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Giménez-Arufe V, Rotea-Salvo S, Martínez-Pradeda A, Mena-de-Cea Á, Margusino-Framiñán L, Suanzes-Hernández J, Martín Herranz MI, Cid-Silva P. Analysing Early Diagnosis Strategies for HIV Infection: A Retrospective Study of Missed Diagnostic Opportunities. Healthcare (Basel) 2024; 12:361. [PMID: 38338246 PMCID: PMC10855914 DOI: 10.3390/healthcare12030361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/13/2024] [Accepted: 01/24/2024] [Indexed: 02/12/2024] Open
Abstract
Early diagnosis of a Human Immunodeficiency Virus (HIV)-infected person represents a cornerstone of HIV prevention, treatment, and care. Numerous publications have developed recommendations where HIV serology is indicated to reduce missed diagnostic opportunities (MDOs). This retrospective study analyses new HIV infection diagnoses and the relationship between late diagnosis (LD)/advanced HIV disease (AHD), baseline characteristics, and MDOs. Sociodemographic data and data related to contact with the health system in the 5 years before diagnosis were collected. Most of the 273 diagnoses were made in primary care (48.5%). Approximately 50.5% and 34.4% had LD and AHD criteria, respectively. Female sex was associated with a higher incidence of LD. Persons infected through the heterosexual route and those at an older age had a higher risk for LD and AHD. People with previous HIV serology presented a lower percentage of LD and AHD. In total, 10% of the health contact instances were classified as MDOs, mostly occurring in primary care. A significant increase in the median of MDOs was observed in patients with LD/AHD. Female sex and hepatitis C virus co-infection were associated with an increase in the number of MDOs. The high percentage of LD and AHD and the significant number of MDOs show that the current screening system should be improved.
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Affiliation(s)
- Víctor Giménez-Arufe
- Service of Pharmacy, Biomedical Research Institute of A Coruña (INIBIC), University Hospital of A Coruña (CHUAC), Sergas, University of A Coruña (UDC), 15006 A Coruña, Spain; (V.G.-A.); (S.R.-S.); (A.M.-P.); (L.M.-F.); (M.I.M.H.)
| | - Sandra Rotea-Salvo
- Service of Pharmacy, Biomedical Research Institute of A Coruña (INIBIC), University Hospital of A Coruña (CHUAC), Sergas, University of A Coruña (UDC), 15006 A Coruña, Spain; (V.G.-A.); (S.R.-S.); (A.M.-P.); (L.M.-F.); (M.I.M.H.)
| | - Alejandro Martínez-Pradeda
- Service of Pharmacy, Biomedical Research Institute of A Coruña (INIBIC), University Hospital of A Coruña (CHUAC), Sergas, University of A Coruña (UDC), 15006 A Coruña, Spain; (V.G.-A.); (S.R.-S.); (A.M.-P.); (L.M.-F.); (M.I.M.H.)
| | - Álvaro Mena-de-Cea
- Division of Clinical Virology, Biomedical Research Institute of A Coruña (INIBIC), University Hospital of A Coruña (CHUAC), Sergas, University of A Coruña (UDC), 15006 A Coruña, Spain;
- Service of Infectious Internal Medicine, Biomedical Research Institute of A Coruña (INIBIC), University Hospital of A Coruña (CHUAC), Sergas, University of A Coruña (UDC), 15006 A Coruña, Spain
| | - Luis Margusino-Framiñán
- Service of Pharmacy, Biomedical Research Institute of A Coruña (INIBIC), University Hospital of A Coruña (CHUAC), Sergas, University of A Coruña (UDC), 15006 A Coruña, Spain; (V.G.-A.); (S.R.-S.); (A.M.-P.); (L.M.-F.); (M.I.M.H.)
