scholarly journals HIV testing and ART initiation in people who inject drugs and are placed on methadone in Kachin State, Myanmar

2020 ◽  
Vol 10 (1) ◽  
pp. 27-32
Author(s):  
N. Lum ◽  
K. T. Wai ◽  
A. M. C. Thar ◽  
K. L. Show ◽  
A. D. Harries ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Testing ◽  
People Who Inject Drugs ◽  
Methadone Maintenance ◽  
Age Distribution ◽  
Methadone Maintenance Therapy ◽  
Hiv Positive ◽  
Art Initiation ◽  
Immunodeficiency Virus ◽  
Testing Uptake

Setting: People who inject drugs (PWID) enrolled for methadone maintenance therapy (MMT) and never previously tested for human immunodeficiency virus (HIV) in Myitkyina Drug Dependency Treatment Hospital, Myitkyina, Kachin State, Myanmar.Objectives: To compare before (2016) and after (2018) adoption of ‘Test and Treat’ guidelines for antiretroviral therapy (ART): 1) the demographic profile of PWID, 2) HIV testing uptake and ART initiation in those diagnosed HIV-positive, and 3) time taken for events.Design: This was a cohort study using secondary programme data.Results: In 2016 and 2018, there were respectively 141 and 146 PWID: all were male except for one female and age distribution between the 2 years was similar. In 2018, significantly more PWID were HIV-tested than in 2016 (85% vs. 45%; P ≤ 0.001). Among those tested, the proportions who were HIV-positive were similar (37% in 2016 and 38% in 2018). In 2018, significantly fewer HIV-positive PWID were started on ART than in 2016 (19% vs. 48%; P = 0.01). Median times between enrolment on MMT and HIV testing (2 vs. 1 day) and between being diagnosed HIV-positive and started on ART (31 vs. 17 days) for 2016 and 2018 were not significantly different.Conclusion: ART uptake decreased in 2018 compared with 2016, and ways to rectify this are urgently needed.

scholarly journals Estimates of the Time From Seroconversion to Antiretroviral Therapy Initiation Among People Newly Diagnosed With Human Immunodeficiency Virus From 2006 to 2015, New York City

2019 ◽  
Vol 71 (8) ◽  
pp. e308-e315
Author(s):  
McKaylee M Robertson ◽  
Sarah L Braunstein ◽  
Donald R Hoover ◽  
Sheng Li ◽  
Denis Nash
Keyword(s):  
Human Immunodeficiency Virus ◽  
Antiretroviral Therapy ◽  
Hiv Testing ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Population Based ◽  
Cd4 Count ◽  
Hiv Diagnosis ◽  
Art Initiation ◽  
Immunodeficiency Virus

Abstract Background We estimated the time from human immunodeficiency virus (HIV) seroconversion to antiretroviral therapy (ART) initiation during an era of expanding HIV testing and treatment efforts. Methods Applying CD4 depletion parameters from seroconverter cohort data to our population-based sample, we related the square root of the first pretreatment CD4 count to time of seroconversion through a linear mixed model and estimated the time from seroconversion. Results Among 28 162 people diagnosed with HIV during 2006–2015, 89% initiated ART by June 2017. The median CD4 count at diagnosis increased from 326 (interquartile range [IQR], 132–504) cells/µL to 390 (IQR, 216–571) cells/µL from 2006 to 2015. The median time from estimated seroconversion to ART initiation decreased by 42% from 6.4 (IQR, 3.3–11.4) years in 2006 to 3.7 (IQR, 0.5–8.3) years in 2015. The time from estimated seroconversion to diagnosis decreased by 28%, from a median of 4.6 (IQR, 0.5–10.5) years to 3.3 (IQR, 0–8.1) years from 2006 to 2015, and the time from diagnosis to ART initiation reduced by 60%, from a median of 0.5 (IQR, 0.2–2.1) years to 0.2 (IQR, 0.1–0.3) years from 2006 to 2015. Conclusions The estimated time from seroconversion to ART initiation was reduced in tandem with expanded HIV testing and treatment efforts. While the time from diagnosis to ART initiation decreased to 0.2 years, the time from seroconversion to diagnosis was 3.3 years among people diagnosed in 2015, highlighting the need for more effective strategies for earlier HIV diagnosis.

