From July 2012 to January 2014, the Project HOPE study interviewed 1,227 people with HIV infection from 11 hospitals in the US to determine eligibility for participation in a randomized trial. Using these screening interviews, we conducted a cross-sectional study with multivariable analysis to examine groups that are at highest risk for having a detectable viral load and engaging in HIV transmission behaviors. Viral suppression was 42.8%. Persons with a detectable viral load were more likely to have sex partners who were HIV-negative or of unknown status (OR=1.72, 95% CI=1.22-2.38), report not cleaning needles after injecting drugs (OR=3.13, 95% CI=1.33-7.14), and to engage in sex acts while high on drugs or alcohol (OR=1.85, 95% CI=1.28-2.7) compared to their counterparts. Many hospitalized people with HIV infection are unsuppressed and more likely to engage in HIV transmission behaviors than those with viral suppression. Developing behavioral interventions targeting HIV transmission behaviors toward patients with unsuppressed HIV viral load in the hospital settings has the potential to prevent HIV transmission.
Keywords: HIV; antiretroviral therapy; injection drug use; sexual risk behaviors; viral suppression.