Cyrus Elena, Okeke Deidre A, Lavia Omari, Trepka Mary Jo, Maragh-Bass Allysha, Duthely Lunthita, Sciauodone Michael, Edwards Jeffrey
Department of Population Health Sciences, College of Medicine, University of Central Florida, Orlando, FL, USA.
Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA.
HIV Res Clin Pract. 2025 Dec;26(1):2443886. doi: 10.1080/25787489.2024.2443886. Epub 2025 Jan 7.
In Trinidad and Tobago, high HIV prevalence among key populations necessitates studying factors that impact durable viral suppression (DVS), crucial for effective HIV management and reducing transmission among at-risk networks. This study investigates these factors using clinical data from a major HIV care clinic in the Caribbean.
A retrospective analysis of 533 adult people with HIV (people) at MRFTT from 2017 to 2021 assessed the proportion achieving DVS, defined as a sustained viral load <200 copies/ml over one year. Initial univariate analysis characterized individuals with DVS, followed by bivariate analysis to explore socio-demographic differences. Significant variables from bivariate analysis were examined in a regression model to identify DVS covariates.
The average age of the sample was 45 years (SD = 10.88), with 52.0% male and 72.1% of African descent. 31.5% achieved durable viral suppression (DVS). Those with DVS were predominantly women (54.1%), older (mean age 45, SD = 11.32), with more frequent clinic visits over five years (mean = 101, SD = 33.26). Regression analysis showed that women (OR = 1.43, 95% CI 0.99-2.07), individuals on long-term antiretroviral therapy (ART) (>5 years) (OR = 1.66, 95% CI 1.03-2.66), and those with extended clinic enrolment (>5 years) (OR = 1.82, 95% CI 1.08-3.06) had higher odds of achieving DVS.
Only a third of the study sample achieved DVS, with men less likely to reach this goal. Lesser engagement in care correlated with lower DVS rates. Further research into social and structural barriers to clinic attendance, particularly among younger men, is recommended.
在特立尼达和多巴哥，重点人群中艾滋病毒感染率较高，因此有必要研究影响持久病毒抑制（DVS）的因素，这对于有效的艾滋病毒管理和减少高危人群网络中的传播至关重要。本研究利用加勒比地区一家主要艾滋病毒护理诊所的临床数据对这些因素进行调查。
对2017年至2021年在MRFTT的533名成年艾滋病毒感染者进行回顾性分析，评估实现DVS的比例，DVS定义为一年内病毒载量持续低于200拷贝/毫升。最初的单变量分析对实现DVS的个体进行特征描述，随后进行双变量分析以探索社会人口统计学差异。在回归模型中检查双变量分析中的显著变量，以确定DVS协变量。
样本的平均年龄为45岁（标准差=10.88），男性占52.0%，非洲裔占72.1%。31.5%的人实现了持久病毒抑制（DVS）。实现DVS的人主要是女性（54.1%），年龄较大（平均年龄45岁，标准差=11.32），在五年内就诊次数更多（平均=101次，标准差=33.26）。回归分析表明，女性（比值比=1.43，95%置信区间0.99-2.07）、接受长期抗逆转录病毒治疗（ART）（>5年）的个体（比值比=1.66，95%置信区间1.03-2.66）以及诊所登记时间延长（>5年）的个体（比值比=1.82，95%置信区间1.08-3.06）实现DVS的几率更高。
研究样本中只有三分之一的人实现了DVS，男性达到这一目标的可能性较小。较少参与护理与较低的DVS率相关。建议进一步研究影响就诊的社会和结构障碍，特别是在年轻男性中。
