High HIV-1 incidence, correlates of HIV-1 acquisition, and high viral loads following seroconversion among men who have sex with men in Coastal Kenya.

Sanders, E; Okuku, H; Smith, A; Mwangome, M; Wahome, E; Fegan, G; Peshu, N; van der Elst, E; Price, M; McClelland, R; Graham, S

Women's Health Collection

Journal article

High HIV-1 incidence, correlates of HIV-1 acquisition, and high viral loads following seroconversion among men who have sex with men in Coastal Kenya.

Abstract:: Background

HIV-1 incidence estimates and correlates of HIV-1 acquisition in African MSM are largely unknown.

Methods

Since 2005, HIV-1-uninfected men who reported sex with men and women (MSMW) or sex with men exclusively (MSME) were followed at scheduled visits for collection of behavioural and clinical examination data and plasma for HIV-1 testing. Urethral or rectal secretions were collected from symptomatic men to screen for gonorrhoea. Poisson regression methods were used to estimate adjusted incidence rate ratios to explore associations between risk factors and incident HIV-1 infection. Plasma viral loads (PVLs) were assessed over 2 years following seroconversion.

Results

Overall HIV-1 incidence in 449 men was 8.6 [95% confidence interval (CI) 6.7–11.0] per 100 person-years. Incidence was 5.8 (95% CI 4.2–7.9) per 100 personyears among MSMW, and 35.2 (95% CI 23.8–52.1) per 100 person-years among SME. Unprotected sex, receptive anal intercourse, exclusive sex with men, group sex, and gonorrhoea in the past 6 months were strongly associated with HIV-1 acquisition, adjusted for confounders. PVL in seroconverters was more than 4 log10 copies/ml at 230 (73.4%) of 313 visits in MSMW and 153 (75.0%) of 204 visits in MSME.

Conclusions

HIV-1 incidence is very high among MSM in coastal Kenya, and many seroconverters maintain high PVL for up to 2 years after infection. Effective HIV-1 prevention interventions, including treatment as prevention, are urgently needed in this population.

Publication status:: Published

Peer review status:: Peer reviewed

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APA Style

Sanders, E., Okuku, H., Smith, A., Mwangome, M., Wahome, E., Fegan, G., Peshu, N., van der Elst, E., Price, M., McClelland, R., & Graham, S. (2013). High HIV-1 incidence, correlates of HIV-1 acquisition, and high viral loads following seroconversion among men who have sex with men in Coastal Kenya. AIDS, 27(3), 437–446.

MLA Style

Sanders, E, et al. “High HIV-1 Incidence, Correlates of HIV-1 Acquisition, and High Viral Loads Following Seroconversion among Men Who Have Sex with Men in Coastal Kenya.” AIDS, vol. 27, no. 3, 2013, pp. 437–46.

Chicago Style

Sanders, E, H Okuku, A Smith, et al. 2013. “High HIV-1 Incidence, Correlates of HIV-1 Acquisition, and High Viral Loads Following Seroconversion among Men Who Have Sex with Men in Coastal Kenya.” AIDS 27 (3): 437–46.
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