Prevalence of self reported photosensitivity and sunscreen use among people living with HIV in Thailand

Abstract

Abnormal cutaneous photosensitivity and photodermatoses have emerged as significant dermatologic manifestations among people living with human immunodeficiency virus infection (PLHIV), with most studies reported in African populations. These cutaneous manifestations correlate with antiretroviral medication usage and decreased CD4 lymphocyte counts. This study assessed the prevalence of self-reported photosensitivity among Thai PLHIV compared with controls and evaluated sunscreen use and photoprotection practices, given the elevated skin cancer risk in PLHIV. A cross-sectional study was conducted among PLHIV and controls, focusing on the history of abnormal cutaneous responses to sunlight or photodermatoses. Data on sunlight exposure and photoprotection practices were collected. The study enrolled 312 participants (PLHIV: 145; controls: 167), predominantly male (PLHIV 88.3%, controls 98.8%). The prevalence of self-reported photosensitivity was comparable between PLHIV (16%) and controls (15.7%). The median time to photosensitivity onset was shorter in PLHIV than in controls, although the difference was not significant. No associations emerged between antiretroviral use or CD4 count and an increase in this symptom. Conversely, the use of nucleoside/nucleotide reverse transcriptase inhibitors were associated with a lower risk. Daily sunscreen use was reported by 32.4% of the PLHIV and 24.7% of the controls, with no significant difference. Fewer PLHIV (16.7%) cited skin cancer concerns related to sunscreen use than did the controls (20.3%). In conclusion, this study revealed no increase in the prevalence of self-reported photosensitivity in Thai PLHIV, although symptoms tended to onset earlier after sun exposure. With only one-third of PLHIV using sunscreen regularly, improving photoprotection awareness is essential.