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Marinho FLDO, Santos NLDL, Neves SPF, Vasconcellos LDS. Performance evaluation of eight rapid tests to detect HIV infection: A comparative study from Brazil. PLoS One 2020; 15:e0237438. [PMID: 32790799 PMCID: PMC7425957 DOI: 10.1371/journal.pone.0237438] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 07/27/2020] [Indexed: 11/19/2022] Open
Abstract
Rapid tests (RTs), also known as point-of-care tests, usually release results within 30 minutes with no need for a qualified staff, equipment, or laboratory structure. The Brazilian Ministry of Health published a resolution in 2013, recommending the use of RTs for the diagnosis of HIV infection, where one positive RT must be followed by another different RT. This was meant to increase the chance of proper diagnosis in specific settings and special populations. However, data comparing and validating the different HIV RTs available in Brazil are scarce. Therefore, the present study seeks to evaluate eight anti-HIV RTs available in the Brazilian market regarding their analytical performance: sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios, and accuracy. We also evaluated the agreement between kits (Kappa index) and the quality of the reading pattern of the tests. This was an observational, analytical, and concordance study, in which previously defined positive and negative samples, based on their serological pattern for anti-HIV antibodies (chemiluminescent immunoassay-ECLIA-used as screening and Western Blot used as the confirmatory test) were tested. Analytical performance and Kappa index were calculated, considering a 95% CI and p<0.05. This study identified differences in the performances of the eight tested kits. Six out of eight RTs showed good performance and can be used in the routine laboratory and health care units as screening tests. Regarding the quality of the RT band reading pattern, two brands had several samples showing quite faint bands, thus compromising its use in clinical and laboratory settings.
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Affiliation(s)
- Feliciana Lage de Oliveira Marinho
- Department of Complementary Propaedeutic & Post-Graduate Program in Pathology, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Instituto Hermes Pardini SA, Vespasiano, Minas Gerais, Brazil
- Research Group on Clinical Pathology/Laboratory Medicine, School of Medicine, Universidade Federal de Minas Gerais (GPPCML—CNPq), Belo Horizonte, Minas Gerais, Brazil
| | | | - Suzane Pretti Figueiredo Neves
- Department of Complementary Propaedeutic & Post-Graduate Program in Pathology, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Leonardo de Souza Vasconcellos
- Department of Complementary Propaedeutic & Post-Graduate Program in Pathology, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Research Group on Clinical Pathology/Laboratory Medicine, School of Medicine, Universidade Federal de Minas Gerais (GPPCML—CNPq), Belo Horizonte, Minas Gerais, Brazil
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Teva I, de Araújo LF, de la Paz Bermúdez M. Knowledge and Concern about STIs/HIV and Sociodemographic Variables Associated with Getting Tested for HIV Among the General Population in Spain. THE JOURNAL OF PSYCHOLOGY 2018; 152:290-303. [PMID: 29652613 DOI: 10.1080/00223980.2018.1451815] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
HIV testing is important in terms of prevention and treatment. However, HIV testing rates in the Spanish general population remains low. Therefore, HIV testing promotion constitutes a key issue. A high level of knowledge about HIV/AIDS is associated with having been tested for HIV. The general aim of this study was to determine the prevalence of people who had ever been tested for HIV in Spain. The sample consisted of 1,106 participants from the general population - 60.0% females and 40.0% males - aged between 17 and 55 years old. The assessment instruments were a questionnaire on sociodemographic data and HIV testing, a scale of knowledge about STIs and HIV/AIDS, and a scale of concern about STIs/HIV. Results showed that greater knowledge about STIs and HIV was associated with a greater likelihood of being tested for HIV (OR = .77; 95.0% CI = .73-.82; p < .05). In addition, higher concern about HIV/AIDS decreased the likelihood of not having been tested for HIV (OR = .87; 95.0% CI = .83-.92; p < .05). In fact, the higher participants concern about STIs was, the lower their likelihood of not having been tested for HIV was (OR = .87; 95.0% CI = .83-.91; p < .05). It is necessary to promote HIV testing in the general population as well as to consider their socio-demographic and psychological characteristics.
