Risk Factors for HIV sero-conversion in a high incidence cohort of men who have sex with men and transgender women in Bangkok, Thailand
Background: We measured Human Immunodeficiency (HIV) incidence, retention, and assessed risk factors for seroconversion among two previously unreported cohorts of men who have sex with men (MSM) and Transgender Women (TGW) in Bangkok, Thailand between 2017 and 2019. Methods: We conducted an 18-month...
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-08-01
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| Series: | EClinicalMedicine |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589537021003138 |
| _version_ | 1819134348001017856 |
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| author | Tanyaporn Wansom Sant Muangnoicharoen Sorachai Nitayaphan Suchai Kitsiripornchai Trevor A. Crowell Leilani Francisco Paileen Gilbert Dixion Rwakasyaguri Jittima Dhitavat Qun Li David King Merlin L. Robb Kirsten Smith Elizabeth A. Heger Siriwat Akapirat Punnee Pitisuttithum Robert J. O'Connell Sandhya Vasan |
| author_facet | Tanyaporn Wansom Sant Muangnoicharoen Sorachai Nitayaphan Suchai Kitsiripornchai Trevor A. Crowell Leilani Francisco Paileen Gilbert Dixion Rwakasyaguri Jittima Dhitavat Qun Li David King Merlin L. Robb Kirsten Smith Elizabeth A. Heger Siriwat Akapirat Punnee Pitisuttithum Robert J. O'Connell Sandhya Vasan |
| author_sort | Tanyaporn Wansom |
| collection | DOAJ |
| description | Background: We measured Human Immunodeficiency (HIV) incidence, retention, and assessed risk factors for seroconversion among two previously unreported cohorts of men who have sex with men (MSM) and Transgender Women (TGW) in Bangkok, Thailand between 2017 and 2019. Methods: We conducted an 18-month prospective cohort study of HIV-uninfected Thai cisgender men and TGW aged between 18 and 35 years who reported sex with men in the past six months and at least one additional risk factor for HIV infection. HIV and syphilis testing and computer-based behavioral questionnaires were administered at each visit. We utilized Poisson regression to calculate HIV incidence rates. A survival random forest model identified the most predictive risk factors for HIV sero-conversion and then used in a survival regression tree model to elucidate hazard ratios for individuals with groups of selected risk factors. Cox proportional hazards (pH) regression evaluated the strength of association between individual covariates and risk of sero-conversion. Findings: From April 2017-October 2019, 1,184 participants were screened, 167 were found ineligible, and 1,017 enrolled. Over the 18-month study, visit retention was 93·4% (95% CI 91·6%–94·8%) and HIV incidence was 3·73 per 100 person-years (95% CI 2·79–5·87). Utilizing survival regression tree modeling, those who were 18–20 years of age, reported sexual attraction to mostly or only men, and had five or more lifetime sexual partners were 4·9 times more likely to seroconvert compared to other cohort participants. Factors associated with HIV incidence utilizing Cox pH regression included sexual attraction to mostly or only men (adjusted hazard ratio (aHR) 14·9 (95% CI 20·1–107·9), younger age (18–19 years, aHR 10·88 (95% CI 4·12–28·7), five or greater lifetime sexual partners (aHR 2·0, 95%CI 1·1–3·6), inconsistent condom use with casual partners (aHR 2·43, 95% CI 1·3–4·5), and prior HIV testing (adjusted HR 2·0, 95% CI 1·1–3·5). Interpretation: Interpretation HIV incidence remains high among Bangkok-based MSM and TGW. These key populations expressed high interest in participating in efficacy evaluation of future prevention strategies and had high retention in this 18 month study. Funding: Funding US National Institute of Allergy and Infectious Diseases (NIAID), Division of AIDS Interagency Agreements (DAIDS) and U.S. Department of the Army. |
| first_indexed | 2024-12-22T10:01:45Z |
| format | Article |
| id | doaj.art-ea735e9f485342a8add647235e0b3851 |
| institution | Directory Open Access Journal |
| issn | 2589-5370 |
| language | English |
| last_indexed | 2024-12-22T10:01:45Z |
| publishDate | 2021-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EClinicalMedicine |
| spelling | doaj.art-ea735e9f485342a8add647235e0b38512022-12-21T18:30:05ZengElsevierEClinicalMedicine2589-53702021-08-0138101033Risk Factors for HIV sero-conversion in a high incidence cohort of men who have sex with men and transgender women in Bangkok, ThailandTanyaporn Wansom0Sant Muangnoicharoen1Sorachai Nitayaphan2Suchai Kitsiripornchai3Trevor A. Crowell4Leilani Francisco5Paileen Gilbert6Dixion Rwakasyaguri7Jittima Dhitavat8Qun Li9David King10Merlin L. Robb11Kirsten Smith12Elizabeth A. Heger13Siriwat Akapirat14Punnee Pitisuttithum15Robert J. O'Connell16Sandhya Vasan17US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, United States; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, United States; Current affiliation: HIV-NAT, Thai Red Cross AIDS Research Centre, and Dreamlopments Social Enterprise and Foundation, Bangkok, ThailandVaccine Trial Centre, Faculty of Tropical Medicine, Mahidol University, Bangkok, ThailandRoyal Thai Army Component, Armed Forces Research Institute of Medical Sciences, Bangkok, ThailandArmed Forces Research Institute of Medical Sciences, Bangkok, ThailandUS Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, United States; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, United