- Division of Clinical Virology, Biomedical Research Institute of A Coruña (INIBIC), University Hospital of A Coruña (CHUAC), Sergas, University of A Coruña (UDC), 15006 A Coruña, Spain;
| | - Jorge Suanzes-Hernández
- Clinical Epidemiology and Biostatistics Unit, Biomedical Research Institute of A Coruña (INIBIC), University Hospital of A Coruña (CHUAC), Sergas, University of A Coruña (UDC), 15006 A Coruña, Spain;
| | - María Isabel Martín Herranz
- Service of Pharmacy, Biomedical Research Institute of A Coruña (INIBIC), University Hospital of A Coruña (CHUAC), Sergas, University of A Coruña (UDC), 15006 A Coruña, Spain; (V.G.-A.); (S.R.-S.); (A.M.-P.); (L.M.-F.); (M.I.M.H.)
| | - Purificación Cid-Silva
- Service of Pharmacy, Biomedical Research Institute of A Coruña (INIBIC), University Hospital of A Coruña (CHUAC), Sergas, University of A Coruña (UDC), 15006 A Coruña, Spain; (V.G.-A.); (S.R.-S.); (A.M.-P.); (L.M.-F.); (M.I.M.H.)
- Division of Clinical Virology, Biomedical Research Institute of A Coruña (INIBIC), University Hospital of A Coruña (CHUAC), Sergas, University of A Coruña (UDC), 15006 A Coruña, Spain;
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De la psicosis a la ceguera: ¿glucocorticoides precozmente en la leucoencefalopatía multifocal progresiva? Neurologia 2022. [DOI: 10.1016/j.nrl.2021.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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González-Granados J, Vera-Tomé A, Calvo-Cano A, Rodríguez-Vidigal FF. From psychosis to blindness: early glucocorticoids for progressive multifocal leukoencephalopathy? NEUROLOGÍA (ENGLISH EDITION) 2022; 37:612-613. [PMID: 35527107 DOI: 10.1016/j.nrleng.2021.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 11/19/2021] [Indexed: 10/18/2022] Open
Affiliation(s)
- J González-Granados
- Servicio de Medicina Interna, Hospital Universitario de Badajoz, Badajoz, Spain.
| | - A Vera-Tomé
- Unidad de Patología Infecciosa, Hospital Universitario de Badajoz, Badajoz, Spain
| | - A Calvo-Cano
- Unidad de Patología Infecciosa, Hospital Universitario de Badajoz, Badajoz, Spain
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Agustí C, Cunillera O, Almeda J, Mascort J, Carrillo R, Olmos C, Montoliu A, Alberny M, Molina I, Cayuelas L, Casabona J. Efficacy of an electronic reminder for HIV screening in primary healthcare based on indicator conditions in Catalonia (Spain). HIV Med 2022; 23:868-879. [DOI: 10.1111/hiv.13270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 01/18/2022] [Accepted: 01/25/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Cristina Agustí
- Centre of Epidemiological Studies on Sexually Transmitted Infections and AIDS of Catalunya (CEEISCAT) Department of Health Generalitat of Catalunya Badalona Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP) Instituto de Salud Carlos III Madrid Spain
| | - Oriol Cunillera
- Institut Universitari d'Investigació en Atenció Primària (IDIAP Jordi Gol) Barcelona Spain
| | - Jesús Almeda
- Institut Universitari d'Investigació en Atenció Primària (IDIAP Jordi Gol) Barcelona Spain
- Research Support Unit Primary Health General Directorate of Costa de Ponent Catalan Institute of Health (ICS) Cornellà de Llobregat Spain
| | - Juanjo Mascort
- Catalan Society of Family and Community Medicine (CAMFiC) Barcelona Spain
- Spanish Society of Family and Community Medicine (semFYC) Barcelona Spain
- Department of Clinical Sciences Faculty of Medicine University of Barcelona (UB) Barcelona Spain
| | - Ricard Carrillo
- Catalan Society of Family and Community Medicine (CAMFiC) Barcelona Spain
- Spanish Society of Family and Community Medicine (semFYC) Barcelona Spain
| | - Carmen Olmos
- Health Department Catalan Government Barcelona Spain
| | - Alexandra Montoliu
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP) Instituto de Salud Carlos III Madrid Spain