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Domínguez-Berjón MF, Pichiule-Castañeda M, García-Riolobos MC, Esteban-Vasallo MD, Arenas-González SM, Morán-Arribas M, Verdejo-Ortés J, Zoni AC, Álvarez-Castillo MC, Astray J. A feasibility study for 3 strategies promoting HIV testing in primary health care in Madrid, Spain (ESTVIH project). J Eval Clin Pract 2017; 23:1408-1414. [PMID: 28971579 DOI: 10.1111/jep.12813] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Revised: 07/23/2017] [Accepted: 07/24/2017] [Indexed: 11/27/2022]
Abstract
RATIONALE AND OBJECTIVES Late diagnosis of HIV infection is a public health problem. Framed by the international guidelines for improving HIV testing, in 2014, the Spanish Ministry of Health published a guide of recommendations to promote early diagnosis of HIV in health care settings. In the Community of Madrid, in order to implement these recommendations, we defined 3 new HIV testing strategies in primary health care. The objectives of this study were to know the interest of professionals and the acceptability for patients towards these strategies. METHODS We performed a quasi-experimental study to assess the feasibility of the implementation of new strategies (indicator condition, risk based, and universal offer) to promote early detection of HIV infection in the framework of the ESTVIH project. The centres participating in this project were randomly chosen among centres located in the health areas with the highest incidence of HIV infection. The feasibility was assessed in 6 centres. We considered outcomes by strategy in relation to the participation of professionals (family physician and nursing) and patients. RESULTS Overall, 56.9% of eligible professionals agreed to take part in the study; however, the percentage of professionals who recruited patients was 25.9%. This percentage was higher in the indicator condition strategy (47.2%, versus 18.5% in the universal offer and 14.3% in the risk-based strategy, P-value < 0.05). The test uptake percentage was greater than 80%, and there were no statistically significant differences between strategies. CONCLUSION Different strategies promoting HIV testing in primary care had different acceptability among professionals and similar among patients. At the end of the ESTVIH project, these results will be complemented with others related to the contribution of each strategy to improving the early diagnosis of HIV infection.
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Affiliation(s)
| | | | | | | | | | | | - José Verdejo-Ortés
- Public Health Directorate, Madrid Regional Health Authority, Madrid, Spain
| | - Ana Clara Zoni
- Public Health Directorate, Madrid Regional Health Authority, Madrid, Spain
| | | | - Jenaro Astray
- Public Health Directorate, Madrid Regional Health Authority, Madrid, Spain
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Ankrah DNA, Lartey M, Mantel-Teeuwisse AK, Leufkens HGM. Five-year trends in treatment changes in an adult cohort of HIV/AIDS patients in Ghana: a retrospective cohort study. BMC Infect Dis 2017; 17:664. [PMID: 28969591 PMCID: PMC5625598 DOI: 10.1186/s12879-017-2752-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 09/21/2017] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND There is limited information on patterns of treatment change among new initiators of highly active antiretroviral therapy (HAART) in the regions most affected by HIV/AIDS. This makes it difficult to identify the determinants of treatment change. In this retrospective cohort study, we examined treatment change patterns over a five-year period among initiators of HAART. METHODS De-identified data were obtained from the Fevers' Unit Database at the Korle-Bu Teaching Hospital. All adult treatment-naive patients who started treatment with first line HAART between 1st January, 2008 and 31st December, 2012 were followed over a minimum period of three months. The main outcome was the first treatment change, defined as the first substitution/switch in accordance with the standard treatment guidelines. Data were analyzed stratified by year of treatment initiation. Crude and adjusted hazard ratios were calculated. RESULTS A total of 3933 patients were followed with almost equal numbers of initiators per year. The mean age (standard deviation) at treatment initiation was 39 (10.3) years. The most prescribed HAART combination was AZT/3TC/EFV and overall for initiators zidovudine combination therapy was about 60%. Utilization of stavudine containing HAART increased gradually until 2010 and then dropped to zero. Over the study period, 44.9% of recorded deaths were from those initiated with a stavudine backbone, 41.1% from a zidovudine backbone, and 11.5% from a tenofovir backbone. Females had a significantly higher rate of treatment change compared to males (p-value = 0.0002), and d4T/3TC/EFV and d4T/3TC/NVP recorded independent treatment change hazard ratios of 12.05 (CI 9.58 to 15.16) and 12.03 (CI 9.27 to 15.61) respectively.. Kaplan-Meier curves showed that treatment change was higher among those who started treatment later in the study period compared with those who started earlier. CONCLUSION A major treatment change in the utilization of antiretroviral medicines in Ghana occurred during the study period which was associated with type of treatment, year of treatment, gender and disease stage. The influence of a policy change during the period may have made a significant impact.. For diseases involving life-long treatment in particular, it is important to monitor and periodically evaluation treatment utilization patterns.
