scholarly journals Suboptimal HIV status ascertainment at antenatal clinics and the impact on HIV prevalence estimates

2021 ◽  
Author(s):  
Fatihiyya Wangara ◽  
Janne Estill ◽  
Hillary Kipruto ◽  
Kara Wools-Kaloustian ◽  
Wendy Chege ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Routine Data ◽  
Hiv Prevalence ◽  
Sentinel Surveillance ◽  
List Type ◽  
Hiv Status ◽  
Hiv Surveillance ◽  
New Findings ◽  
Prevalence Estimates ◽  
Antenatal Clinics

AbstractIntroductionHIV prevalence estimates is a key indicator to inform the coverage and effectiveness of HIV prevention measures. Many countries including Kenya transitioned from sentinel surveillance to the use of routine antenatal care data to estimate the burden of HIV. Countries in Sub Saharan Africa reported several challenges of this transition, including low uptake of HIV testing and sub national / site-level differences in HIV prevalence estimates.MethodsWe examine routine data from Kwale County, Kenya, for the period January 2015 to December 2019 and predict HIV prevalence among women attending antenatal care (ANC) at 100% HIV status ascertainment. We estimate the bias in HIV prevalence estimates as a result of imperfect uptake of HIV testing and make recommendations to improve the utility of ANC routine data for HIV surveillance. We used a generalized estimating equation with binomial distribution to model the observed HIV prevalence as explained by HIV status ascertainment and region (Sub County). We then used marginal standardization to predict the HIV prevalence at 100% HIV status ascertainment.ResultsHIV testing at ANC was at 91.3%, slightly above the global target of 90%. If there was 100% HIV status ascertainment at ANC, the HIV prevalence would be 2.7% (95% CI 2.3-3.2). This was 0.3% lower than the observed prevalence. Similar trends were observed with yearly predictions except for 2018 where the HIV prevalence was underestimated with an absolute bias of -0.2%. This implies missed opportunities for identifying new HIV infections in the year 2018.ConclusionsImperfect HIV status ascertainment at ANC overestimates HIV prevalence among women attending ANC in Kwale County. However, the use of ANC routine data may underestimate the true population prevalence. There is need to address both community level and health facility level barriers to the uptake of ANC services.Key questionsWhat is already known?▪HIV surveillance estimates from antenatal clinics (ANC) can serve as a useful proxy for HIV prevalence trends in the general female population.▪Kenya has conducted multiple studies which have shown that national HIV prevalence estimates from sentinel surveillance and those from routine program data to be similar.▪However, these studies have also revealed ongoing challenges to the suitability of using routine data as compared to sentinel surveillance including sub optimal uptake of HIV testing and sub national/ site-level differences in HIV prevalence estimates.What are the new findings?▪HIV positive pregnant women are more likely to be tested at ANC as compared to HIV negative women, leading to higher HIV prevalence estimates among women attending ANC.▪Health facility level HIV prevalence estimates are lower than that of the general population.What do the new findings imply?▪HIV positive women are underrepresented in antenatal clinics.▪In Kwale County (and similar contexts), use of routine ANC data is still not a reliable method to estimate HIV prevalence, both at facility and community level.

Effect of nondisclosure of HIV status in sexual health clinics on unlinked anonymous HIV prevalence estimates in England, 2005–2009

AIDS ◽  
2015 ◽  
pp. 1
Author(s):  
Emma J. Savage ◽  
Catherine M. Lowndes ◽  
Ann K. Sullivan ◽  
David J. Back ◽  
Laura J. Else ◽  
...  
Keyword(s):  
Sexual Health ◽  
Hiv Prevalence ◽  
Hiv Status ◽  
Health Clinics ◽  
Prevalence Estimates ◽  
Sexual Health Clinics

scholarly journals Explaining the HIV prevalence of international traveler population in China, 2005-2012

2015 ◽  
Vol 4 (3) ◽  
pp. 61
Author(s):  
Kongxin Hu ◽  
Xuezheng Ma ◽  
Lijuan Liu ◽  
Baogang Wang ◽  
Hailei Wu ◽  
...  
Keyword(s):  
Hiv Prevalence ◽  
Surveillance Data ◽  
Downward Trend ◽  
Hiv Status ◽  
Hiv Surveillance ◽  
Significant Downward Trend