- Unit of Infections and Cancer ‐ Information and Interventions (UNIC ‐ I&I) Cancer Epidemiology Research Program (CERP) Hospitalet de Llobregat Barcelona Spain
| | - Mireia Alberny
- Medical Management of Primary Care Servicies STI/HIV Area Catalan Institute of Health (ICS) Barcelona Spain
| | - Izarbe Molina
- Association of Family and Community Nursing of Catalonia (AIFiCC) Barcelona Spain
| | - Laia Cayuelas
- Centro de Atención Primaria Casanova Consorci d’Atenció Primària de Salut Barcelona Esquerra (CAPSBE) Barcelona Spain
| | - Jordi Casabona
- Centre of Epidemiological Studies on Sexually Transmitted Infections and AIDS of Catalunya (CEEISCAT) Department of Health Generalitat of Catalunya Badalona Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP) Instituto de Salud Carlos III Madrid Spain
- Department of Paediatrics, Obstetrics and Gynecology and Preventive Medicine Universitat Autónoma de Barcelona Badalona Spain
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Would eligible gay, bisexual and other men who have sex with men use PrEP? Awareness, knowledge, eligibility and intention to use PrEP among EMIS-2017 participants in Spain. Prev Med 2022; 156:106962. [PMID: 35065972 DOI: 10.1016/j.ypmed.2022.106962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 12/23/2021] [Accepted: 01/15/2022] [Indexed: 11/20/2022]
Abstract
Pre-exposure prophylaxis (PrEP) is an efficacious strategy for reducing the incidence of HIV infection. It has been available in Spain since 2019. We aim to report on awareness, knowledge of, intention to use, and eligibility for PrEP and related factors among participants in the European Men-Who-Have-Sex-With-Men Internet Survey (EMIS-2017) in Spain. We used Spanish data from EMIS-2017, a cross-sectional study performed among gay, bisexual, and other men who have sex with mean (GBMSM) from 50 countries. We found that 65.3% of the 10,634 participants were aware of PrEP, some 30.1% of those HIV-negative and ≥ 18 years were eligible and 52.7% of those eligible intended to use it. Regarding knowledge about PrEP, only 15.4% of the participants knew 3 statement with true information about that PrEP meant. Older age, being born in Western Europe (WE) and greater outness were associated with greater awareness. Older age, being born in Latin America or Caribbean or WE, sex work, and living in a large city were associated with greater eligibility. A greater degree of outness was associated with reduced intention to use. Our study point to possible barriers in the implementation of PrEP in Spain and similar countries.
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Gallego-Márquez N, Iniesta C. Targeting fast-track goals: Missed opportunities for HIV testing in the Community of Madrid. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2022; 40:138-141. [PMID: 34969654 DOI: 10.1016/j.eimce.2021.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 04/20/2021] [Accepted: 04/22/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION In Spain HIV testing is recommended to people with risk behaviors for HIV and with indicator conditions (IC) related to HIV infection. Missed diagnostic opportunities (MO) are defining as situations where these recommendations are not followed. OBJECTIVE To characterize MO due to risk behaviors (directed) and due to IC (indicated) among people diagnosed with HIV in the Region of Madrid. METHODS A total of 109 participants newly diagnosed with HIV were recruited from 7 health centers (April 2018-March 2019) by a telephone survey. Diagnostic opportunities were defined as any contact with the healthcare system in which an HIV test should have been carried out. Frequency of MO was calculated within the previous 2 years from HIV diagnosis. RESULTS Of the 32 directed and indicated diagnostic opportunities, 96.9% and 57.8% respectively resulted in MO. Overall, 83.8% of diagnostic opportunities resulted in MO. CONCLUSION MO, both directed and indicated, are an important area for improvement to reduce late diagnosis.