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Affiliation(s)
- Daniel N. A. Ankrah
- Korle-Bu Teaching Hospital, P. O. Box 77, Korle-Bu, Accra, Ghana
- Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), PO Box 80082, 3508 TB Utrecht, the Netherlands
| | - Margaret Lartey
- Korle-Bu Teaching Hospital, P. O. Box 77, Korle-Bu, Accra, Ghana
- University of Ghana Medical School, P. O. Box GP, 4236 Accra, Ghana
| | - Aukje K. Mantel-Teeuwisse
- Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), PO Box 80082, 3508 TB Utrecht, the Netherlands
| | - Hubert G. M. Leufkens
- Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), PO Box 80082, 3508 TB Utrecht, the Netherlands
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Borsci S, Buckle P, Hanna GB. Why you need to include human factors in clinical and empirical studies ofin vitropoint of care devices? Review and future perspectives. Expert Rev Med Devices 2016; 13:405-16. [DOI: 10.1586/17434440.2016.1154277] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Bottero J, Boyd A, Gozlan J, Carrat F, Nau J, Pauti MD, Rougier H, Girard PM, Lacombe K. Simultaneous Human Immunodeficiency Virus-Hepatitis B-Hepatitis C Point-of-Care Tests Improve Outcomes in Linkage-to-Care: Results of a Randomized Control Trial in Persons Without Healthcare Coverage. Open Forum Infect Dis 2015; 2:ofv162. [PMID: 26668814 PMCID: PMC4676801 DOI: 10.1093/ofid/ofv162] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 10/15/2015] [Indexed: 01/05/2023] Open
Abstract
In this randomized-control trial, conducted at a free clinic in France for predominately immigrant populations without healthcare, we demonstrate that simultaneous HIV/HBV/HCV point-of-care rapid testing improves screening outcomes. Increased awareness of infection status likely helped link these patients to care. Background. In Europe and the United States, more than two thirds of individuals infected with hepatitis B virus (HBV) or hepatitis C virus (HCV) and 15%–30% of human immunodeficiency virus (HIV)-positive individuals are unaware of their infection status. Simultaneous HIV-, HBV-, and HCV-rapid tests could help improve infection awareness and linkage-to-care in particularly vulnerable populations. Methods. The OptiScreen III study was a single-center, randomized, control trial conducted at a free clinic (“Médecins du Monde”, Paris, France). Participants were randomized 1:1 to receive 1 of 2 interventions testing for HIV, HBV, and HCV: standard serology-based testing (S-arm) or point-of-care rapid testing (RT-arm). The main study endpoints were the proportion of participants who became aware of their HIV, HBV, and HCV status and who were linked to care when testing positive. Results. A total of 324 individuals, representing mainly African immigrants, were included. In the S-arm, 115 of 162 (71.0%) participants performed a blood draw and 104 of 162 (64.2%) retrieved their test result. In comparison, 159 of 162 (98.2%) of participants randomized to the RT-arm obtained their results (P < .001). Of the 38 (11.7%) participants testing positive (HIV, n = 7; HBV, n = 23; HCV, n = 8), 15 of 18 (83.3%) in the S-arm and 18 of 20 (90.0%) in the RT-arm were linked-to-care (P = .7). In post hoc analysis assuming the same disease prevalence in those without obtaining test results, difference in linkage-to-care was more pronounced (S-arm = 60.0% vs RT-arm = 90.0%; P = .04). Conclusions. In a highly at-risk population for chronic viral infections, the simultaneous use of HIV, HBV, and HCV point-of-care tests clearly improves the “cascade of screening” and quite possibly linkage-to-care.
