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BACKGROUND: Population-based HIV viral load could be used in monitoring HIV transmission potential and evaluating quality of HIV care and treatment. Differences of HIV viral load in different community groups may suggest disparity in access to care and adherence among groups. The objective of this study is to evaluate the trends of HIV viral load among different vulnerable groups of HIV positive persons in Houston/Harris County, Texas from 2010 to 2014. The vulnerable groups included men who have sex with men (MSM), injection drug users (IDU), both MSM and IDU (IDU&MSM), and cases in correctional settings.
METHODS: All HIV positive cases over 13 years of age reported to the enhanced HIV/AIDS Reporting System (eHARS) in Houston/Harris County with at least one viral load test result from 2010 to 2014 are included in this study. The population is grouped by different risk behaviors. HIV viral load in risk and non-risk groups was defined as the geometric mean of viral loads of all qualified HIV individuals calculated using CDC Guidance on Community Viral Load. Trend analysis and pairwise comparison of trends was performed in risk and non-risk groups by using Joinpoint Regression Program (Version 4.0.1). Average annual percentage change (AAPC) was also calculated.
RESULTS: Overall, the geometric mean of viral load in all reported cases had a declining trend from 2010 to 2014 for all risk groups. A significantly lower viral load was observed in MSM group (AAPC=-25.2) than in the non-MSM group (AAPC=-23.6) (p<0.05). A preliminary analysis of the other risk groups which include IDU group, IDU&MSM and incarcerated groups showed a significantly higher viral load in comparison to MSM group (p<0.05). Final analysis results will be shared at the conference presentation.
CONCLUSIONS: This analysis showed an overall declining viral load trend in all vulnerable groups, which may suggest good access to care and adherence in these groups. HIV viral loads were unexpectedly lower in MSM group compared to non-MSM group, which suggests HIV positive MSM are more likely to seek and comply with HIV care in Houston/Harris County compared to non-MSM group. Further studies are needed to explain the lower HIV viral loads in MSM group in comparison to higher viral loads in other groups.