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Affiliation(s)
- Nuria Gallego-Márquez
- Unidad de Vigilancia de VIH, Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain; Master of Science in Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States
| | - Carlos Iniesta
- Unidad de Coordinación de la Cohorte de la Red de Investigación en Sida (CoRIS), Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain.
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Gallego-Márquez N, Iniesta C. Targeting fast-track goals: Missed opportunities for HIV testing in the Community of Madrid. Enferm Infecc Microbiol Clin 2021; 40:S0213-005X(21)00181-6. [PMID: 34112557 DOI: 10.1016/j.eimc.2021.04.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 04/20/2021] [Accepted: 04/22/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION In Spain HIV testing is recommended to people with risk behaviors for HIV and with indicator conditions related to HIV infection. Missed diagnostic opportunities (MO) are defining as situations where these recommendations are not followed. OBJECTIVE To characterize MO due to risk behaviors (directed) and due to indicator conditions (indicated) among people diagnosed with HIV in the Region of Madrid. METHODS A total of 109 participants newly diagnosed with HIV were recruited from 7 health centers (April 2018-March 2019) by a telephone survey. Diagnostic opportunities were defined as any contact with the healthcare system in which an HIV test should have been carried out. Frequency of MO was calculated within the previous 2 years from HIV diagnosis. RESULTS Of the 32 directed and indicated diagnostic opportunities, 96.9 and 57.8% respectively resulted in MO. Overall, 83.8% of diagnostic opportunities resulted in MO. CONCLUSION MO, both directed and indicated, are an important area for improvement to reduce late diagnosis.
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Affiliation(s)
- Nuria Gallego-Márquez
- Unidad de Vigilancia de VIH, Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, España; Master of Science in Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, EE. UU
| | - Carlos Iniesta
- Unidad de coordinación de la Cohorte de la Red de Investigación en Sida (CoRIS), Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, España.
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Akinosoglou K, Kostaki EG, Paraskevis D, Gogos CA. Assessment of HIV testing recommendations in Greek specialty guidelines: A missed opportunity and room for improvement for recommending testing. AIDS Care 2021; 33:1312-1315. [PMID: 33678071 DOI: 10.1080/09540121.2021.1876837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
HIV testing for individuals presenting with indicator conditions (ICs) including AIDS-defining conditions (ADCs) is explicitly recommended by European guidelines. We aimed to review specialty guidelines in Greece and assess if HIV was discussed and testing recommended. We reviewed European guidelines to produce a list of 25 ADCs and 48 ICs. We identified Greek guidelines for 11 of 25 (44%) ADCs and 30 of 48 (63%) ICs. In total, 47 guidelines were reviewed (range: 1-6 per condition); 11 (23%) for ADCs and 36 (77%) for ICs. Association with HIV was discussed in 7 of 11 (64%) ADC and 8 of 36 IC guidelines (22%), whereas HIV testing was appropriately recommended in two of 11 ADC (18%) and 10 of 36 IC guidelines (28%). Significant differences were found for the distribution of recommendations to test in both types of condition, with ICs having higher percentage of non-recommendation (50%, p < 0.05). No association was found between source of guideline or publication year and testing recommendation. Most guidelines for ICs and ADCs do not recommend testing. Specialists managing most ICs and ADCs may be unaware of the actual prevalence of undiagnosed HIV infection among their patients or the respective recommendations produced by HIV societies.