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Affiliation(s)
- Julie Bottero
- Sorbonne Universités, Université Pierre-et-Marie-Curie Paris 06, Institut National de la Sante et de la Recherche Medicale (INSERM), Institut Pierre Louis d'Épidémiologie et de Santé Publique ; Service de Maladies Infectieuses, Centre Hospitalier Universitaire (CHU) St. Antoine
| | - Anders Boyd
- Sorbonne Universités, Université Pierre-et-Marie-Curie Paris 06, Institut National de la Sante et de la Recherche Medicale (INSERM), Institut Pierre Louis d'Épidémiologie et de Santé Publique
| | - Joel Gozlan
- Laboratoire de Virologie, CHU St. Antoine ; INSERM U1135 Centre d'Immunologie et des Maladies Infectieuses
| | - Fabrice Carrat
- Sorbonne Universités, Université Pierre-et-Marie-Curie Paris 06, Institut National de la Sante et de la Recherche Medicale (INSERM), Institut Pierre Louis d'Épidémiologie et de Santé Publique ; Département de Santé Publique , Hôpital St-Antoine, Assistance Publique-Hôpitaux de Paris
| | - Jean Nau
- Médecins du Monde, Centre d'Accueil de Soins et d'Orientation
| | | | - Hayette Rougier
- Service de Maladies Infectieuses, Centre Hospitalier Universitaire (CHU) St. Antoine
| | - Pierre-Marie Girard
- Sorbonne Universités, Université Pierre-et-Marie-Curie Paris 06, Institut National de la Sante et de la Recherche Medicale (INSERM), Institut Pierre Louis d'Épidémiologie et de Santé Publique ; Service de Maladies Infectieuses, Centre Hospitalier Universitaire (CHU) St. Antoine
| | - Karine Lacombe
- Sorbonne Universités, Université Pierre-et-Marie-Curie Paris 06, Institut National de la Sante et de la Recherche Medicale (INSERM), Institut Pierre Louis d'Épidémiologie et de Santé Publique ; Service de Maladies Infectieuses, Centre Hospitalier Universitaire (CHU) St. Antoine
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Fraisse T, Fourcade C, Brazes-Sanz J, Koumar Y, Lavigne JP, Sotto A, Laureillard D. A cross sectional survey of the barriers for implementing rapid HIV testing among French general practitioners. Int J STD AIDS 2015; 27:1005-12. [PMID: 26429893 DOI: 10.1177/0956462415605413] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 08/18/2015] [Indexed: 11/17/2022]
Abstract
In France, almost 30,000 people are unaware of their HIV-positive status. Innovative screening strategies are essential to reach this population. The aim of this study was to describe the acceptability of rapid HIV testing (RHT) among French general practitioners (GPs) working in the south of France and barriers for implementing this strategy. We analysed an anonymous questionnaire sent by mail to GPs about demographic data, routine practice, knowledge of RHT and barriers to its use. Between 1 April and 30 September 2013, out of the 165 GPs contacted, 78 returned the questionnaires. The GPs' mean age was 52 years; 49 were men. Fifty-one GPs reported that their registered patients included at least one HIV-infected person and 70 GPs reported taking care of high-risk patients. Sixty-three percent of GPs reported being interested in using RHT in their daily practice. The main reasons reported by uninterested GPs were: greater confidence in standard HIV testing, difficulties including RHT during the routine consultation, difficulties to screen for other sexually transmitted infections simultaneously, and difficulties to deliver a positive result. French National Authorities for Health propose to screen the population at least once in their lifetime and high-risk people at least once a year. In order to achieve this aim, RHT should be included in the GPs' arsenal for HIV testing. We showed a high acceptability of RHT by GPs. If specific and adapted training is developed, and if solutions to barriers reported by GPs are found, RHT could be implemented in to their routine activity.
