alexa HIV Treatment Cascades that Leak: Correlates of Drop-off from the HIV Care Continuum among Men who have Sex with Men Worldwide
ISSN 2155-6113

Journal of AIDS & Clinical Research
Open Access

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Research Article

HIV Treatment Cascades that Leak: Correlates of Drop-off from the HIV Care Continuum among Men who have Sex with Men Worldwide

George Ayala1*, Keletso Makofane1, Glenn-Milo Santos2,3, Sonya Arreola1, Pato Hebert1, Matthew Thomann4, Patrick Wilson5, Jack Beck1 and Tri D. Do5

1The Global Forum on MSM & HIV (MSMGF), Oakland, California, USA

2Department of Community Health Systems, University of California, San Francisco, California, USA

3San Francisco Department of Public Health, San Francisco, California, USA

4Mailman School of Public Health, Columbia University, New York, New York, USA

5Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, California, USA

*Corresponding Author:
George Ayala
The Global Forum on MSM & HIV (MSMGF)
436 14th Street, Suite 1500
Oakland, California 94612, USA
Tel: 1 (213) 268-1777
E-mail: [email protected]

Received Date: June 20, 2014; Accepted Date: July 31, 2014; Published Date: August 08, 2014

Citation: Ayala G, Makofane K, Santos GM, Arreola S, Hebert P, et al. (2014) HIV Treatment Cascades that Leak: Correlates of Drop-off from the HIV Care Continuum among Men who have Sex with Men Worldwide. J AIDS Clin Res 5:331. doi:10.4172/2155-6113.1000331

Copyright: © 2014 Ayala G, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Objectives: The health and prevention benefits of antiretroviral therapies (ART), delivered as part of comprehensive HIV care programs remain unrealized for men who have sex with men (MSM). This multilevel study explores the correlates of drop-off from the HIV care continuum in an international study of MSM, taking into account individual and regional differences in access to and utilization of care.

Methods: We conducted a study of the continuum of HIV diagnosis and care among 6095 MSM using data collected from an international online survey of MSM conducted in 2012. In this model of the HIV treatment cascade, we treated each point along the continuum as an outcome variable. We then investigated the relationships between clinical care outcomes and a set of demographic and psychosocial factors that were hypothesized to correlate with the outcomes using bivariate and multivariable statistical techniques.

Results: Among MSM living with HIV for longer than 12 months (n=632), 50%(n=319) were virologically suppressed. Among MSM recently infected with HIV (n=91), the proportion was relatively smaller at 33%. Significant correlates of being on ART and retained in care included: accessibility of HIV treatment; comfort with a healthcare provider; and engagement in a gay community. Perceptions of homophobia were negatively associated with being on ART and being retained in care.

Conclusions: These findings underscore the need for service delivery models that sensitively address HIV among MSM. Public health officials should adopt comprehensive HIV programs that include mutually reinforcing components and that address varying needs of MSM newly diagnosed and living with HIV. Comprehensive HIV programs must also support the critical role communities play in linking and retaining MSM into HIV services. Further studies validating the findings in country-specific contexts are warranted.

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