{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T20:04:42Z","timestamp":1762459482891},"reference-count":30,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2017,4,26]],"date-time":"2017-04-26T00:00:00Z","timestamp":1493164800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"PRIN","award":["2012L783TW_003"],"award-info":[{"award-number":["2012L783TW_003"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>We assessed whether changes in community viral load (<jats:styled-content style=\"fixed-case\">CVL<\/jats:styled-content>) over time were associated with the rate of new <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> diagnoses (<jats:styled-content style=\"fixed-case\">ND<\/jats:styled-content>s).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u20101\u2010positive individuals referred to our institute and permanently residing in our province were considered for inclusion in the study. A total of 861 <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010infected adults with at least one <jats:styled-content style=\"fixed-case\">HIV RNA<\/jats:styled-content> measurement (12 530 measurements in total) between 2008 and 2014 were included. Viraemia copy\u2010years were calculated from all <jats:styled-content style=\"fixed-case\">HIV RNA<\/jats:styled-content> values for each patient using the trapezoidal rule; multiple <jats:styled-content style=\"fixed-case\">CVL<\/jats:styled-content> indicators were considered. Total <jats:styled-content style=\"fixed-case\">ND<\/jats:styled-content>s and recent infections (&lt; 1 year) were analysed separately. The association between <jats:styled-content style=\"fixed-case\">ND<\/jats:styled-content>s and <jats:styled-content style=\"fixed-case\">CVL<\/jats:styled-content> was tested by means of mixed Poisson models, with <jats:styled-content style=\"fixed-case\">CVL<\/jats:styled-content> as a fixed effect and year as a random effect.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The incidence of <jats:styled-content style=\"fixed-case\">ND<\/jats:styled-content>s was 2.28 per 100 000 residents in 2008 and 2.52 per 100 000 residents in 2014. Total numbers of <jats:styled-content style=\"fixed-case\">ND<\/jats:styled-content>s and recent infections did not vary significantly over time (<jats:italic>P<\/jats:italic> for trend 0.879 and 0.39, respectively). Mean <jats:styled-content style=\"fixed-case\">HIV RNA<\/jats:styled-content> decreased from 31 095.8 <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u20101 <jats:styled-content style=\"fixed-case\">RNA<\/jats:styled-content> copies\/mL in 2008 to 21 231.5 copies\/mL in 2014 (<jats:italic>P<\/jats:italic> &lt; 0.001); a downward trend was always observed regardless of the <jats:styled-content style=\"fixed-case\">CVL<\/jats:styled-content> indicator considered. Depending on the indicator, there were some differences in <jats:styled-content style=\"fixed-case\">CVL<\/jats:styled-content> by patient characteristics. The most substantial contributors to <jats:styled-content style=\"fixed-case\">CVL<\/jats:styled-content> appeared to be male individuals, men who have sex with men (<jats:styled-content style=\"fixed-case\">MSM<\/jats:styled-content>), non\u2010Italians, and untreated subjects (all <jats:italic>P<\/jats:italic> &lt; 0.05). The relative risk of <jats:styled-content style=\"fixed-case\">ND<\/jats:styled-content> increased among Italians and <jats:styled-content style=\"fixed-case\">MSM<\/jats:styled-content> with an increasing proportion of subjects having an undetectable <jats:styled-content style=\"fixed-case\">HIV RNA<\/jats:styled-content>, and decreased in the same population with increasing levels of <jats:styled-content style=\"fixed-case\">CVL<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In our setting, <jats:styled-content style=\"fixed-case\">CVL<\/jats:styled-content> represented a good marker of access to care and treatment; however, reduced <jats:styled-content style=\"fixed-case\">CVL<\/jats:styled-content> did not coincide with a reduction in the rate of <jats:styled-content style=\"fixed-case\">ND<\/jats:styled-content>s.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.12515","type":"journal-article","created":{"date-parts":[[2017,4,26]],"date-time":"2017-04-26T07:58:48Z","timestamp":1493193528000},"page":"711-723","source":"Crossref","is-referenced-by-count":3,"title":["Reduced community viral load does not coincide with a reduction in the rate of new <scp>HIV<\/scp> diagnoses and recent infections: data from a region of southern Italy"],"prefix":"10.1111","volume":"18","author":[{"given":"L","family":"Monno","sequence":"first","affiliation":[{"name":"Clinic of Infectious Diseases University of Bari Bari Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Saracino","sequence":"additional","affiliation":[{"name":"Clinic of Infectious Diseases University of Bari Bari Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L","family":"Scudeller","sequence":"additional","affiliation":[{"name":"Scientific Direction Clinical Epidemiology Unit IRCCS San Matteo Foundation Pavia Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C","family":"Santoro","sequence":"additional","affiliation":[{"name":"Clinic of Infectious Diseases University of Bari Bari Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G","family":"Brindicci","sequence":"additional","affiliation":[{"name":"Clinic of Infectious Diseases University of Bari Bari Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G","family":"Punzi","sequence":"additional","affiliation":[{"name":"Clinic of Infectious Diseases University of Bari Bari Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Lagioia","sequence":"additional","affiliation":[{"name":"Clinic of Infectious Diseases University of Bari Bari Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S","family":"Lo Caputo","sequence":"additional","affiliation":[{"name":"Clinic of Infectious Diseases University of Bari Bari Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G","family":"Angarano","sequence":"additional","affiliation":[{"name":"Clinic of Infectious Diseases University of Bari Bari Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,4,26]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1086\/651478"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200003303421303"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1105243"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0011068"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60936-1"},{"key":"e_1_2_6_7_1","unstructured":"StallR FriedmanM MarshalM WisniewskiS.What's driving the US epidemic in MSM. 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