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Affiliation(s)
- Thibaut Fraisse
- Department of Geriatric Medicine, General Hospital, Alès, France
| | - Camille Fourcade
- Department of Infectious and Tropical Diseases, University Hospital, Nîmes, France
| | | | - Yatrika Koumar
- Department of Infectious and Tropical Diseases, University Hospital, Nîmes, France
| | | | - Albert Sotto
- Department of Infectious and Tropical Diseases, University Hospital, Nîmes, France
| | - Didier Laureillard
- Department of Infectious and Tropical Diseases, University Hospital, Nîmes, France
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Joore IK, Arts DL, Kruijer MJP, Moll van Charante EP, Geerlings SE, Prins JM, van Bergen JE. HIV indicator condition-guided testing to reduce the number of undiagnosed patients and prevent late presentation in a high-prevalence area: a case-control study in primary care. Sex Transm Infect 2015; 91:467-72. [PMID: 26126531 DOI: 10.1136/sextrans-2015-052073] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 06/13/2015] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES Recent guidelines advocate accelerated provider-initiated HIV testing by general practitioners (GPs). We aimed to identify the number of patient consultations in six general practices in the South-East of Amsterdam, and the incidence of HIV indicator conditions reported in their medical files prior to diagnosis. METHODS A cross-sectional search in an electronic general practice database. We used a case-control design to identify those conditions most associated with an HIV-positive status. RESULTS We included 102 HIV cases diagnosed from 2002 to 2012, and matched them with 299 controls. In the year prior to HIV diagnosis, 61.8% of cases visited their GP at least once, compared with 38.8% of controls. In the 5 years prior to HIV diagnosis, 58.8% of HIV cases had exhibited an HIV indicator condition, compared with 7.4% of controls. The most common HIV-related conditions were syphilis and gonorrhoea. The most common HIV-related symptoms were weight loss, lymphadenopathy and peripheral neuropathy. During this period, average HIV prevalence among people aged 15-59 years increased from 0.4% to 0.9%. CONCLUSIONS This study revealed many opportunities for HIV indicator condition-guided testing in primary care. As yet, however, HIV indicator conditions are not exploited as triggers for early HIV testing.
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Affiliation(s)
- Ivo K Joore
- Department of General Practice, Division of Clinical Methods and Public Health, Academic Medical Center, Amsterdam, The Netherlands
| | - Derk L Arts
- Department of General Practice, Division of Clinical Methods and Public Health, Academic Medical Center, Amsterdam, The Netherlands
| | - Marjan J P Kruijer
- Department of General Practice, Division of Clinical Methods and Public Health, Academic Medical Center, Amsterdam, The Netherlands
| | - Eric P Moll van Charante
- Department of General Practice, Division of Clinical Methods and Public Health, Academic Medical Center, Amsterdam, The Netherlands
| | - Suzanne E Geerlings
- Department of Internal Medicine, Division of Infectious Diseases, Academic Medical Center, Amsterdam, The Netherlands
| | - Jan M Prins
- Department of Internal Medicine, Division of Infectious Diseases, Academic Medical Center, Amsterdam, The Netherlands
| | - Jan Eam van Bergen
- Department of General Practice, Division of Clinical Methods and Public Health, Academic Medical Center, Amsterdam, The Netherlands STI AIDS Netherlands (Soa Aids Nederland), Amsterdam, The Netherlands Epidemiology & Surveillance Unit, Centre for Infectious Disease Control, National Institute of Public Health and the Environment (RIVM), Bilthoven, The Netherlands
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Cayuelas-Redondo L, Menacho-Pascual I, Noguera-Sánchez P, Goicoa-Gago C, Pollio-Peña G, Blanco-Delgado R, Barba-Ávila O, Sequeira-Aymar E, Muns M, Clusa T, García F, León A. [Indicator condition guided human immunodeficiency virus requesting in primary health care: results of a collaboration]. Enferm Infecc Microbiol Clin 2015; 33:656-62. [PMID: 25769383 DOI: 10.1016/j.eimc.2015.01.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Revised: 01/28/2015] [Accepted: 01/29/2015] [Indexed: 11/27/2022]
