دورية أكاديمية
أعرض في EDS

Predictors of testing history and new HIV diagnosis among adult outpatients seeking care for symptoms of acute HIV infection in coastal Kenya: a cross-sectional analysis of intervention participants in a stepped-wedge HIV testing trial.

التفاصيل البيبلوغرافية
العنوان: Predictors of testing history and new HIV diagnosis among adult outpatients seeking care for symptoms of acute HIV infection in coastal Kenya: a cross-sectional analysis of intervention participants in a stepped-wedge HIV testing trial.
المؤلفون: Agutu CA; Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya. claraagutu@gmail.com., Oduor TH; Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya., Hassan AS; Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya., Mugo PM; Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya., Chege W; Prevention Sciences Program, Division of AIDS (DAIDS), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, MD, USA., de Wit TFR; Department of Global Health, Amsterdam Institute for Global Health and Development, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands., Sanders EJ; Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya.; Department of Global Health, Amsterdam Institute for Global Health and Development, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands.; Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK., Graham SM; Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya.; Departments of Global Health, Medicine, and Epidemiology, University of Washington, Seattle, USA.
المصدر: BMC public health [BMC Public Health] 2022 Feb 11; Vol. 22 (1), pp. 280. Date of Electronic Publication: 2022 Feb 11.
نوع المنشور: Clinical Trial; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 100968562 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2458 (Electronic) Linking ISSN: 14712458 NLM ISO Abbreviation: BMC Public Health Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : BioMed Central, [2001-
مواضيع طبية MeSH: HIV Infections*/diagnosis , HIV Infections*/epidemiology, Adult ; Cross-Sectional Studies ; Female ; HIV Testing ; Humans ; Infant ; Kenya/epidemiology ; Male ; Outpatients
مستخلص: Background: HIV testing is the first step to stop transmission. We aimed to evaluate HIV testing history and new diagnoses among adult outpatients in Kenya aged 18-39 years seeking care for symptoms of acute HIV infection (AHI).
Methods: The Tambua Mapema Plus study, a stepped-wedge trial, enrolled patients presenting to care at six primary care facilities with symptoms of AHI for a targeted HIV-1 nucleic acid (NA) testing intervention compared with standard provider-initiated testing using rapid antibody tests. Intervention participants underwent a questionnaire and NA testing, followed by rapid tests if NA-positive. Multinomial logistic regression was used to analyse factors associated with never testing or testing > 1 year ago ("late retesting") relative to testing ≤ 1 year ago ("on-time testers"). Logistic regression was used to analyse factors associated with new diagnosis. All analyses were stratified by sex.
Results: Of 1,500 intervention participants, 613 (40.9%) were men. Overall, 250 (40.8%) men vs. 364 (41.0%) women were late retesters, and 103 (16.8%) men vs. 50 (5.6%) women had never tested prior to enrolment. Younger age, single status, lower education level, no formal employment, childlessness, sexual activity in the past 6 weeks, and > 1 sexual partner were associated with testing history among both men and women. Intimate partner violence > 1 month ago, a regular sexual partner, and concurrency were associated with testing history among women only. New diagnoses were made in 37 (2.5%) participants (17 men and 20 women), of whom 8 (21.6%) had never tested and 16 (43.2%) were late retesters. Newly-diagnosed men were more likely to have symptoms for > 14 days, lower education level and no religious affiliation and less likely to be young, single, and childless than HIV-negative men; newly-diagnosed women were more likely to report fever than HIV-negative women. Among men, never testing was associated with fivefold increased odds (95% confidence interval 1.4-20.9) of new diagnosis relative to on-time testers in adjusted analyses.
Conclusion: Most new HIV diagnoses were among participants who had never tested or tested > 1 year ago. Strengthening provider-initiated testing targeting never testers and late retesters could decrease time to diagnosis among symptomatic adults in coastal Kenya.
Trial Registration: ClinicalTrials.gov Identifier: NCT03508908 registered on 26/04/2018.
(© 2022. The Author(s).)
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معلومات مُعتمدة: R01 AI124968 United States AI NIAID NIH HHS; P30 AI027757 United States AI NIAID NIH HHS; United Kingdom WT_ Wellcome Trust
فهرسة مساهمة: Keywords: Acute HIV; Coverage; HIV testing; Primary care
سلسلة جزيئية: ClinicalTrials.gov NCT03508908
تواريخ الأحداث: Date Created: 20220212 Date Completed: 20220419 Latest Revision: 20220531
رمز التحديث: 20221213
مُعرف محوري في PubMed: PMC8832653
DOI: 10.1186/s12889-022-12711-1
PMID: 35148720
قاعدة البيانات: MEDLINE
الوصف
تدمد:1471-2458
DOI:10.1186/s12889-022-12711-1