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Changes in HIV care continuum indicators among community-based samples of HIV-infected people who inject drugs and men who have sex with men across 21 cities in India.

Authors
  • Prata Menezes, Neia S1
  • Solomon, Sunil S2, 3
  • McFall, Allison M1
  • Srikrishnan, Aylur K3
  • Vasudevan, Canjeevaram K3
  • Kumar, M Suresh3
  • Celentano, David D1, 2
  • Mehta, Shruti H1
  • Lucas, Gregory M2
  • 1 Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
  • 2 Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
  • 3 Y.R. Gaitonde Centre for AIDS Research and Education, Chennai, India. , (India)
Type
Published Article
Journal
AIDS care
Publication Date
Oct 01, 2023
Volume
35
Issue
10
Pages
1570–1579
Identifiers
DOI: 10.1080/09540121.2022.2119470
PMID: 36120904
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Monitoring key populations' progress towards UNAIDS 90-90-90 targets is essential to achieving HIV/AIDS epidemic control. Using serial cross-sectional data, we evaluated changes in HIV care continuum among people who inject drugs(PWID) and men who have sex with men(MSM) in India. Cross-sectional baseline (2012/2013) and follow-up (2016/2017) samples were recruited using respondent-driven sampling across 21 cities. All participants were tested for HIV and RNA measured in HIV-positive participants. Linear regression was used to model temporal site-level changes in continuum indicators in MSM versus PWID. At baseline, we recruited 2,544 HIV-infected PWID and 1,086 HIV-infected MSM. At follow-up, we recruited 2,517 HIV-infected PWID and 1,763 HIV-infected MSM. At baseline, there were no significant differences in continuum indicators between MSM and PWID. At follow-up, compared to PWID, the proportion of MSM reaching each care continuum indicator-awareness of status, receipt of care, ART use, viral suppression-increased by 15-33 percentage points: 78% of MSM versus 49% of PWID were aware of their status (p < 0.01); 56% of MSM versus 32% of PWID were virologically suppressed (p = 0.05). MSM showed marked improvements across the care continuum, whereas PWID lagged and may require additional intervention. Differential improvement in HIV engagement may necessitate population-specific interventions and routine surveillance to facilitate HIV elimination.

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