Explaining of HIV surveillance data (2005-2012) on international travelers from Chinese ports of entry indicated that a significant downward trend of HIV prevalence was observed from 2006 through 2010 among the international immigrants. Moreover, this data reflected HIV prevalence among a specific and clear subpopulation of people defined as unknown HIV status population.

scholarly journals Prevalence and Risk Factors Associated with HIV Infection among Pregnant Women in Odisha State, India

2020 ◽  
Vol 9 (3) ◽  
pp. 411-420
Author(s):  
Aridoss Santhakumar ◽  
Malathi Mathiyazhakan ◽  
Nagaraj Jaganathasamy ◽  
Balsubramanian Ganesh ◽  
N Manikandan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Global Health ◽  
Pregnant Women ◽  
Hiv Prevalence ◽  
Sentinel Surveillance ◽  
Truck Drivers ◽  
Surveillance Period ◽  
Factors Associated ◽  
Agricultural Laborers ◽  
Antenatal Clinics

Background and Objectives: The purpose of this study was to analyze trends in HIV prevalence and risk factors associated with HIV infection among pregnant women attending antenatal clinics in Odisha State, India. Methods: Data were from the HIV Sentinel Surveillance (HSS) among pregnant women, a descriptive cross-sectional study using consecutive sampling method and conducted in India. Data and samples were collected from pregnant women attending select antenatal clinics that act as designated sentinel sites in Odisha State, India, during the three months surveillance period and in three surveillance years: 2013, 2015, and 2017. All eligible pregnant women aged between 15 and 49 years, attending the sentinel sites for the first time during the surveillance period, were included. Information on their socio-demographic characteristics and blood samples were also collected. Results: In total, 38,384 eligible pregnant women were included in the survey. Of these, 107 women were HIV positive, with an overall prevalence of 0.28%. HIV prevalence indicated a stabilizing trend between 2013 and 2017. However, pregnant women whose spouses were non-agricultural laborers, truck drivers, or migrants were significantly at higher risk of being infected. Likewise, HIV prevalence significantly increased over the years among pregnant women whose spouses were in the service sector (government or private). District-wise fluctuations in HIV prevalence was observed, with the district of Cuttack recording the highest prevalence among the districts. Conclusion and Global Health Implications: Women who are spouses of non-agricultural laborers, truck drivers or migrants need focused interventions, such as creating awareness on HIV and its prevention. Migration, due to poverty and its impact on sexually transmitted diseases among migrants from low and middle-income countries, have been documented globally. Single male migrant specific interventions are recommended to halt the disease progression among pregnant women and general population in Odisha, India. Key words: • HIV sentinel surveillance • Pregnant women • HIV prevalence • Socio-demographic factor • Odisha • India   Copyright © 2020 Santhakumar et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) which permits unre-stricted use, distribution, and reproduction in any medium, provided the original work, first published in this journal, is properly cited.

scholarly journals Documentation of HIV Testing and Treatment Status Among Patients Presenting for Cancer Care in Uganda

2016 ◽  
Vol 2 (3_suppl) ◽  
pp. 58s-58s
Author(s):  
Matine J. Ghadrshenas ◽  
Rachel A. Bender Ignacio ◽  
Daniel H. Low ◽  
Warren Phipps ◽  
Jackson Orem ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Hiv Testing ◽  
Cancer Patients ◽  
Conflicts Of Interest ◽  
Hiv Prevalence ◽  
Cancer Knowledge ◽  
Hiv Status ◽  
Hiv Patients ◽  
Incidence And Mortality ◽  
Hiv Negative

