WP 73 Prevalence of High-Risk Behaviors and Anti-Retroviral Therapy Non-Adherence Among HIV-Positive Men Who Have Sex with Men Who Are Linked to Care

Wednesday, September 21, 2016
Galleria Exhibit Hall
Jose A. Bazan, DO1, Courtney Maierhofer, MPH1, Abigail Norris Turner, PhD2, Brandon Snyder, (Research Assistant)3, Anjali Mannava, (Research Assistant)3, Hillary Landon, (Research Assistant)2, Carlos Malvestutto, MD1 and Susan Koletar, MD2, 1Division of Infectious Diseases, The Ohio State University College of Medicine, Columbus, OH, 2The Ohio State University College of Medicine, Columbus, OH, 3The Ohio State University, Columbus, OH

Background: Antiretroviral therapy (ART) non-adherence is associated with increased risk of HIV-disease progression, transmission, and development of ART resistance.  High-risk sexual behaviors and recreational drug use may be associated with ART non-adherence. Among a cohort of HIV-positive men who have sex with men (MSM) who are linked to care, we examined the prevalence of high-risk sexual behaviors and recreational drug use and their associations with ART non-adherence.

Methods: We analyzed data from an ongoing cross-sectional study of HIV-positive MSM attending an HIV clinic at an academic medical center between March 2015 and February 2016. Through a self-administered survey, participants reported on their current ART use, ART adherence (number of doses missed in the previous 7 days), recent sexual behaviors (last 3 months), and recent recreational drug use (last 3 months).

Results:  Among the 158 HIV-positive MSM enrolled, 87 (55%) reported recent unprotected anal intercourse (UAI), 32 (20%) repoted recent sex with an anonymous partner, and 72 (46%) reported recent use of recreational drug(s) (marijuana, MDMA, methamphetamines, alkyl nitrites, nitrous oxide, or cocaine). Overall, 127 (80%) participants reported currently being on ART. Among those taking ART, 104 (82%) reported never missing a dose in the previous 7 days. There was a trend toward higher ART non-adherence among participants who reported recent UAI (prevalence ratio (PR): 1.77, 95% confidence interval (CI): 0.74–4.20, p=0.19), recent sex with an anonymous partner (PR: 1.24, 95% CI: 0.50–3.02, p=0.64), or recent recreational drug use (PR: 1.71, 95% CI: 0.75–3.89, p=0.19).

Conclusions: A high-proportion of HIV-positive MSM who are linked to care reported recently engaging in high-risk behaviors such as UAI, anonymous sex, or recreational drug use. These high-risk behaviors trended towards increased ART non-adherence and could result in ongoing risk for HIV-disease progression, transmission and development of ART resistance.