Abstract
INTRODUCTION The search of HIV infected patients guided by indicator conditions (IC) is a strategy used to increase the early detection of HIV. The objective is to analyze whether a collaboration to raise awareness of the importance of early detection of HIV in 3 primary care centers influenced the proportion of HIV serology requested. METHODS Multicenter retrospective study was conducted comparing the baseline and a post-collaboration period. The collaboration consisted of training sessions and participation in the HIDES study (years 2009-2010). Patients between 18 and 64 years old with newly diagnosed herpes zoster, seborrheic eczema, mononucleosis syndrome, and leucopenia/thrombocytopenia in 3 primary care centers in 2008 (baseline period) and 2012 (post-collaboration period). The sociodemographic variables, HIV risk conditions, requests for HIV serology, and outcomes were evaluated. RESULTS A total of 1,219 ICs were included (558 in 2008 and 661 in 2012). In 2008 the number of HIV tests in patients with an IC was 3.9%, and rose to 11.8% in 2012 (P<.0001). The HIV infection rate was 2.2% (95% CI: 0.4-7.3) (n=2). It was estimated that 25 new cases (12 in 2008 and 13 in 2012) would have been diagnosed if they had performed the test on all patients with IC. Predictors of HIV request were, having an IC in 2012, a younger age, having an mononucleosis syndrome, and not being Spanish. CONCLUSIONS The HIV request demand tripled, after the collaboration with primary care centers, however in 88% the test was not requested, resulting in diagnostic losses. New strategies are needed to raise awareness of the importance of early detection of HIV.
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Affiliation(s)
- Laia Cayuelas-Redondo
- Centro de Atención Primaria Casanova, Consorci d'Atenció Primària de Salut de l'Eixample (CAPSE), Instituto de Investigaciones Biomédicas Augusto Pi i Sunyer (IDIBAPS), Barcelona, España.
| | - Ignacio Menacho-Pascual
- Centro de Atención Primaria Les Corts, Consorci d'Atenció Primària de Salut de l'Eixample (CAPSE), Instituto de Investigaciones Biomédicas Augusto Pi i Sunyer (IDIBAPS), Barcelona, España
| | - Pablo Noguera-Sánchez
- Centro de Atención Primaria Casanova, Consorci d'Atenció Primària de Salut de l'Eixample (CAPSE), Instituto de Investigaciones Biomédicas Augusto Pi i Sunyer (IDIBAPS), Barcelona, España
| | - Carmen Goicoa-Gago
- Centro de Atención Primaria Casanova, Consorci d'Atenció Primària de Salut de l'Eixample (CAPSE), Instituto de Investigaciones Biomédicas Augusto Pi i Sunyer (IDIBAPS), Barcelona, España
| | - Gernónimo Pollio-Peña
- Centro de Atención Primaria Les Corts, Consorci d'Atenció Primària de Salut de l'Eixample (CAPSE), Instituto de Investigaciones Biomédicas Augusto Pi i Sunyer (IDIBAPS), Barcelona, España
| | - Rebeca Blanco-Delgado
- Centro de Atención Primaria Les Corts, Consorci d'Atenció Primària de Salut de l'Eixample (CAPSE), Instituto de Investigaciones Biomédicas Augusto Pi i Sunyer (IDIBAPS), Barcelona, España
| | - Olga Barba-Ávila
- Centro de Atención Primaria Comte Borrell, Consorci d'Atenció Primària de Salut de l'Eixample (CAPSE), Instituto de Investigaciones Biomédicas Augusto Pi i Sunyer (IDIBAPS), Barcelona, España
| | - Ethel Sequeira-Aymar
- Centro de Atención Primaria Casanova, Consorci d'Atenció Primària de Salut de l'Eixample (CAPSE), Instituto de Investigaciones Biomédicas Augusto Pi i Sunyer (IDIBAPS), Barcelona, España
| | - Mercè Muns
- Centro de Atención Primaria Raval Sud, Intitut Català de la Salut, Barcelona, España
| | - Thais Clusa
- Centro de Atención Primaria Raval Sud, Intitut Català de la Salut, Barcelona, España
| | - Felipe García
- Unidad de Enfermedades Infecciosas, Hospital Clínico y Provincial de Barcelona, Instituto de Investigaciones Biomédicas Augusto Pi i Sunyer (IDIBAPS), Barcelona, España
| | - Agathe León
- Unidad de Enfermedades Infecciosas, Hospital Clínico y Provincial de Barcelona, Instituto de Investigaciones Biomédicas Augusto Pi i Sunyer (IDIBAPS), Barcelona, España