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Affiliation(s)
- Karolina Akinosoglou
- Department of Internal Medicine and Infectious Diseases, University General Hospital of Patras, Patra, Greece
| | - Evangelia Georgia Kostaki
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Paraskevis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Charalambos A Gogos
- Department of Internal Medicine and Infectious Diseases, University General Hospital of Patras, Patra, Greece
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Basoulis D, Kostaki EG, Paraskevis D, Hatzakis A, Psichogiou M. Tracking missed opportunities for an early HIV diagnosis in a population of people living with HIV with known time of infection. Sex Transm Infect 2021; 98:79-84. [PMID: 33608478 DOI: 10.1136/sextrans-2020-054697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 12/09/2020] [Accepted: 01/30/2021] [Indexed: 11/03/2022] Open
Abstract
PURPOSE The goal of 90-90-90 first requires the expansion of access to HIV testing. Our aim was to record frequencies of HIV indicator conditions (ICs) and identify missed opportunities for an early HIV diagnosis. METHODS We retrospectively identified ICs in a population of 231 people living with HIV with known infection dates who attended our clinic. The study population was divided into four groups: (1) those self-tested pre-emptively (47/231, 20.3%), (2) those offered targeted testing based on risk factors (67/231, 29%), (3) those tested after an IC (73/231, 31.6%) and (4) those who were not offered testing after an IC (44/231, 19%). HIV acquisition dates were estimated by molecular clock analysis. RESULTS A total of 169 healthcare contacts (HCCs) were recorded. The most frequent HCC was mononucleosis-like syndrome (20.1%), unexplained weight loss (10.7%) and STIs (10.1%). AIDS-defining conditions were detected in 11.8%. Only 62.4% (73/117) of those with an IC were offered testing after their first HCC. Patients in group 4 had statistically significant delay in diagnosis compared with group 3 (109.1 weeks (IQR 56.4-238.6) vs 71.6 weeks (IQR 32.3-124.6)). The proportion of patients diagnosed as late presenters in each group was: (1) 16/47 (34%), (2) 37/67 (55.2%), (3) 43/73 (58.9%) and (4) 27/44 (61.4%) (p=0.027). CONCLUSIONS Our study uses a combination of molecular and clinical data and shows evidence that late presentation occurs in a high proportion of patients even in the presence of an IC. Given that risk-based targeted testing has low coverage, IC-guided testing provides a reasonable alternative to facilitate earlier HIV diagnosis and to improve late diagnosis across Europe and globally.
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Affiliation(s)
- Dimitrios Basoulis
- 1st Internal Medicine Department, Laiko General Hospital, National and Kapodistrian University of Athens, Athens, Attica, Greece
| | - Evangelia Georgia Kostaki
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens School of Health Sciences, Athens, Greece
| | - Dimitrios Paraskevis
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens School of Health Sciences, Athens, Greece
| | - Angelos Hatzakis
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens School of Health Sciences, Athens, Greece
| | - Mina Psichogiou
- 1st Internal Medicine Department, Laiko General Hospital, National and Kapodistrian University of Athens, Athens, Attica, Greece
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Marih L, Sawras V, Pavie J, Sodqi M, Malmoussi M, Tassi N, Bensghir R, Nani S, Lahsen AO, Laureillard D, El Filali KM, Champenois K, Weiss L. Missed opportunities for HIV testing in patients newly diagnosed with HIV in Morocco. BMC Infect Dis 2021; 21:48. [PMID: 33430783 PMCID: PMC7802172 DOI: 10.1186/s12879-020-05711-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 12/15/2020] [Indexed: 12/20/2022] Open
Abstract
Background In Morocco, of the estimated 29,000 people living with HIV in 2011, only 20% were aware of their HIV status. More than half of diagnoses were at the AIDS stage. We assumed that people who were unaware of their infection had contacts with the healthcare system for HIV indicators that might prompt the healthcare provider to offer a test. The aim was to assess missed opportunities for HIV testing in patients newly diagnosed with HIV who accessed care in Morocco. Methods A cross-sectional study was conducted in 2012–2013 in six Moroccan HIV centers. Participants were aged ≥18, and had sought care within 6 months after their HIV diagnosis. A standardized questionnaire administered during a face-to-face interview collected the patient’s characteristics at HIV diagnosis, HIV testing and medical history. Contacts with care and the occurrence of clinical conditions were assessed during the 3 years prior to HIV diagnosis. Over this period, we assessed whether healthcare providers had offered HIV testing to patients with HIV-related clinical or behavioral conditions. Results We enrolled 650 newly HIV-diagnosed patients (median age: 35, women: 55%, heterosexuals: 81%, diagnosed with AIDS or CD4 < 200 cells/mm3: 63%). During the 3 years prior to the HIV diagnosis, 71% (n = 463) of participants had ≥1 contact with the healthcare system. Of 323 people with HIV-related clinical conditions, 22% did not seek care for them and 9% sought care and were offered an HIV test by a healthcare provider. The remaining 69% were not offered a test and were considered as missed opportunities for HIV testing. Of men who have sex with men, 83% did not address their sexual behavior with their healthcare provider, 11% were not offered HIV testing, while 6% were offered HIV testing after reporting their sexual behavior to their provider. Conclusions Among people who actually sought care during the period of probable infection, many opportunities for HIV testing, based on at-risk behaviors or clinical signs, were missed. This highlights the need to improve the recognition of HIV clinical indicators by physicians, further expand community-based HIV testing by lay providers, and implement self-testing to increase accessibility and privacy. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-020-05711-2.