Mandatory HIV testing in critical care/emergency patients

1990 ◽  
Vol 10 (10) ◽  
pp. 22-25
Author(s):  
DW Unkle
Keyword(s):  
Human Immunodeficiency Virus ◽  
Critical Care ◽  
Hiv Testing ◽  
Healthcare Services ◽  
Hiv Positive ◽  
Controversial Issues ◽  
Seropositive Patient ◽  
Delivery Of Healthcare ◽  
Immunodeficiency Virus ◽  
Social Ostracism

Testing for the presence of the human immunodeficiency virus (HIV) remains one of the most controversial issues of this decade. Among persons diagnosed to be HIV positive, social ostracism and exaggerated atypical behavior are common. The resulting impact on the delivery of healthcare services to the seropositive patient has raised many ethical and professional dilemmas. Discussion of HIV testing and the subsequent effects of seropositivity on the delivery of healthcare will be emphasized.

Index testing among HIV-positive patients is feasible and successful in identifying additional HIV infections in Pakistan

2021 ◽  
pp. 6-10
Author(s):  
Arshad Altaf ◽  
Syed Sharaf Ali Shah ◽  
Safdar Pasha ◽  
Altaf Ahmed Soomro ◽  
Nazia Farrukh ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Testing ◽  
Hiv Infections ◽  
Control Programme ◽  
Hiv Positive ◽  
Outreach Workers ◽  
Immunodeficiency Virus ◽  
Testing Approach ◽  
Immunodeficiency Syndrome ◽  
Study Participants

Objective: To assess the feasibility of index testing approach to test the parents and siblings of human immunodeficiency virus (HIV)-positive children, and identify HIV-positive individuals. Methods: The study was conducted at Ratodero, Pakistan. Study participants were enrolled from September 2019 to February 2020.  The list of HIV-positive persons was provided by the Provincial Acquired Immunodeficiency Syndrome (AIDS) Control Programme. Families of 706 HIV-positive persons were approached and all of them agreed to participate. The first test was performed by trained outreach workers. All those with a reactive first test were transported to the nearest health facility for further testing and confirmation. Mothers and siblings were tested at home while additional visits were carried out to reach the fathers.  Results: A total of 1766 persons were tested through HIV index testing. Biological siblings accounted for 81% of the contacts. We were able to test 413/463 (89.2%) mothers, 232/413 (56.2%) fathers and 1121/1392 (80.5%) siblings. Out of these, 7 mothers (1.7%) and 22 siblings (2.0%) were confirmed to be HIV-positive, while no one was found to be positive among the fathers. The overall HIV prevalence was 1.6% (29/1766). All HIV-positive persons were guided for treatment and care.  Conclusion: Results indicate that index-testing approach is feasible in Pakistan to expand HIV testing services through home visits.  Key words: Human immunodeficiency virus, HIV, HIV testing, Pakistan, Index testing, HIV outbreak, Prevalence.

scholarly journals From Hospital to the Community: Redesigning the Human Immunodeficiency Virus (HIV) Clinical Service Model to Respond to an Outbreak of HIV Among People Who Inject Drugs

2020 ◽  
Vol 222 (Supplement_5) ◽  
pp. S410-S419
Author(s):  
Rebecca Metcalfe ◽  
Manon Ragonnet-Cronin ◽  
Amanda Bradley-Stewart ◽  
Andrew McAuley ◽  
Harrison Stubbs ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Phylogenetic Analysis ◽  
People Who Inject Drugs ◽  
Hiv Care ◽  
Viral Load Suppression ◽  
Art Initiation ◽  
Immunodeficiency Virus ◽  
Complex Population ◽  
Care Models ◽  
The Impact

Abstract An outbreak of human immunodeficiency virus (HIV) among people who inject drugs in Glasgow, Scotland started in 2014. We describe 156 cases over 5 years and evaluate the impact of clinical interventions using virological and phylogenetic analysis. We established (1) HIV services within homeless health facilities, including outreach nurses, and (2) antiretroviral therapy (ART) via community pharmacies. Implementation of the new model reduced time to ART initiation from 264 to 23 days and increased community viral load suppression rates to 86%. Phylogenetic analysis demonstrated that 2019 diagnoses were concentrated within a single network. Traditional HIV care models require adaptation for this highly complex population.