Abstract 23 HIV increases the incidence and mortality of cancer; knowledge of HIV status and treatment is essential for management of patients with HIV-associated malignancies (HIVAM). In Uganda, where the prevalence of HIV infection is 7.4%, the incidence of AIDS-defining cancers (ADCs) is high, and non-AIDS defining cancers (NADCs) are increasingly common. We investigated how often cancer providers documented HIV status and clinical parameters of HIV infection among patients at the Uganda Cancer Institute (UCI). Medical records of patients aged ≥18 who registered at the UCI June - September 2015 were abstracted for demographics and cancer and HIV parameters. We calculated binomial proportions and used χ2 tests to evaluate factors associated with HIV. Among 1,130 patients in this analysis, 71% of charts documented HIV status. Of those documenting HIV status, 32% were HIV+, and 58% of HIV+ individuals had an ADC. The documented HIV prevalence in NADCs was 21%. Women were more likely to lack HIV results (RR 1.32, p=0.009); 36% of women lacked results, including 40% with cervical cancer. HIV+ patients were younger than HIV-negative patients (median age 41 vs. 49, p<0.001). 62% of HIV-infected patients had a CD4 count recorded; CD4 counts were lower among persons with ADC (median 270 cells/ml, IQR 80-460) compared with NADC (median 370, IQR 215-564), p=0.006. There was no difference in the proportion of HIV patients with ADCs and NADCs receiving ART (both 86%, p=0.45). HIV prevalence was 4.5 times higher in Ugandan cancer patients with documented status than in the general population. Though the majority of cancer patients had HIV testing performed, gaps remained in documenting HIV status, even among cancers considered AIDS-defining in HIV. This study highlights opportunities to educate cancer clinicians in Africa on the burden of HIV in cancer patients and opportunities to coordinate management of both cancer and HIV. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST: Matine J. Ghadrshenas No relationship to disclose Rachel A. Bender Ignacio No relationship to disclose Daniel H. Low No relationship to disclose Warren Phipps No relationship to disclose Jackson Orem No relationship to disclose Ann Duerr No relationship to disclose Corey Casper Leadership: Temptime Consulting or Advisory Role: Janssen Pharmaceuticals Research Funding: Janssen Pharmaceuticals Travel, Accommodations, Expenses: Temptime Corporation, GlaxoSmithKline

scholarly journals Back to Basics: Correlates of HIV Risk in a Community Sample of Haiti

2020 ◽  
Author(s):  
Manisha Joshi ◽  
Guitele J. Rahill ◽  
Christopher Rice ◽  
Paul Phycien ◽  
Cameron Burris ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Hiv Testing ◽  
Hiv Risk ◽  
Community Sample ◽  
Hiv Prevalence ◽  
Hiv Status ◽  
Hiv Knowledge ◽  
The Past ◽  
Hiv Test ◽  
Hiv Awareness

AbstractHaiti has a 2.2 % HIV prevalence (highest in the Caribbean); this has diminished from over 12% in the past three decades (depending on sex and gender, province, and neighborhood). Preliminary studies indicate that in the Cite Soleil neighborhood of Haiti (HIV prevalence >3%) as in socioeconomically equivalent adjacent neighborhoods, over 50% of girls and women experience non-partner sexual violence (NPSV), typically perpetrated by groups of men. Rates of NPSV against men in those neighborhoods were not available. Coercive sex heightens HIV risk. Accurate HIV knowledge empowers individuals (including survivors of NPSV) to assess personal HIV risk and increases likelihood of getting tested and of determining personal HIV status; thus, accurate HIV knowledge is foundational to behavioral risk reduction for victims in future consensual relationships and to engagement in either the HIV prevention or care continuum.Between March and July 2017, we surveyed individuals 18 years or older (210 women, 257 men), assessing experience of NPSV, HIV knowledge, history of HIV testing, knowledge of HIV status, assessment of self-risk, and sexual risk behaviors. Nearly 30% of men and 24% of women endorsed having experienced NPSV. Knowledge of HIV transmission was low: 90% endorsed HIV myths, e.g. transmission occurs via public toilets, via sharing a glass with or by being exposed to a cough or sneeze from a person living with HIV. High endorsement of these myths contrasted with low endorsement of protective behavior: Only 14.3 % used a condom during consensual sex in the past year. Only 47.9% of the respondents had ever attended an HIV awareness program; 16% of knew their HIV status, although 79% assessed their HIV risk as moderate to high. Results regressing knowledge of HIV testing on participant characteristics indicated that women (OR=2.8), individuals with a partner (OR=2.2), individuals who attended an HIV awareness class (OR=2.1), individuals who knew someone with HIV (OR=3.9), and individuals who had an HIV test (OR=33.5) were more likely to know what an HIV test is. Participants who endorsed experiencing NPSV (OR=0.33) and those who had been diagnosed with an STI (OR=0.44) were less likely to know about HIV testing.Experience of NPSV combined with low HIV knowledge, awareness and testing heighten the HIV prevention needs of Cite Soleil residents and underscore the need to return to basics on the road to HIV eradication in that context.

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