Syndemics Predict Bio-Behavioral HIV Sexual Transmission Risk Behavior Longitudinally in US HIV Clinics Satyanand Satyanarayana, Steven A. Safren, Brooke.

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Presentation transcript:

Syndemics Predict Bio-Behavioral HIV Sexual Transmission Risk Behavior Longitudinally in US HIV Clinics Satyanand Satyanarayana, Steven A. Safren, Brooke G. Rogers, Sierra Bainter, Katerina A. Christopoulos, Rob J. Fredericksen, William C. Mathews, Richard D. Moore, Michael J. Mugavero, Sonia Napravnik, Matthew J. Mimiaga, Kenneth H. Mayer, and Heidi M. Crane Syndemics Co-occurring psychosocial conditions that exacerbate risk for HIV transmission Usually studied in context of populations at risk of contracting HIV Less known about HIV transmission risk created by syndemics occurring in HIV-infected patients receiving clinical care Syndemics could help identify patients to receive psychosocial intervention to curb new HIV transmissions CNICS Network of CFAR sites providing patients with clinical care Health information collected at patient visits with patient-reported outcomes (PROs) collected at visits at least 4-6 months apart 15 727 pts from July 2000 to April 2017 68 984 total visits (mean 4.4 visits/pt) Acknowledgments CNICS is an NIH-funded program (R24 AI067039) made possible by the National Institute of Allergy and Infectious Diseases (NIAID) and the National Heart, Lung, and Blood Institute (NHLBI). The CFAR sites involved in CNICS include Univ of Alabama at Birmingham (P30 AI027767), Univ of Washington (P30 AI027757), Univ of California San Diego (P30 AI036214), Univ of California San Francisco (P30 AI027763), Case Western Reserve Univ (P30 AI036219), Johns Hopkins Univ (P30 AI094189, U01 DA036935), Fenway Health/Harvard (P30 AI060354), and Univ of North Carolina Chapel Hill (P30 AI50410). Author time was supported by 9K24 DA040489 (Safren) and by the University of Miami Dean’s Fellowship. Conflicts of Interest No conflicts to disclose

Analysis Predictors Outcome No. of syndemics Bio-behavioral transmission risk behavior (TRB): condomless sex while virally detectable (HIV RNA > 400) with a partner of unknown or HIV-negative status Depression (PHQ-9) Anxiety (Brief PHQ) Alcohol Use (AUDIT-C) Drug Use (ASSIST) Time (measured by visit number) Behavioral risk group

Results } Cis women as referent group Conclusions Identifying syndemics via patient-report-outcome measures in HIV clinics is feasible. Integrating the identification and treatment of syndemic conditions within HIV clinical settings carries potential for reducing the number of new infections via bio-behavioral transmission risk behavior.