scholarly journals Human Immunodeficiency Virus Testing Among People Who Inject Drugs in Rural West Virginia

2020 ◽  
Vol 222 (Supplement_5) ◽  
pp. S346-S353
Author(s):  
Sean T Allen ◽  
Suzanne M Grieb ◽  
Rebecca Hamilton White ◽  
Allison O’Rourke ◽  
Michael E Kilkenny ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
West Virginia ◽  
Drug Treatment ◽  
Hiv Testing ◽  
People Who Inject Drugs ◽  
Multivariable Analysis ◽  
Crystal Methamphetamine ◽  
Factors Associated ◽  
The Past ◽  
Immunodeficiency Virus

Abstract Background Limited research exists on factors associated with human immunodeficiency virus (HIV) testing among people who inject drugs (PWID) in rural America. The purpose of this research is to identify factors associated with rural PWID in Appalachia having not been tested for HIV in the past year. Methods Cross-sectional data (n = 408) from a 2018 PWID population estimation study in West Virginia were used to examine factors associated with PWID having not been tested for HIV in the past year. Results Most participants identified as male (61%), white, non-Hispanic (84%), and reported having recently injected heroin (81%) and/or crystal methamphetamine (71%). Most (64%) reported having been tested for HIV in the past year, 17% reported having been tested but not in the past year, and 19% reported never having been tested. In multivariable analysis, not having been in a drug treatment program in the past year was associated with PWID not having been tested for HIV in the past year (adjusted prevalence ratio, 1.430; 95% confidence interval, 1.080–1.894). Conclusions Drug treatment programs may be important venues for rural PWID to access HIV testing; however, testing services should be offered at multiple venues as most PWID had not engaged in drug treatment in the past year.

Perceptions of Human Immunodeficiency Virus (HIV) Testing Services Among HIV-Positive Persons Not in Medical Care

2005 ◽  
Vol 32 (4) ◽  
pp. 207-213 ◽  
Author(s):  
Ellen T. Rudy ◽  
Pamela J. Mahoney-Anderson ◽  
Anita M. Loughlin ◽  
Lisa R. Metsch ◽  
Peter R. Kerndt ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Medical Care ◽  
Hiv Testing ◽  
Hiv Positive ◽  
Immunodeficiency Virus ◽  
Hiv Testing Services

scholarly journals Integrated Tuberculosis/Human Immunodeficiency Virus Community-Based Case Finding in Rural South Africa: Implications for Tuberculosis Control Efforts

2017 ◽  
Vol 4 (3) ◽  
Author(s):  
Sheela V Shenoi ◽  
Anthony P. Moll ◽  
Ralph P. Brooks ◽  
Tassos Kyriakides ◽  
Laurie Andrews ◽  
...  
Keyword(s):  
South Africa ◽  
Human Immunodeficiency Virus ◽  
Hiv Testing ◽  
Case Finding ◽  
Hiv Positive ◽  
Community Based ◽  
Rural South ◽  
Number Needed To Screen ◽  
Immunodeficiency Virus ◽  
Rural South Africa

