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Utility of self-report antiretroviral adherence for predicting HIV viral load among persons who inject drugs in Hai Phong Vietnam: assessing differences by methamphetamine use. | LitMetric

AI Article Synopsis

  • - The study evaluated the effectiveness of self-reported adherence to antiretroviral therapy (ART) as a substitute for HIV viral load testing among people who inject drugs (PWID) in Hai Phong, Vietnam.
  • - Researchers analyzed data from 792 PWID over two years, focusing on the accuracy of self-reporting ART adherence and its correlation with actual HIV viral load levels, finding a positive predictive value (PPV) above 90%.
  • - The findings indicate that in settings lacking access to viral load testing, self-reported ART adherence could help prioritize which PWID may need viral load testing, with high adherence generally suggesting effective HIV suppression regardless of recent methamphetamine use.

Article Abstract

In resource-limited settings, alternatives to HIV viral load testing may be necessary to monitor the health of people living with HIV. We assessed the utility of self-report antiretroviral therapy (ART) to screen for HIV viral load among persons who inject drugs in Hai Phong Vietnam, and consider differences by recent methamphetamine use. From 2016 to 2018 we recruited PWID through cross sectional surveys and collected self-report ART adherence and HIV viral load to estimate sensitivity, specificity, positive and negative predictive values (PPV, NPV) and likelihood ratios (LR+, LR-) for self-reported ART adherence as a screening test for HIV viral load. We used three HIV viral load thresholds: < 1000, 500 and 250 copies/mL; laboratory-confirmed HIV viral load was the gold standard. Among 792 PWID recruited, PPV remained above 90% regardless of recent methamphetamine use with slightly higher PPV among those not reporting recent methamphetamine use. The results remained consistent across all three HIV viral load thresholds. Our findings suggest that when HIV viral load testing is not possible, self-reported ART adherence may inform decisions about how to prioritize HIV viral load testing among PWID. The high PPV values suggest self-reported high ART adherence indicates likely HIV viral suppression, irrespective of methamphetamine use.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10932855PMC
http://dx.doi.org/10.1080/09540121.2023.2275041DOI Listing

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