute of Allergy and Infectious Diseases (NIAID), National Institute on Drug Abuse (NIDA), and Office of AIDS Research, of the National Institutes of Health (NIH) [UM1-AI068613 (Eshleman); UM1-AI068617 (Donnell); and UM1-AI068619 (Cohen/El-Sadr)].

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Authors

Contributions

All of the authors contributed to manuscript preparation and reviewed the manuscript before submission. JMF: Designed the study, analysed data; prepared the manuscript. YZ: Assisted with data analysis and presentation. PJP: Assisted with data analysis and presentation. XG: HPTN 074 data analyst; performed statistical analysis. WC: Provided scientific oversight for antiretroviral drug testing. AB: Performed antiretroviral drug testing. PR: HPTN Laboratory Center QAQC Representative for HPTN 074; responsible for laboratory activities in HPTN 074. EPM: HPTN Laboratory Center QAQC Representative for HPTN 074; responsible for laboratory activities in HPTN 074. ELH: Study Coordinator for HPTN 074. TVH: HPTN 074 Site PI. KD: HPTN 074 Site PI. ZD: HPTN 074 Site PI. IH: HPTN 074 Protocol Co-Chair. BH: HPTN 074 Statistician. WCM: HPTN 074 Protocol Chair. SHE: HPTN 074 Virologist; designed the study, analysed data; prepared the manuscript.

Corresponding author

Correspondence to Susan H. Eshleman.

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Conflict of Interest

None of the authors has a financial or personal relationship with other people or organizations that could inappropriately influence (bias) their work, with the following exceptions: Susan Eshleman has collaborated on research studies with investigators from Abbott; Abbott has provided reagents for collaborative research studies.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Fogel, J.M., Zhang, Y., Palumbo, P.J. et al. Use of Antiretroviral Drug Testing to Assess the Accuracy of Self-reported Data from HIV-Infected People Who Inject Drugs. AIDS Behav 23, 2101–2108 (2019). https://doi.org/10.1007/s10461-018-2379-8

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Keywords

  • HIV
  • ART
  • Self-report
  • PWID
  • Indonesia
  • Ukraine
  • Vietnam