Abstract
Stimulant use is associated with higher HIV viral load (VL) and sexual HIV transmission risk among men who have sex with men (MSM) living with HIV. There is little research on willingness of drug users living with HIV to fully participate in studies, especially those involving self-collection of biomarker data. This study presents findings from an at-home dried blood spot collection study measuring laboratory-quantified VL among U.S. HIV-positive MSM who reported high-risk sexual behavior and/or suboptimal antiretroviral therapy (ART) adherence to assess the association between drug-use behavior and (1) ability to complete a study protocol and (2) VL outcomes. Among recruited participants (n = 766), 35% reported stimulant drug use (amphetamines, cocaine, crack, crystal meth, ecstasy, or a combination of stimulant drugs), 39% reported using other drugs (heroin, marijuana, prescription opioids, and others), and 27% reported no drug use in the past 3 months. In all, 61% of enrolled participants completed the study protocol. Stimulant drug users were less likely (ARR 0.84; 95% CI 0.72–0.98) to complete the protocol than other drug users. Furthermore, other drug users were significantly less likely than non-drug users (ARR 0.52; 95% CI 0.28–0.97) to have an HIV VL result ≥ 1500 copies/mL. This study provides important estimates regarding the likelihood of participation in biomedical research activities among HIV-positive MSM with varying drug-use behaviors, showing that it is feasible to conduct such biomedical studies with drug-using MSM who report high-risk sexual behavior and struggle with their ART adherence.
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Acknowledgements
This research was supported by a grant from the National Institute of Mental Health (R01-MH100973-03S1) to Sabina Hirshfield, principal investigator. Richard Teran was supported by a pre-doctoral fellowship in the Global HIV Implementation Science Research training program sponsored by the Mailman School of Public Health, Columbia University, with funding from the National Institute of Allergy and Infectious Diseases (T32 AI114398, PI: Howard). Suzan Walters was supported with funding from the National Institute on Drug Abuse (T32 DA007233-31, PI: Falkin) and Interdisciplinary Research Training Institute on Hispanic Drug Abuse (R25 DA026401; PI Avelardo Valdez). The authors would like to thank Steven Houang, Irene Yoon, and Dayana Bermudez for their contributions to study enrollment, data collection, and retention activities.
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Teran, R.A., Carrico, A.W., Horvath, K.J. et al. Stimulant Use and Study Protocol Completion: Assessing the Ability of Men Who Have Sex with Men to Collect Dried Blood Spots for Laboratory Measurement of HIV Viral Load. Arch Sex Behav 49, 195–209 (2020). https://doi.org/10.1007/s10508-019-01515-x
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DOI: https://doi.org/10.1007/s10508-019-01515-x