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Improvements in Virologic Control Among PWH Over Time: Narrowing the Gap Between Those With and Without STIs

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Abstract

Using the incidence of bacterial sexually transmitted infection (STI) as a surrogate for condomless sexual behavior, we assessed the association between STI and uncontrolled HIV replication among in-care persons with HIV (PWH) enrolled in a longitudinal HIV cohort study in the District of Columbia (the DC Cohort). Although STI occurrence initially correlated with higher HIV viral load (VL), this difference became more attenuated over time (2012–2016). This was true overall and among those with the greatest number of STIs [age 18–34, men who have sex with men (MSM)]. This likely reflects gains in population-wide virologic control through improved antiretroviral therapy and access to care, which helps mitigate the risk of HIV transmission.

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Data Availability

The authors confirm that the data that supports the findings of this study are available in the article and the supplementary materials.

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Acknowledgements

We would like to thank the site Principal Investigators, Research Assistants, the Community Advisory Board, the patients themselves, the DC Department of Health, and the National Institutes of Health (NIH) for their contributions to the DC Cohort. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. Data in this manuscript were collected by the DC Cohort Study Group with investigators and research staff located at: Children’s National Medical Center Adolescent (Lawrence D’Angelo) and Pediatric (Natella Rakhmanina) clinics; The Senior Deputy Director of the DC Department of Health HAHSTA (Michael Kharfen); Family and Medical Counseling Service (Michael Serlin); Georgetown University (Princy Kumar); The George Washington University Biostatistics Center (Vinay Bhandaru, Tsedenia Bezabeh, Nisha Grover-Fairchild, Lisa Mele, Susan Reamer, Alla Sapozhnikova, Greg Strylewicz, Marinella Temprosa, Naji Younes, and Kevin Xiao); The George Washington University Department of Epidemiology (Morgan Byrne, Amanda Castel, Alan Greenberg, Maria Jaurretche, Paige Kulie, Anne Monroe, James Peterson, Bianca Stewart, and Brittany Wilbourn) and Department of Biostatistics and Bioinformatics (Yan Ma); The George Washington University Medical Faculty Associates (Hana Akselrod); Howard University Adult Infectious Disease Clinic (Jhansi L. Gajjala) and Pediatric Clinic (Sohail Rana); Kaiser Permanente Mid-Atlantic States (Michael Horberg); La Clinica Del Pueblo (Ricardo Fernandez); MetroHealth (Annick Hebou); National Institutes of Health (Carl Dieffenbach, Henry Masur); Washington Health Institute, formerly Providence Hospital (Jose Bordon); Unity Health Care (Gebeyehu Teferi); Veterans Affairs Medical Center (Debra Benator); Washington Hospital Center (Maria Elena Ruiz); and Whitman-Walker Institute (Stephen Abbott).

Funding

The DC Cohort is funded by the National Institute of Allergy and Infectious Diseases, UM1 AI069503 and 1R24AI152598-01. This research was supported by the District of Columbia Center for AIDS Research, an NIH funded program (AI117970), which is supported by the following NIH CoFunding and Participating Institutes and Centers: NIAID, NCI, NICHD, NHLBI, NIDA, NIMH, NIA, FIC, NIGMS, NIDDK, and OAR. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

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Authors and Affiliations

  1. Division of Infectious Diseases, George Washington University School of Medicine and Health Sciences, Washington, DC, USA

    Hana Akselrod, Jose Lucar, Alessandra Secco, David Parenti, Debra Benator, Hana Akselrod & Debra Benator

  2. Department of Epidemiology, George Washington University Milken Institute School of Public Health, Washington, DC, USA

    Morgan Byrne, Matt Levy, Anne Monroe, Amanda Castel, Morgan Byrne, Amanda Castel & Anne Monroe

  3. Infectious Diseases Section, DC Veterans Administration Medical Center, Washington, DC, USA

    Jeannette Lundberg, Heather Rivasplata, Debra Benator & Debra Benator

  4. Department of Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, USA

    Jonathan Mamber Czeresnia

  5. Westat, Rockville, MD, USA

    Matt Levy

  6. Kaiser Permanente Mid-Atlantic Permanente Research Institute, Rockville, MD, USA

    Michael Horberg & Michael Horberg

  7. DC Department of Health, HIV/AIDS, Hepatitis, STD, and TB Administration, Washington, DC, USA

    Rupali Doshi

  8. Department of Psychology, DC Veterans Affairs Medical Center, Washington, DC, USA

    Leah Squires

Authors
  1. Hana Akselrod
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  2. Morgan Byrne
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  3. Jeannette Lundberg
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  4. Jonathan Mamber Czeresnia
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  5. Jose Lucar
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  6. Alessandra Secco
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  7. Matt Levy
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  8. Anne Monroe
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  9. Amanda Castel
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  10. Michael Horberg
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  11. Rupali Doshi
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  12. Heather Rivasplata
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  13. Leah Squires
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  14. David Parenti
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  15. Debra Benator
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Consortia

the DC Cohort Executive Committee

  • Lawrence D’Angelo
  • , Natella Rakhmanina
  • , Michael Kharfen
  • , Michael Serlin
  • , Princy Kumar
  • , Vinay Bhandaru
  • , Tsedenia Bezabeh
  • , Nisha Grover-Fairchild
  • , Lisa Mele
  • , Susan Reamer
  • , Alla Sapozhnikova
  • , Greg Strylewicz
  • , Marinella Temprosa
  • , Naji Younes
  • , Kevin Xiao
  • , Morgan Byrne
  • , Amanda Castel
  • , Alan Greenberg
  • , Maria Jaurretche
  • , Paige Kulie
  • , Anne Monroe
  • , James Peterson
  • , Bianca Stewart
  • , Brittany Wilbourn
  • , Yan Ma
  • , Hana Akselrod
  • , Jhansi L. Gajjala
  • , Sohail Rana
  • , Michael Horberg
  • , Ricardo Fernandez
  • , Annick Hebou
  • , Carl Dieffenbach
  • , Henry Masur
  • , Jose Bordon
  • , Gebeyehu Teferi
  • , Debra Benator
  • , Maria Elena Ruiz
  •  & Stephen Abbott

Contributions

Not applicable.

Corresponding author

Correspondence to Morgan Byrne.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

IRB APPROVAL: #071029 George Washington University IRB.

Consent to Participate

Participants in the DC Cohort consent to have their demographic and clinical data electronically and manually abstracted from medical records at the participating sites, entered into a centralized database and linked to DC Department of Health HIV/AIDS, Hepatitis, STD, TB Administration (DC HAHSTA) surveillance databases.

Consent for Publication

Not applicable.

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Akselrod, H., Byrne, M., Lundberg, J. et al. Improvements in Virologic Control Among PWH Over Time: Narrowing the Gap Between Those With and Without STIs. AIDS Behav 27, 673–677 (2023). https://doi.org/10.1007/s10461-022-03802-6

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