Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
South African Field Epidemiology Training ProgrammeProgramme, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa.
BMC Infect Dis. 2024 Jan 30;24(1):148. doi: 10.1186/s12879-023-08756-1.
Sexually transmitted infections (STIs), particularly in the absence of viral suppression, increase the risk of HIV transmission to uninfected partners. We determined factors associated with having an unsuppressed VL among HIV-positive individuals attending STI services in South Africa (SA).
We analysed secondary cross-sectional data collected on HIV-positive individuals presenting with STI symptoms s at sentinel sites in Western Cape and Gauteng provinces between January-December 2019 in SA. We compared demographic characteristics of individuals on ART or not on ART, and a Poisson regression model to identify factors associated with having an unsuppressed VL (≥ 50 copies/ml) was used.
Among 93 HIV-positive individuals attending STI services with VL data, the median age was 32 years (IQR 27-37). Thirty-two (34.41%) individuals were on ART compared to 61 (65.59%) not on ART. Most of those on ART (56.25%) had an unsuppressed VL, while 86.89% of those not on ART had an unsuppressed VL. ART use was associated with a 33% lower prevalence of having unsuppressed VL. In a model adjusting for age, age at first sex and oral sex, none of the factors were significant. Among those on ART, individuals < 25 years were more likely to have an unsuppressed VL (aPRR = 1.94: 95% CI = 1.27-2.97) compared to those ≥ 25 years.
ART use among HIV-positive individuals was low and VL suppression among those on ART was sub-optimal. Intensified ART initiation and adherence support to HIV-positive individuals seeking STI services could improve VL suppression.
性传播感染（STI），特别是在没有病毒抑制的情况下，会增加 HIV 感染者将病毒传播给未感染伴侣的风险。我们确定了在南非（SA）接受性传播感染服务的 HIV 阳性个体中，与 VL 未受抑制相关的因素。
我们分析了 2019 年 1 月至 12 月期间在西开普省和豪登省哨点就诊的 HIV 阳性个体的二次横断面数据。我们比较了接受和未接受抗逆转录病毒治疗（ART）的个体的人口统计学特征，并使用泊松回归模型来确定与 VL 未受抑制（≥50 拷贝/ml）相关的因素。
在 93 名接受性传播感染服务且有 VL 数据的 HIV 阳性个体中，中位年龄为 32 岁（IQR 27-37）。32 名（34.41%）个体正在接受 ART，而 61 名（65.59%）未接受 ART。大多数接受 ART 的个体（56.25%）VL 未受抑制，而未接受 ART 的个体中 86.89%的 VL 未受抑制。ART 使用与 VL 未受抑制的流行率降低 33%相关。在调整年龄、首次性行为年龄和口交的模型中，没有一个因素具有统计学意义。在接受 ART 的个体中，年龄<25 岁的个体更有可能 VL 未受抑制（aPRR=1.94：95%CI=1.27-2.97），而年龄≥25 岁的个体则不然。
HIV 阳性个体中 ART 的使用率较低，而接受 ART 的个体中病毒抑制率不理想。加强对接受性传播感染服务的 HIV 阳性个体的 ART 启动和依从性支持，可改善病毒抑制率。