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Conway DP, Guy R, McNulty A, Couldwell DL, Davies SC, Smith DE, Keen P, Cunningham P, Holt M. Effect of testing experience and profession on provider acceptability of rapid HIV testing after implementation in public sexual health clinics in Sydney. HIV Med 2015; 16:280-7. [PMID: 25604470 DOI: 10.1111/hiv.12209] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Rapid HIV testing (RHT) is well established in many countries, but it is new in Australia since a policy change in 2011. We assessed service provider acceptability of RHT before and after its implementation in four Sydney public sexual health clinics. METHODS Service providers were surveyed immediately after training in RHT and again 6-12 months later. Differences in mean scores between survey rounds were assessed via t-tests, with stratification by profession and the number of tests performed. RESULTS RHT was rated as highly acceptable among staff at baseline and acceptability scores improved between survey rounds. Belief in being sufficiently skilled and experienced to perform RHT (P = 0.004) and confidence in the delivery of nonreactive results increased (P = 0.007), while the belief that RHT was disruptive declined (P = 0.001). Acceptability was higher for staff who had performed a greater number of tests regarding comfort with their role in RHT (P = 0.004) and belief that patients were satisfied with RHT (P = 0.007). Compared with nurses, doctors had a stronger preference for a faster rapid test (P = 0.027) and were more likely to agree that RHT interfered with consultations (P = 0.014). CONCLUSIONS Differences in responses between professions may reflect differences in staff roles, the type of patients seen by staff and the model of testing used, all of which may affect the number of tests performed by staff. These findings may inform planning for how best to implement RHT in clinical services.
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Affiliation(s)
- D P Conway
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia; Short Street Sexual Health Centre, St George Hospital, Kogarah, NSW, Australia
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Wouters K, Fransen K, Beelaert G, Kenyon C, Platteau T, Van Ghyseghem C, Collier I, Buyze J, Florence E. Use of rapid HIV testing in a low threshold centre in Antwerp, Belgium, 2007–2012. Int J STD AIDS 2014; 25:936-42. [DOI: 10.1177/0956462414526705] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The Antwerp Helpcenter is a low threshold screening centre for HIV and STI testing focused on high-risk groups. The aim of this work is to describe our experience with the use of rapid HIV tests including the analysis of the characteristics of new cases of HIV infection. We performed a retrospective analysis of all rapid tests routinely performed at the Helpcenter in the period June 2007 to December 2012. The Determine®HIV-1/2 (3rd generation) was used until May 2009 and thereafter the Determine Combo®HIV-1/2 Ag/Ab (Alere) test (4th generation) on venous blood. All reactive tests were confirmed using a standard confirmation algorithm with ELISAs and a confirmation test (INNO-LIA HIVI/II Score®). In all, 5025 rapid tests were performed on blood specimens of 3881 clients including 1173 men having sex with men and 454 migrants from sub-Sahara Africa. The overall prevalence of HIV infection was 1.5% and higher among the risk groups: 4.0% of men having sex with men and 2.2% of migrants from sub-Sahara Africa. The availability of a rapid test was an important reason to present at the Helpcenter. The rapid test was successfully introduced into an outpatient testing centre. Client satisfaction with RT was high and most clients were successfully linked to care.
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Affiliation(s)
- Kristien Wouters
- Institute of Tropical Medicine, Antwerpen, Belgium
- Helpcenter-ITG, Antwerpen, Belgium
| | | | | | - Chris Kenyon
- Institute of Tropical Medicine, Antwerpen, Belgium
| | - Tom Platteau
- Institute of Tropical Medicine, Antwerpen, Belgium
- Helpcenter-ITG, Antwerpen, Belgium
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