StatesUS Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, United States; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, United StatesUS Army Medical Research Development Command (USAMRDC) Office of Regulated Activities (ORA) Special Operations Branch, Fort Detrick, Fort Detrick, MD, USAUS Army Medical Research Development Command (USAMRDC) Office of Regulated Activities (ORA) Special Operations Branch, Fort Detrick, Fort Detrick, MD, USAVaccine Trial Centre, Faculty of Tropical Medicine, Mahidol University, Bangkok, ThailandUS Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, United States; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, United StatesHenry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, United StatesUS Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, United States; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, United StatesUS Army Medical Research and Development Command, Fort Detrick, Maryland, USAUS Army Medical Materiel Development Activity, Fort Detrick, Maryland, USAArmed Forces Research Institute of Medical Sciences, Bangkok, ThailandVaccine Trial Centre, Faculty of Tropical Medicine, Mahidol University, Bangkok, ThailandUS Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, United States; Armed Forces Research Institute of Medical Sciences, Bangkok, ThailandUS Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, United States; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, United States; Corresponding author.Background: We measured Human Immunodeficiency (HIV) incidence, retention, and assessed risk factors for seroconversion among two previously unreported cohorts of men who have sex with men (MSM) and Transgender Women (TGW) in Bangkok, Thailand between 2017 and 2019. Methods: We conducted an 18-month prospective cohort study of HIV-uninfected Thai cisgender men and TGW aged between 18 and 35 years who reported sex with men in the past six months and at least one additional risk factor for HIV infection. HIV and syphilis testing and computer-based behavioral questionnaires were administered at each visit. We utilized Poisson regression to calculate HIV incidence rates. A survival random forest model identified the most predictive risk factors for HIV sero-conversion and then used in a survival regression tree model to elucidate hazard ratios for individuals with groups of selected risk factors. Cox proportional hazards (pH) regression evaluated the strength of association between individual covariates and risk of sero-conversion. Findings: From April 2017-October 2019, 1,184 participants were screened, 167 were found ineligible, and 1,017 enrolled. Over the 18-month study, visit retention was 93·4% (95% CI 91·6%–94·8%) and HIV incidence was 3·73 per 100 person-years (95% CI 2·79–5·87). Utilizing survival regression tree modeling, those who were 18–20 years of age, reported sexual attraction to mostly or only men, and had five or more lifetime sexual partners were 4·9 times more likely to seroconvert compared to other cohort participants. Factors associated with HIV incidence utilizing Cox pH regression included sexual attraction to mostly or only men (adjusted hazard ratio (aHR) 14·9 (95% CI 20·1–107·9), younger age (18–19 years, aHR 10·88 (95% CI 4·12–28·7), five or greater lifetime sexual partners (aHR 2·0, 95%CI 1·1–3·6), inconsistent condom use with casual partners (aHR 2·43, 95% CI 1·3–4·5), and prior HIV testing (adjusted HR 2·0, 95% CI 1·1–3·5). Interpretation: Interpretation HIV incidence remains high among Bangkok-based MSM and TGW. These key populations expressed high interest in participating in efficacy evaluation of future prevention strategies and had high retention in this 18 month study. Funding: Funding US National Institute of Allergy and Infectious Diseases (NIAID), Division of AIDS Interagency Agreements (DAIDS) and U.S. Department of the Army.http://www.sciencedirect.com/science/article/pii/S2589537021003138 |
| spellingShingle | Tanyaporn Wansom Sant Muangnoicharoen Sorachai Nitayaphan Suchai Kitsiripornchai Trevor A. Crowell Leilani Francisco Paileen Gilbert Dixion Rwakasyaguri Jittima Dhitavat Qun Li David King Merlin L. Robb Kirsten Smith Elizabeth A. Heger Siriwat Akapirat Punnee Pitisuttithum Robert J. O'Connell Sandhya Vasan Risk Factors for HIV sero-conversion in a high incidence cohort of men who have sex with men and transgender women in Bangkok, Thailand EClinicalMedicine |
| title | Risk Factors for HIV sero-conversion in a high incidence cohort of men who have sex with men and transgender women in Bangkok, Thailand |
| title_full | Risk Factors for HIV sero-conversion in a high incidence cohort of men who have sex with men and transgender women in Bangkok, Thailand |
| title_fullStr | Risk Factors for HIV sero-conversion in a high incidence cohort of men who have sex with men and transgender women in Bangkok, Thailand |
| title_full_unstemmed | Risk Factors for HIV sero-conversion in a high incidence cohort of men who have sex with men and transgender women in Bangkok, Thailand |
| title_short | Risk Factors for HIV sero-conversion in a high incidence cohort of men who have sex with men and transgender women in Bangkok, Thailand |
| title_sort | risk factors for hiv sero conversion in a high incidence cohort of men who have sex with men and transgender women in bangkok thailand |
| url | http://www.sciencedirect.com/science/article/pii/S2589537021003138 |
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