Abstract Background Intensive case finding is endorsed for tuberculosis (TB) control in high-risk populations. Novel case-finding strategies are needed in hard-to-reach rural populations with high prevalence of TB and human immunodeficiency virus (HIV). Methods We performed community-based integrated HIV and TB intensive case finding in a rural South African subdistrict from March 2010 to June 2012. We offered TB symptom screening, sputum collection for microbiologic diagnosis, rapid fingerstick HIV testing, and phlebotomy for CD4 cell count. We recorded number of cases detected and calculated population-level rates and number needed to screen (NNS) for drug-susceptible and -resistant TB. Results Among 5615 persons screened for TB at 322 community sites, 91.2% accepted concurrent HIV testing, identifying 510 (9.9%) HIV-positive individuals with median CD4 count of 382 cells/mm3 (interquartile range = 260–552). Tuberculosis symptoms were reported by 2049 (36.4%), and sputum was provided by 1033 (18.4%). Forty-one (4.0%) cases of microbiologically confirmed TB were detected for an overall case notification rate of 730/100000 (NNS = 137); 11 (28.6%) were multidrug-resistant or extensively drug-resistant TB. Only 5 (12.2%) TB cases were HIV positive compared with an HIV coinfection rate of 64% among contemporaneously registered TB cases (P = .001). Conclusion Community-based integrated intensive case finding is feasible and is high yield for drug-susceptible and -resistant TB and HIV in rural South Africa. Human immunodeficiency virus–negative tuberculosis predominated in this community sample, suggesting a distinct TB epidemiology compared with cases diagnosed in healthcare facilities. Increasing HIV/TB integrated community-based efforts and other strategies directed at both HIV-positive and HIV-negative tuberculosis may contribute to TB elimination in high TB/HIV burden regions.

scholarly journals Diagnostic yield of active case finding for tuberculosis at human immunodeficiency virus testing in Haiti

2019 ◽  
Vol 23 (11) ◽  
pp. 1217-1222
Author(s):  
V. R. Rivera ◽  
L. Lu ◽  
O. Ocheretina ◽  
M. A. Jean Juste ◽  
P. Julma ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Testing ◽  
Chronic Cough ◽  
Diagnostic Yield ◽  
Cohort Analysis ◽  
High Yield ◽  
Hiv Positive ◽  
Hiv Test ◽  
Immunodeficiency Virus ◽  
Hiv Negative

SETTING: The Groupe Haïtien d'étude du Sarcome de Kaposi et des Infections Opportunistes (GHESKIO) Centres, Port-au-Prince, Haiti, facilitate “test and treat” strategies by screening all patients for tuberculosis (TB) at human immunodeficiency virus (HIV) testing.OBJECTIVE: 1) To determine the proportion of patients with chronic cough at HIV testing diagnosed with TB, stratified by HIV test results; and 2) to evaluate the additional diagnostic yield of Xpert® MTB/RIF vs. sputum microscopy.DESIGN: We conducted a retrospective cohort analysis including all adults tested for HIV at GHESKIO from August 2014 to July 2015.RESULTS: Of 29 233 adult patients tested for HIV, 2953 (10%) were diagnosed as HIV-positive. Chronic cough lasting ≥2 weeks was reported by 1116 (38%) HIV-positive patients; 984 (88%) were tested and 265 (27%) were diagnosed with TB. Chronic cough was reported by 5985 (23%) HIV-negative patients; 5654 (94%) were tested and 1179 (21%) were diagnosed with TB. Of all bacteriologically confirmed cases, 27% were smear-negative and Xpert-positive. Among all TB patients, 81% were HIV-negative.CONCLUSIONS: Screening for TB at HIV testing was high-yield, among both HIV-infected and HIV-negative individuals. Testing for both diseases should be conducted among patients who present with chronic cough at HIV testing.

Peer assisted HIV self-testing increases positivity rates among key populations in Burundi: descriptive analysis of routine programmatic data (Preprint)

2020 ◽  
Author(s):  
Tiffany Lillie ◽  
Dorica Boyee ◽  
Gloriose Kamariza ◽  
Alphonse Nkunzimana ◽  
Dismas Gashobotse ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Sex Workers ◽  
Descriptive Analysis ◽  
Case Finding ◽  
Hiv Positive ◽  
Key Populations ◽  
Standard Testing ◽  
Art Initiation ◽  
Treatment Standard ◽  
Self Testing

