Undetectable HIV Viral Load Key to Reducing New Infection Among MSM

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In order to meet the 90-90-90 HIV targets, 75% of all MSM living with HIV will need to be virally suppressed by 2020.
In order to meet the 90-90-90 HIV targets, 75% of all MSM living with HIV will need to be virally suppressed by 2020.

A new mathematical model based on data from the National Institutes of Health (NIH), Baltimore, Maryland, predicts that meeting the 90-90-90 HIV targets would require 75% of all men who have sex with men (MSM) living with HIV to be virally suppressed by 2020, leading to a 50% reduction in HIV incidence.1

At the HIV Research for Prevention (HIVR4P) 2016 conference in Chicago, Illinois, researchers from the NIH-supported HIV Prevention Trials Network (HPTN) presented findings from the mathematical model, which is part of a large clinical research study sponsored by the National Institute of Allergy and Infectious Diseases and the HIV Prevention Trials Network called HPTN 078 (ClinicalTrials.gov Identifier: NCT02663219).2


HPTN 078 is enrolling MSM living with HIV from high HIV burden cities - Baltimore, Atlanta, Birmingham, and Boston. The researchers are testing a new peer-to-peer recruitment strategy to identify MSM who are living with HIV and not adequately virally suppressed. The study aims to recruit approximately 2700 MSM aged 16 years and older. Once recruitment is complete, the participants will be randomly assigned to either a case management intervention or to standard care. Those assigned to the case management intervention study arm will receive enhanced linkage to coordinated care, with close attention paid to treatment adherence and retention.

The designated primary outcome measure to be evaluated is degree of viral suppression 24 month post-clinical trial enrollment.   Application of the new mathematical model will be used to identify demographic, behavioral, and clinical factors associated with reduction in population-level HIV incidence in MSM in the regions being evaluated.  

“Access and adherence to antiretroviral therapy are key to sustained HIV suppression, which dramatically reduces the risk of transmitting HIV to others,” the news release noted.  The “mathematical modeling is a supporting component of the HPTN 078 study. Moving forward, HPTN researchers will use models to predict the effects of the case management intervention and the level of viral suppression achieved in the trial on new HIV infections within the population, among other goals.”

HPTN 078 (NCT02663219) is funded by NIH's National Institute of Allergy and Infectious Diseases (NIAID) and National Institute of Mental Health (NIMH).

References

  1. Large increases in HIV suppression needed to reduce new infections in critical population [news release].  Bethesda, MD: National Institutes of Health; October 19, 2016.
  2. Mitchell KM, et al. Potential impact on HIV incidence of increasing viral suppression among HIV-positive MSM in Baltimore: Mathematical modelling for HPTN 078. Presented at: HIV Research for Prevention (HIVR4P) 2016. Chicago, IL; October 17-21, 2016.
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