Wimonsate Wipas, Sriporn Anuwat, Pattanasin Sarika, Varangrat Anchalee, Promda Nutthawoot, Sukwicha Wichuda, Holtz Timothy H, Ungsedhapand Chaiwat, Chitwarakorn Anupong, Hickey Andrew C, Dunne Eileen F
Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Thailand Ministry of Public Health - U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand.
Int J STD AIDS. 2021 Jul;32(8):687-693. doi: 10.1177/0956462420985342. Epub 2021 Feb 25.
Data on HIV antiretroviral therapy (ART) initiation among key-affected populations will support reaching the UNAIDS goal to end AIDS by 2030.
We assessed ART initiation among HIV-positive participants of the Bangkok Men Who Have Sex with Men (MSM) Cohort Study, which enrolled sexually experienced MSM aged ≥ 18 years and included visits every four months for a period of 3-5 years, from 2006-2016. At each visit, participants had HIV testing and completed computer-assisted self-interviewing on demographics and HIV risk behaviors. If they acquired HIV infection during the study, they received active referral for HIV treatment, continued in the cohort, and were asked about ART initiation. We used logistic regression to determine factors associated with ART initiation.
Overall, 632 (36.2%) participants were diagnosed with HIV infection; 463 (73%) had a follow-up visit reporting information about ART, of those 346 (74%) reported ART initiation, with 323 (93%) on ART initiating ART through their registered national health benefit program. Only 70 (11%) were eligible for ART at time of diagnosis, and 52 (74%) initiated ART, on average, within six months of diagnosis. Multivariable analysis evaluating factors associated with ART initiation demonstrated that low CD4 cell count at time of diagnosis was the only independent factor associated with ART initiation.
Most HIV-positive participants in the cohort reported ART initiation through the national health benefit program but limited data suggests there could be improvements in length of time to initiation of ART. Efforts should focus on ART start in MSM and transgender women soon after HIV diagnosis.
关键受影响人群中艾滋病病毒抗逆转录病毒治疗（ART）起始的数据将有助于实现联合国艾滋病规划署到2030年终结艾滋病的目标。
我们评估了曼谷男男性行为者（MSM）队列研究中HIV阳性参与者的ART起始情况。该研究纳入了年龄≥18岁且有性经验的MSM，在2006年至2016年期间每四个月进行一次为期3至5年的随访。每次随访时，参与者进行HIV检测，并通过计算机辅助自我访谈完成人口统计学和HIV风险行为调查。如果他们在研究期间感染了HIV，会被积极转介接受HIV治疗，继续留在队列中，并被询问ART起始情况。我们使用逻辑回归来确定与ART起始相关的因素。
总体而言，632名（36.2%）参与者被诊断为HIV感染；463名（73%）有随访记录报告了ART相关信息，其中346名（74%）报告开始了ART，323名（93%）通过其注册的国家健康福利计划开始接受ART治疗。诊断时只有70名（11%）符合ART治疗条件，其中52名（74%）平均在诊断后六个月内开始接受ART治疗。评估与ART起始相关因素的多变量分析表明，诊断时CD4细胞计数低是与ART起始相关的唯一独立因素。
队列中大多数HIV阳性参与者报告通过国家健康福利计划开始接受ART治疗，但有限的数据表明ART起始时间可能还有改进空间。应努力促使MSM和变性女性在HIV诊断后尽快开始接受ART治疗。
