Misdiagnosis of HIV infection during a South African community-based survey: implications for rapid HIV testing

Objectives. This article describes the demographic and behavioral characteristics, human immunodeficiency virus (HIV) testing history, and results of HIV testing of transgender (TG) people recruited for rapid HIV testing by community-based organizations (CBOs) in three cities. Methods. CBOs in Miami Beach, Florida, New York City, and San Francisco offered TG people rapid HIV testing and prevention services, and conducted a brief survey. Participants were recruited in outreach settings using various strategies. The survey collected information on demographic characteristics, HIV risk behaviors, and HIV testing history. Results. Among 559 male-to-female (MTF) TG participants, 12% were newly diagnosed with HIV infection. None of the 42 female-to-male participants were newly diagnosed with HIV. A large proportion of MTF TG participants reported high-risk behaviors in the past year, including 37% who reported unprotected receptive anal intercourse and 44% who reported commercial sex work. Several factors were independently associated with increased likelihood of being newly diagnosed with HIV infection among MTF TG participants, including having a partner of unknown HIV status in the past year; being 20–29 or ≥40 years of age; having last been tested for HIV more than 12 months ago; and having been recruited at the New York City site. Conclusions. Based on the high proportion of undiagnosed HIV infection among those tested, TG people represent an important community for enhanced HIV testing and prevention efforts. MTF TG people should be encouraged to have an HIV test at least annually or more often if indicated, based upon clinical findings or risk behaviors. Efforts should continue for developing novel strategies to overcome barriers and provide HIV testing and prevention services to TG people.

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Mental health intervention with premature infants and their mothers in a South African community based hospital

PsycEXTRA Dataset ◽

10.1037/e579192013-368 ◽

2012 ◽

Author(s):

S. Maharaj ◽

J. Koursaris

Keyword(s):

Mental Health ◽

South African ◽

Premature Infants ◽

Health Intervention ◽

Mental Health Intervention ◽

Community Based ◽

African Community

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High percentage of undiagnosed HIV cases within a hyperendemic South African community: a population-based study

Journal of Epidemiology & Community Health ◽

10.1136/jech-2017-209713 ◽

2017 ◽

Vol 72 (2) ◽

pp. 168-172 ◽

Cited By ~ 12

Author(s):

Alain Vandormael ◽

Tulio de Oliveira ◽

Frank Tanser ◽

Till Bärnighausen ◽

Joshua T Herbeck

Keyword(s):

Hiv Testing ◽

South African ◽

Hiv Infections ◽

Population Based ◽

Hiv Positive ◽

Aids Epidemic ◽

Undiagnosed Hiv ◽

African Community ◽

Repeat Hiv Testing ◽

High Level

BackgroundUndiagnosed HIV infections could undermine efforts to reverse the global AIDS epidemic by 2030. In this study, we estimated the percentage of HIV-positive persons who remain undiagnosed within a hyperendemic South African community.MethodsThe data come from a population-based surveillance system located in the Umkhanyakude district of the northern KwaZulu-Natal province, South Africa. We annually tested 38 661 adults for HIV between 2005 and 2016. Using the HIV-positive test results of 12 039 (31%) participants, we then back-calculated the incidence of infection and derived the number of undiagnosed cases from this result.ResultsThe percentage of undiagnosed HIV cases decreased from 29.3% in 2005 to 15.8% in 2011. During this period, however, approximately 50% of the participants refused to test for HIV, which lengthened the average time from infection to diagnosis. Consequently, the percentage of undiagnosed HIV cases reversed direction and steadily increased from 16.1% to 18.9% over the 2012–2016 period.ConclusionsResults from this hyperendemic South African setting show that the HIV testing rate is low, with long infection times, and an unsatisfactorily high percentage of undiagnosed cases. A high level of repeat HIV testing is needed to minimise the time from infection to diagnosis if the global AIDS epidemic is to be reversed within the next two decades.

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Incorporating Rapid HIV Testing into Partner Counseling and Referral Services

Public Health Reports ◽

10.1177/00333549081230s315 ◽

2008 ◽

Vol 123 (3_suppl) ◽

pp. 126-135 ◽

Cited By ~ 10

Author(s):

Elin B. Begley ◽

Alexandra M. Oster ◽

Binwei Song ◽

Linda Lesondak ◽

Kelly Voorhees ◽

...

Keyword(s):

