ArticleBMC infectious diseases2018
Reduction in HIV community viral loads following the implementation of a "Treatment as Prevention" strategy over 2 years at a population-level among men who have sex with men in Hangzhou, China.
Article in BMC infectious diseases, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- The precision of behavioral intervention strategies remain one of the key strategies for HIV prevention among MSM in the era of pharmaceutical interventions: an ecological study.BMC infectious diseases · 2025Article
- Challenges in the delivery of health services for people living with HIV in Dar es Salaam, Tanzania: a qualitative descriptive study among healthcare providers.Frontiers in health services · 2024Article
- Current syphilis infection in virally suppressed people living with HIV: a cross-sectional study in eastern China.Frontiers in public health · 2024Article
- Sexual behaviour changes and HIV infection among men who have sex with men: evidence from an open cohort in China.BMJ open · 2022Article
- HIV Testing and Risks of Sexual Behavior among HIV-Negative Men Who Have Sex with Men in Ningbo, China.International journal of environmental research and public health · 2020Article
- "Getting to Zero" Among Men Who Have Sex with Men in China: a Review of the HIV Care Continuum.Current HIV/AIDS reports · 2019Review
- HIV incidence and cohort retention among men who have sex with men in Hangzhou, China: A prospective cohort study.Medicine · 2019Observational
- Determinants of survival of people living with HIV/AIDS on antiretroviral therapy in Brazil 2006-2015.BMC infectious diseases · 2019Article
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15 authors.
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Abstract
backgroundPrevious studies have shown that the increased coverage of antiretroviral therapy (ART) could reduce the community viral load (CVL) and reduce the occurrence of new HIV infections. However, the impact on the reduction of HIV transmission among men who have sex with men (MSM) is much less certain. The frequency of HIV infections in MSM have been rapidly increasing in recent years in Hangzhou, China. The "Treatment as Prevention" strategy was implemented at a population-level for HIV-infected MSM from January 2014 to June 2016 in Hangzhou; it aimed to increase the ART coverage, reduce the CVL, and reduce HIV transmission.
methodsWe investigated a subset of MSM diagnosed with HIV pre- and post-implementation of the strategy, using random sampling methods. Viral load (VL) testing was performed for all enrolled individuals; the lower limits of detection were 20 and 50 copies/mL. The data on infections were collected from the national epidemiology database of Hangzhou. Logistic regression analyses were conducted to identify factors associated with the differences in social demographic characteristics and available VL data.
resultsThe ART coverage increased from 60.7% (839/1383) during the pre-implementation period to 92.3% (2183/2365) during the post-implementation period in Hangzhou. A total of 940 HIV-infected MSM were selected for inclusion in this study: 490 (52.1%) and 450 (47.9%) MSM in the pre- and post-implementation periods, respectively. In total, 89.5% (841/940) of patients had data available on VL rates. The mean CVL was 579 copies/mL pre-implementation and this decreased to 33 copies/mL post-implementation (Kruskal-Wallis < 0.001). The mean CVL decreased for all variables investigated post-implementation of the treatment strategy (P < 0.05). The undetectable VL (≤400 copies/mL) rate pre-implementation period was 50.0% which increased to 84.7% post-implementation (P < 0.001). The mean CVL at the county level significantly decreased in each county post-implementation (Kruskal-Wallis < 0.05).
conclusionOur study confirmed a population-level association between increased ART coverage and decreased mean CVL; overall 84.7% of HIV infected MSM had an undetectable VL and were no longer infectious.
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