Browsing by Author "Williamson BD"

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    Frequency and predictors of estimated HIV transmissions and bacterial STI acquisition among HIV-positive patients in HIV care across three continents.
    (2016) Safren SA; Hughes JP; Mimiaga MJ; Moore AT; Friedman RK; Srithanaviboonchai K; Limbada M; Williamson BD; Elharrar V; Cummings V; Magidson JF; Gaydos CA; Celentano DD; Mayer KH; Institute for Community Health Promotion, Brown University, Providence RI, USA.; Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.; Instituto Nacional de Infectologia Evandro Chagas, FIOCRUZ, Rio de Janeiro, Brazil.; Department of Medicine, Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, MD, USA.; Department of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA.; FHI360, Durham, NC, USA.; Department of Psychology, University of Miami, Coral Gables, FL, USA; ssafren@miami.edu.; Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand.; National Institute of Allergy and Infectious Disease (NIAID), Bethesda, MD, USA.; School of Public Health, University of Washington, Seattle, WA, USA.; Behavioral Medicine Service, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.; Department of Pathology, Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, MD, USA.; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.; Fred Hutchinson Cancer Research Center, Seattle, WA, USA.; The Fenway Institute, Fenway Health, Boston, MA, USA.; Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
    INTRODUCTION: Successful global treatment as prevention (TasP) requires identifying HIV-positive individuals at high risk for transmitting HIV, and having impact via potential infections averted. This study estimated the frequency and predictors of numbers of HIV transmissions and bacterial sexually transmitted infection (STI) acquisition among sexually active HIV-positive individuals in care from three representative global settings. METHODS: HIV-positive individuals ( RESULTS: An estimated 3.81 (standard error, (SE)=0.63) HIV transmissions occurred for every 100 participants over the 15 months, which decreased over time. The highest rate was 19.50 (SE=1.68) for every 100 MSM in Brazil. In a multivariable model, country×risk group interactions emerged: in Brazil, MSM had 2.85 (95% CI=1.45, 4.25, CONCLUSIONS: These data help to estimate the potential number of HIV infections transmitted and bacterial STIs acquired over time in patients established in care, a group typically considered at lower transmission risk, and found substantial numbers of estimated HIV transmissions. These findings provide an approach for evaluating the impact (in phase 2 studies) and potentially cost-effectiveness of global TasP efforts.