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Affiliation(s)
- Latifa Marih
- Service des maladies infectieuses, Centre Hospitalier Universitaire Ibn Rochd, Casablanca, Morocco
| | - Victoire Sawras
- Inserm, IAME, UMR 1137, Paris, France.,Université Paris Nord, Sorbonne Paris Cité, Paris, France.,Hôpital Bichat Claude Bernard, AP-HP, Paris, France
| | - Juliette Pavie
- Service d'Immunologie Clinique, Hôpital Européen Georges Pompidou, AP-HP, INSERM UMR 1149, 20, rue Leblanc, 75015, Paris, France
| | - Mustapha Sodqi
- Service des maladies infectieuses, Centre Hospitalier Universitaire Ibn Rochd, Casablanca, Morocco
| | - Mourad Malmoussi
- Service des maladies infectieuses, Hôpital Hassan II, Agadir, Morocco
| | - Noura Tassi
- Service des maladies infectieuses, Centre Hospitalier Universitaire Mohamed VI, Marrakech, Morocco
| | - Rajaa Bensghir
- Service des maladies infectieuses, Centre Hospitalier Universitaire Ibn Rochd, Casablanca, Morocco
| | - Samira Nani
- Laboratoire d'épidémiologie, Faculté de Médecine et de Pharmacie, Casablanca, Morocco
| | - Ahd Oulad Lahsen
- Service des maladies infectieuses, Centre Hospitalier Universitaire Ibn Rochd, Casablanca, Morocco
| | | | - Kamal Marhoum El Filali
- Service des maladies infectieuses, Centre Hospitalier Universitaire Ibn Rochd, Casablanca, Morocco
| | - Karen Champenois
- Inserm, IAME, UMR 1137, Paris, France.,Université Paris Nord, Sorbonne Paris Cité, Paris, France.,Hôpital Bichat Claude Bernard, AP-HP, Paris, France
| | - Laurence Weiss
- Service d'Immunologie Clinique, Hôpital Européen Georges Pompidou, AP-HP, INSERM UMR 1149, 20, rue Leblanc, 75015, Paris, France. .,Université Paris Descartes, Sorbonne Paris Cité, INSERM U976, 20, rue Leblanc, 75015, Paris, France.
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Del Amo J, Iniesta C. Missed opportunities within the health system for the diagnosis of HIV infection in MSM in Spain: Greater commitment and action is required. Enferm Infecc Microbiol Clin 2018; 36:463-464. [PMID: 29958707 DOI: 10.1016/j.eimc.2018.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 06/11/2018] [Indexed: 10/28/2022]
Affiliation(s)
- Julia Del Amo
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, España; CIBERESP, Instituto de Salud Carlos III, España.
| | - Carlos Iniesta
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, España; CIBERESP, Instituto de Salud Carlos III, España
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