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HIV Testing and Treatment to Prevent Onward HIV Transmission among High-risk MSM

This study will assess the feasibility and potential impact of interventions to reduce high rates of onward transmission associated with acute HIV infection (AHI) and unsafe sex practices and poor medication adherence due to alcohol use. These results will inform community-based seek-test-treat-retain (STTR) interventions and HIV/AIDS program development.

This US NIH/NIDA-funded research will expand upon mathematical models for HIV prevention based on voluntary testing using serologic assays and prompt initiation of treatment among individuals with established infection. Our hypothesis is that the efficacy of “test-and-treat” strategies will be improved by specifically intervening to reduce the impact of a major driver of onward transmission – ongoing risk behavior related to substance abuse among individuals with acute and established HIV infection. This hypothesis will be addressed in two specific aims. The first will assess population effects of substance use through analysis of transmission clusters, and modeling of the potential impact of high adherence to antiretroviral treatment by MSM with acute, as well as established, HIV infection. The second will assesses alcohol effects at an individual level in a randomized placebo-controlled trial of naltrexone in HIV-infected MSM with alcohol use disorder. This feasibility study will be a conducted among MSM in Lima, Peru over a five-year period.

Local Principal Investigator: Dr. Javier Lama.