Medical Research Foundation of Trinidad and Tobago , Port of Spain , Trinidad and Tobago.
Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Florida International University , Miami , FL , USA.
Glob Public Health. 2019 Nov;14(11):1569-1577. doi: 10.1080/17441692.2019.1633379. Epub 2019 Jun 30.
In Trinidad and Tobago, despite persons living with HIV (PLHIV) having access to subsidised treatment and care, only 47% PLHIV attain viral suppression. The study assessed the role of individual-level factors on viral suppression among PLHIV in Trinidad and Tobago. Data from 9,629 PLHIV who attended an HIV clinic between 2016 and 2018 were analysed. Cases were aged ≥18 who met the CDC HIV case definition. Viral suppression defined as a viral load of <200 copies/ml at last assessment. The chi-square test of association determined statistically significant relationships between individual factors and viral suppression. Logistic regression was used to estimate odds ratios (OR) for viral suppression. PLHIV who were males (OR = 0.76, 95% CI 0.67-0.87), men who have sex with men (MSM) (OR = 0.82, 95% CI 0.67-0.99), single/unmarried (OR = 0.69, 95% CI 0.55-0.87), aged 18-24 years (OR = 0.66, 95% CI 0.49-0.89), aged 25-49 years (OR = 0.81, 95% CI 0.70-0.94) were less likely to achieve viral suppression. These study findings demonstrate that retention/adherence programmes must urgently identify and target vulnerable PLHIV populations in Trinidad and Tobago to improve viral suppression. Further research examining community and societal factors, such as stigma and discrimination, is warranted.
在特立尼达和多巴哥，尽管艾滋病毒感染者（PLHIV）能够获得补贴治疗和护理，但只有 47%的 PLHIV 实现了病毒抑制。本研究评估了个体因素在特立尼达和多巴哥 PLHIV 中实现病毒抑制的作用。分析了 2016 年至 2018 年间在艾滋病毒诊所就诊的 9629 名 PLHIV 的数据。病例为符合疾病预防控制中心艾滋病毒病例定义的年龄≥18 岁的患者。病毒抑制定义为上次评估时病毒载量<200 拷贝/ml。卡方检验用于确定个体因素与病毒抑制之间的统计学显著关系。逻辑回归用于估计病毒抑制的优势比（OR）。男性（OR=0.76，95%CI 0.67-0.87）、男男性行为者（MSM）（OR=0.82，95%CI 0.67-0.99）、单身/未婚（OR=0.69，95%CI 0.55-0.87）、年龄 18-24 岁（OR=0.66，95%CI 0.49-0.89）、年龄 25-49 岁（OR=0.81，95%CI 0.70-0.94）的 PLHIV 不太可能实现病毒抑制。这些研究结果表明，保留/依从性计划必须紧急确定和针对特立尼达和多巴哥的脆弱 PLHIV 人群，以提高病毒抑制率。需要进一步研究社区和社会因素，如耻辱和歧视。
