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Updated: Aug 13, 2026

An Affordable HIV-1 Drug Resistance Monitoring Method for Resource Limited Settings
Published on: March 30, 2014
HIV transmission risk behavior and its relation to antiretroviral treatment adherence
Rachel C Flaks1, William J Burman, Patrick J Gourley
1Department of Public Health, Denver Health and Hospital Authority, University of Colorado Health Sciences Center, Denver, Colorado, USA.
Background:
Rising rates of antiretroviral drug resistance among recently infected persons are evidence of high-risk behavior among persons in HIV care.
Goal:
The goal was to determine HIV transmission risk behavior among persons in HIV care and evaluate its association with treatment adherence.
Study Design:
The study involved a structured interview of a random sample of patients in HIV care in an urban public clinic. Participants were categorized by transmission risk: high risk = unprotected anal/vaginal sex and/or needle sharing; low risk = protected anal/vaginal sex, unprotected and/or protected oral sex, no needle sharing; no risk = no sex or needle sharing.
Results:
Of the 95 participants, 21 (22%) reported high-risk behavior, 36 (38%) reported low-risk behavior, and 38 (40%) reported no transmission risk in the past 3 months. Younger, more educated persons and those with an active substance abuse diagnosis were more likely to have high transmission risk (P < or = 0.05). Patients who engaged in high-risk behavior had equivalent use of antiretroviral therapy (P = 0.80) but lower adherence (P < or = 0.01) and higher median plasma viral loads (P = 0.05).
Conclusions:
There was a wide spectrum of transmission risk behavior among persons in HIV care. Persons reporting high-risk behavior were less adherent to antiretroviral therapy, providing a behavioral basis for transmission of drug-resistant HIV.
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