دورية أكاديمية
A randomized controlled trial evaluating combination detection of HIV in Malawian sexually transmitted infections clinics.
| العنوان: | A randomized controlled trial evaluating combination detection of HIV in Malawian sexually transmitted infections clinics. |
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| المؤلفون: | Chen JS; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA., Matoga M; UNC Project Malawi, Lilongwe, Malawi., Pence BW; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA., Powers KA; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA., Maierhofer CN; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA., Jere E; UNC Project Malawi, Lilongwe, Malawi., Massa C; UNC Project Malawi, Lilongwe, Malawi., Khan S; UNC Project Malawi, Lilongwe, Malawi., Rutstein SE; Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA., Phiri S; Lighthouse Trust, Lilongwe, Malawi., Hosseinipour MC; Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA., Cohen MS; Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA., Hoffman IF; Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA., Miller WC; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.; Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, USA., Lancaster KE; Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, USA. |
| المصدر: | Journal of the International AIDS Society [J Int AIDS Soc] 2021 Apr; Vol. 24 (4), pp. e25701. |
| نوع المنشور: | Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: John Wiley & Sons, Inc Country of Publication: Switzerland NLM ID: 101478566 Publication Model: Print Cited Medium: Internet ISSN: 1758-2652 (Electronic) Linking ISSN: 17582652 NLM ISO Abbreviation: J Int AIDS Soc Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2017- : Hoboken, NJ : John Wiley & Sons, Inc Original Publication: [London] : BioMed Central |
| مواضيع طبية MeSH: | Contact Tracing* , Standard of Care*, HIV Infections/*diagnosis , Mass Screening/*methods , Sexually Transmitted Diseases/*diagnosis, Adult ; Female ; HIV Infections/epidemiology ; Humans ; Malawi ; Male ; Sexual Behavior ; Sexual Partners ; Sexually Transmitted Diseases/epidemiology |
| مستخلص: | Introduction: HIV diagnosis is the necessary first step towards HIV care initiation, yet many persons living with HIV (PLWH) remain undiagnosed. Employing multiple HIV testing strategies in tandem could increase HIV detection and promote linkage to care. We aimed to assess an intervention to improve HIV detection within socio-sexual networks of PLWH in two sexually transmitted infections (STI) clinics in Lilongwe, Malawi. Methods: We conducted a randomized controlled trial to evaluate an intervention combining acute HIV infection (AHI) screening, contract partner notification and social contact referral versus the Malawian standard of care: serial rapid serological HIV tests and passive partner referral. Enrolment occurred between 2015 and 2019. HIV-seropositive persons (two positive rapid tests) were randomized to the trial arms and HIV-seronegative (one negative rapid test) and -serodiscordant (one positive test followed by a negative confirmatory test) persons were screened for AHI with HIV RNA testing. Those found to have AHI were offered enrolment into the intervention arm. Our primary outcome of interest was the number of new HIV diagnoses made per index participant within participants' sexual and social networks. We also calculated total persons, sexual partners and PLWH (including those previously diagnosed) referred per index participant. Results: A total of 1230 HIV-seropositive persons were randomized to the control arm, and 561 to the intervention arm. Another 12,713 HIV-seronegative or -serodiscordant persons underwent AHI screening, resulting in 136 AHI cases, of whom 94 enrolled into the intervention arm. The intervention increased the number of new HIV diagnoses made per index participant versus the control (ratio: 1.9; 95% confidence interval (CI): 1.2 to 3.1). The intervention also increased the numbers of persons (ratio: 2.5; 95% CI: 2.0 to 3.2), sexual partners (ratio: 1.7; 95% CI: 1.4 to 2.0) and PLWH (ratio: 2.3; 95% CI: 1.7 to 3.2) referred per index participant. Conclusions: Combining three distinct HIV testing and referral strategies increased the detection of previously undiagnosed HIV infections within the socio-sexual networks of PLWH seeking STI care. Combination HIV detection strategies that leverage AHI screening and socio-sexual contact networks offer a novel and efficacious approach to increasing HIV status awareness. (© 2021 The Authors. Journal of the International AIDS Society published by John Wiley & Sons Ltd on behalf of International AIDS Society.) |
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| معلومات مُعتمدة: | D43 TW010060 United States TW FIC NIH HHS; R01 AI114320 United States AI NIAID NIH HHS; R01 DK108424 United States DK NIDDK NIH HHS; T32 AI070114 United States AI NIAID NIH HHS |
| فهرسة مساهمة: | Keywords: Africa; HIV care continuum; HIV epidemiology; clinical trials; sexually transmitted infections/diseases |
| سلسلة جزيئية: | ClinicalTrials.gov NCT02467439 |
| تواريخ الأحداث: | Date Created: 20210430 Date Completed: 20210916 Latest Revision: 20240401 |
| رمز التحديث: | 20240401 |
| مُعرف محوري في PubMed: | PMC8085969 |
| DOI: | 10.1002/jia2.25701 |
| PMID: | 33929094 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1758-2652 |
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| DOI: | 10.1002/jia2.25701 |