501. Community Viral Load and New HIV Diagnoses in Rhode Island, 2003-2010
Session: Poster Abstract Session: HIV Testing and Prevention
Friday, October 21, 2011
Room: Poster Hall B1
Background: A decrease in community viral load (CVL) has been associated with a decrease in new HIV diagnoses supporting the Seek, Test, and Treat strategy to control the HIV epidemic. We estimated the annual CVL and the proportion of patients receiving antiretroviral therapy (ART) from 2003-2010 at the largest HIV clinic in RI (1,383 active patients in 2010) and compared these findings to the annual number of new HIV diagnoses reported to the RI Department of Health (RIDOH).

Methods: Our clinic’s electronic database was used to calculate the annual CVL and the proportion of patients receiving ART. The CVL was calculated as the mean of the last available HIV plasma viral loads (PVLs) in a given year. The annual number of new HIV diagnoses was provided by the RIDOH.  We used log-linear function (with a Poisson distribution assumption) to assess the relationship between the CVL and new HIV diagnoses. 

Results: Our results show a decline in the CVL from 16,589 in 2003 to 11,992 in 2010 (p=0.048). There was an increase in the proportion of patients on ART from 67% to 86% (p=0.0004). Correspondingly, there was an increase in the proportion of patients with an undetectable viral load (<75 copies/mL) from 48% to 69%. New HIV diagnoses declined from 134 to 106 (p=0.07). Although this decline did not reach statistical significance, there was a significant positive relationship between log-transformed CVL and the new diagnosis rate (p=0.006).  According to primary risk factor, the proportion of new HIV diagnoses reported as men who have sex with men (MSM) increased from 34% to 51% (p=0.0005); those with intravenous drug use or heterosexual risk decreased (9.7% to 5.7% and 18.7% to 12.3%, respectively).

Conclusion: There was a decline in the CVL among our patients, an increase in the proportion receiving ART, and there was an associated decline in the annual number of new HIV diagnoses in RI. In contrast to other major risk groups, MSM-associated new HIV diagnoses increased in our community. These findings support using CVL as a measure of the overall HIV status of a population. The rise in new diagnoses among MSM may reflect ongoing high-risk sexual behaviors and supports the need for additional research and development of targeted prevention programs.

Subject Category: H. HIV/AIDS and other retroviruses

Peter Ackerman, MD1, Fizza Gillani, PhD1,2, Sutopa Chowdhury, MBBS, MPH3, Aadia Rana, MD1,2 and Curt Beckwith, MD1,2, (1)Division of Infectious Diseases, The Miriam Hospital, Providence, RI, (2)The Warren Alpert Medical School of Brown University, Providence , RI, (3)Rhode Island Department of Health, Providence , RI


P. Ackerman, None

F. Gillani, None

S. Chowdhury, None

A. Rana, None

C. Beckwith, None

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