High Risk ◽

Hiv Infection ◽

Hiv Testing ◽

The United States ◽

High Risk Population ◽

Newly Diagnosed ◽

Infected People ◽

Rapid Hiv Testing ◽

Undiagnosed Hiv ◽

Locating Information

Objectives. Partner counseling and referral services (PCRS) provide a unique opportunity to decrease transmission of human immunodeficiency virus (HIV) by notifying sex and drug-injection partners of HIV-infected individuals of their exposure to HIV. We incorporated rapid HIV testing into PCRS to reduce barriers associated with conventional HIV testing and identify undiagnosed HIV infection within this high-risk population. Methods. From April 2004 through June 2006, HIV-infected people (index clients) were interviewed, and their partners were notified of their potential exposure to HIV and offered rapid HIV testing at six sites in the United States. The numbers of index clients participating and the numbers of partners interviewed and tested were compared by site. Descriptive and bivariate analyses were performed. Results. A total of 2,678 index clients were identified, of whom 779 (29%) provided partner locating information. A total of 1,048 partners were elicited, of whom 463 (44%) were both interviewed and tested for HIV. Thirty-seven partners (8%) were newly diagnosed with HIV. The number of index clients interviewed to identify one partner with newly diagnosed HIV infection ranged from 10 to 137 at the participating sites. Conclusions. PCRS provides testing and prevention services to people at high risk for HIV infection. Incorporating rapid HIV testing into PCRS and identifying previously undiagnosed infections likely confer individual and public health benefits. Further evaluation is needed to determine the best methods of identifying partners with previously unrecognized HIV infection.

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P179 Community based local rapid HIV testing campaigns to expand HIV diagnostic coverage

10.1136/sextrans-2019-sti.334 ◽

2019 ◽

Author(s):

Ana Amélia Bones ◽

Mcarthur Barrow ◽

Carlos Andres Casas ◽

Marina Dias ◽

Gabriela Storck ◽

...

Keyword(s):

Hiv Testing ◽

Community Based ◽

Rapid Hiv Testing

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Community-based rapid HIV testing in homeless and marginally housed adults in San Francisco

HIV Medicine ◽

10.1111/j.1468-1293.2007.00423.x ◽

2007 ◽

Vol 8 (1) ◽

pp. 28-31 ◽

Cited By ~ 38

Author(s):

JB Buchér ◽

KM Thomas ◽

D Guzman ◽

E Riley ◽

N Dela Cruz ◽

...

Keyword(s):

Hiv Testing ◽

San Francisco ◽

Community Based ◽

Rapid Hiv Testing ◽

Marginally Housed

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HIV Testing Rates and Outcomes in a South African Community, 2001-2006: Implications for Expanded Screening Policies

JAIDS Journal of Acquired Immune Deficiency Syndromes ◽

10.1097/qai.0b013e3181a248e6 ◽

2009 ◽

Vol 51 (3) ◽

pp. 310-316 ◽

Cited By ~ 32

Author(s):

Michael D April ◽

Rochelle P Walensky ◽

Yuchiao Chang ◽

Jennifer Pitt ◽

Kenneth A Freedberg ◽

...

Keyword(s):

Hiv Testing ◽

South African ◽

African Community

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Prevalence and characteristics of hearing and vision loss in preschool children from low income South African communities: results of a screening program of 10,390 children

BMC Pediatrics ◽

10.1186/s12887-021-03095-z ◽

2022 ◽

Vol 22 (1) ◽

Author(s):

Susan Eksteen ◽

Robert H. Eikelboom ◽

Hannah Kuper ◽

Stefan Launer ◽

De Wet Swanepoel

Keyword(s):

Hearing Loss ◽

Preschool Children ◽

South African ◽

Vision Loss ◽

Screening Program ◽

Vision Screening ◽

Community Based ◽

Sensory Impairments ◽

African Community

Abstract Background The majority of children with sensory impairments live in low- and middle-income countries. More studies of hearing and vision impairment prevalence are needed, in order to generate more accurate estimates of trends in sensory impairments. This study aimed to estimate the prevalence and describe the characteristics of hearing and vision loss among preschool children (4–7 years) in an underserved South African community following community-based mobile health (mHealth) supported hearing and vision services. Methods A screening program of sensory impairments was undertaken of children attending preschools in the communities of Khayelitsha and Mitchell’s Plain, Cape Town, from September 2017 until June 2019. Hearing and vision screening were done by trained community health workers using mHealth technology. Children who failed hearing and vision screening were seen for follow-up assessments at their preschools. Follow-up assessments were conducted using smartphones that host point-of-care validated and calibrated hearing and vision testing applications (hearTest app, hearX Group, South Africa and PeekAcuity app, Peek Vision, United Kingdom). Descriptive statistical analysis and logistic regression analysis were conducted after extracting data from a secure cloud-based server (mHealth Studio, hearX Group) to Microsoft Excel (2016). Results A total of 10,390 children were screened at 298 preschools over 22 months. Of the children screened, 5.6 and 4.4% of children failed hearing and vision screening respectively. Community-based follow-up hearing tests were done at the preschools on 88.5% (514) of children of whom 240 children (54.2% female) presented with hearing loss. A preschool-based follow-up vision test was done on 400 children (88.1%). A total of 232 children (46.1% female) had a vision impairment, and a further 32 children passed the test but had obvious signs of ocular morbidity. Logistic regression analysis found that age was a significant predictor of vision loss (p < 0.05), but not for hearing loss (p = 0.06). Gender was not a significant predictor of hearing (p = 0.22) or vision loss (p = 0.20). Conclusions Hearing loss is prevalent in at least 22 per 1000 and vision loss in at least 23 per 1000 preschool children in an underserved South African community. Timely identification of sensory losses can be facilitated through community-based hearing and vision services supported by mHealth technology.

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