BACKGROUND In Burundi, given the low testing numbers among key populations, peer assisted HIV self-testing (HIVST) was initiated for female sex workers (FSWs), men who have sex with men (MSM), and transgender people (TG) to provide another testing option. HIVST was provided by existing peer outreach workers (POWs) who were trained to provide support before, during, and after the administration of the test. People who screened reactive were referred and actively linked to confirmatory testing, and those confirmed positive were linked to treatment. Standard testing included HIV testing by clinical staff either at mobile clinics or in facilities. OBJECTIVE The objective was to improve access to HIV testing to underserved KP members, increase HIV positivity rates, and link those who were confirmed HIV positive with life-saving treatment for epidemic control. METHODS A descriptive analysis of routine programmatic data was conducted from a nine-month implementation period (June 2018-March 2019) of peer assisted HIVST among FSWs, MSM, and TG in six provinces where the USAID- and PEPFAR-funded LINKAGES Burundi project worked. Chi-squared tests were used to compare case-finding rates among individuals tested through HIVST versus standard testing. RESULTS A total of 2,198 HIVST test kits were administered (1,791 FSWs, 363 MSM, 44 TG). Three hundred and sixty-six people (17%) were reactive to HIV screening (296 FSWs, 60 MSM, 10 TG); 314 (14%) were confirmed HIV positive (257 FSWs, 47 MSM, 10 TG); and 301 (96%) (251 FSWs, 40 MSM, 10 TG) of those confirmed were initiated on treatment. HIV case-finding rates were significantly higher with HIVST compared to standard testing for FSW and MSM but not TG: FSWs (14% vs. 9%, P < .001); MSM (13% vs. 4%, P < .001); and TG (23% vs. 17%, P > .10). ART initiation rates were significantly lower for MSM confirmed HIV positive through HIVST than through standard testing (85% vs. 99%, P < .001) but not among FSWs or TG (FSWs: 98% vs. 97%, P > .10; TG: 100% vs. 100%). CONCLUSIONS The results demonstrate the potential effectiveness of HIVST in identifying individuals who are living with HIV.

scholarly journals 1061. False Positive Human Immunodeficiency Virus Testing Due to Acute Hepatitis A Infection: A Case Series

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S559-S559
Author(s):  
Maria V Bandres ◽  
Daniel Mueller
Keyword(s):  
Human Immunodeficiency Virus ◽  
Acute Hepatitis ◽  
Hiv Testing ◽  
False Positive ◽  
Hepatitis A ◽  
Screening Tests ◽  
Hiv Screening ◽  
Immunodeficiency Virus ◽  
Acute Hepatitis A ◽  
Hiv 1

Abstract Background In our urban, underserved patient population, Human Immunodeficiency Virus (HIV) is hyper-endemic, and HIV screening is frequently performed. Although HIV screening tests have high specificity, false positives can occur. Numerous reasons for false positive testing have been cited, including vaccinations, autoimmune diseases, and viral infections. In 2019, Philadelphia experienced a large Hepatitis A outbreak, during which time false positive HIV screening tests were discovered. Our aim was to further describe these patients who had been diagnosed with acute Hepatitis A infection and in whom false positive HIV testing had occurred. Methods We conducted a retrospective chart review of adult patients admitted to our hospital between January 2017 and December 2019 who had a positive Hepatitis A Virus (HAV) IgM. Demographics, HIV tests, viral hepatitis tests, and liver tests were recorded. False positive HIV was defined as a positive HIV screen (p24 antigen and HIV-1 and 2 antibody combo), followed by a negative differentiation assay for HIV-1 and 2 antibodies, combined with a negative HIV PCR. Results A total of 156 unique patients were found to have acute HAV, with 138 cases identified in 2019. Of these, 3 patients had confirmed false positive HIV testing, and 1 patient had suspected false positive HIV testing (HIV-2 differentiation assay indeterminate, with very low local prevalence of HIV-2), for a false positive test rate of 2.6% (4/156). Ages ranged from 36-47 years, 3 were male, and 2 were persons who injected drugs (PWID). Three patients had prior negative HIV testing. Two patients had fevers during admission, but none of the four were febrile at the time of HIV test collection. Three patients had elevated transaminases, and two had abnormal coagulation testing. Coinfection with Hepatitis C was found in three patients. One patient had follow-up HIV testing performed, which was negative. Conclusion To our knowledge, this is the first report of false positive HIV testing related to acute HAV. Prevalence of false positives was low, but awareness can facilitate patient counseling. With low sample size, conclusions cannot be drawn about risk factors related to false positive testing. Disclosures All Authors: No reported disclosures

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