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Fernàndez-López L, Reyes-Urueña J, Egea L, Chernyshev A, Upmace I, Ćosić M, Mejías W, González V, Blondeel K, Thwin SS, Gios L, Mirandola M, Peeling R, Kiarie J, Casabona J, Toskin I. A clinical utility evaluation of dual HIV/Syphilis point-of-care tests in non-clinical settings for screening for HIV and syphilis in men who have sex with men. BMC Infect Dis 2024; 24:264. [PMID: 38419023 PMCID: PMC10902924 DOI: 10.1186/s12879-024-09017-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 01/11/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Dual point-of-care tests (POCTs) for the simultaneous detection of antibodies to HIV and syphilis have been developed. Since community-based organisations (CBO) are effective providers of HIV and syphilis testing among men who have sex with men (MSM), evaluation of the utility of these dual tests at CBO testing services is a high priority. The aim of this study is to determine the feasibility of performing dual HIV-syphilis POCT testing among both users and providers at these non-clinical sites. METHODS This evaluation assessed the utility of two lateral flow immunochromatographic antibody technologies for dual screening for HIV/syphilis among MSM seeking testing in four CBO testing services in Spain, Slovenia, Latvia, and Ukraine. The study's conceptual framework divides the concept of feasibility into two inter-related domains, acceptability, and usability and further breaks it down into six subdomains: learnability, willingness, suitability, satisfaction, efficacy, and effectiveness. The feasibility analysis was performed by calculating the median score in 3 stages (for individual questions, subdomains, and domains), using a summated scores method. RESULTS The final sample included 844 participants, 60 of which were found to be HIV test positive (7.1%) and 61 (7.2%) positive on testing for syphilis. There was a small difference (1.1%) when comparing the results of the two dual POCTs under evaluation to the tests routinely used at each site. The inter-rater agreement showed a high concordance between two independent readings. The analysis of the feasibility for the users of the services indicated good satisfaction, suitability, and willingness. In addition, among 18 providers the total mean score showed good acceptability and usability, good willingness, easy learnability, high suitability, and good efficacy, but lower satisfaction and effectiveness. The operational characteristics of both dual study POCTs were well evaluated by providers. CONCLUSIONS The introduction of dual HIV and syphilis POCTs in CBO testing services for screening of MSM is feasible, with a high acceptability and usability both for users and providers. Implementation of dual POCTs for HIV and syphilis in CBO testing services is an opportunity for scaling up integrated HIV/syphilis testing for MSM.
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Affiliation(s)
- Laura Fernàndez-López
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain.
- Institute for Health Science Research Germans Trias I Pujol (IGTP), Badalona, Spain.
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
| | - Juliana Reyes-Urueña
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
- Institute for Health Science Research Germans Trias I Pujol (IGTP), Badalona, Spain
| | - Laia Egea
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
- School of Mathematics, Statistics and Operations Research, Victoria University of Wellington, Wellington, New Zealand
| | | | | | | | | | - Victoria González
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
- Institute for Health Science Research Germans Trias I Pujol (IGTP), Badalona, Spain
- Microbiology Department, Laboratori Clínic Metropolitana Nord. Hospital Universitari Germans Trias I Pujol, Badalona, Spain
| | - Karel Blondeel
- Department of Sexual and Reproductive Health and Research (SRH), including UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Soe Soe Thwin
- Department of Sexual and Reproductive Health and Research (SRH), including UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| | - Lorenzo Gios
- Epidemiology Unit - Division of Infectious Diseases, Department of Medicine, Verona University Hospital, Verona, Italy
| | - Massimo Mirandola
- Epidemiology Unit - Division of Infectious Diseases, Department of Medicine, Verona University Hospital, Verona, Italy
- School of Sport and Health Sciences, University of Brighton, Brighton, UK
| | - Rosanna Peeling
- International Diagnostics Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - James Kiarie
- Department of Sexual and Reproductive Health and Research (SRH), including UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| | - Jordi Casabona
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
- Institute for Health Science Research Germans Trias I Pujol (IGTP), Badalona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Igor Toskin
- Department of Sexual and Reproductive Health and Research (SRH), including UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
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Tolmane I, Upmace I, Azina I, Rozentale B. 1235. Anti-HCV Prevalence and Associated Risk Factors in Patients of Psychiatry Hospitals in Latvia. Open Forum Infect Dis 2022. [PMCID: PMC9752307 DOI: 10.1093/ofid/ofac492.1067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background According to previous epidemiological studies there is 2.4% prevalence of anti-HCV in Latvian population. Hepatitis C can lead to liver cirrhosis and HCC. There is available an effective HCV treatment with 100% reimbursement. WHO has settled a goal – to eliminate HCV as a public health threat by 2030. The biggest obstacle to achieve this goal is to find an infected persons. The aim of this study was to screen and analyze the data of patients from Psychiatry hospitals (PH) in Latvia. Patients were screened for hepatitis C infection (anti-HCV) and analyze the possible risk factors. Methods 795 patients of all PH in Latvia were tested, including 57.1% males and 42.9% females. The mean age was 49 years (range 18 - 93). Data were obtained by performing survey and rapid blood antibody tests. The questionnaire included demographic information and 10 questions on infection risk factors. Study was done from May till October 2021 by HIV Prevention Point workers in PHs of 7 PH in Latvia – Riga, Daugavpils, Liepaja, Strenci, Gintermuiza, Akniste and Vecpiebalga. Data were analyzed using MS Excel and IBM SPSS. Results 24.8% of patients noted they have been sexually active in the last year, but only 9.9% admitted usage of condoms. 3.8% noted they are or have been used IV drugs. 11.2% of patients have a history of incarceration. In total 6.8% of performed tests were positive for anti-HCV. Incarcerated persons were positive in 16% of cases, non-incarcerated – in 6%. IV drug users (IVDU) were positive in 49%, non-users – in 4.9%, all differences are statistically significant. Conclusion Patients in PH are at higher risk of HCV infection in comparison to population in Latvia. Besides already well known risk groups – IVDU and incarcerated people, we found 2.8 times higher anti-HCV prevalence in psychiatric hospital’s patients, with markedly higher prevalence in those previously incarcerated or IVDU. This study provides valuable data to better identify groups of individuals with higher risk of HCV infection. Latvia. PNC patients should further be tested, especially individuals who have been incarcerated, use or have used IV drugs. Disclosures All Authors: No reported disclosures.
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Affiliation(s)
- Ieva Tolmane
- Riga East University Hospital, Rīga, Riga, Latvia
| | | | - Inga Azina
- Riga East University Hospital, Rīga, Riga, Latvia
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Marty L, Lemsalu L, Ķīvīte-Urtāne A, Costagliola D, Kaupe R, Linina I, Upmace I, Rüütel K, Supervie V. Revealing HIV epidemic dynamics and contrasting responses in two WHO Eastern European countries: insights from modeling and data triangulation. AIDS 2021; 35:675-680. [PMID: 33259346 DOI: 10.1097/qad.0000000000002778] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES In the early 2000s, Estonia and Latvia experienced a rapidly growing HIV epidemic among people who inject drugs (PWID), and had, with Russia, the highest diagnosis rates in Europe. Understanding epidemic dynamics in both countries and how responses to HIV impacted them is essential to ending injection-driven epidemics. DESIGN Statistical modeling, programmatic data collection, and triangulation. METHODS Data on newly diagnosed HIV cases were used in a back-calculation model to estimate, for each country, trends in HIV incidence, time to diagnosis, and undiagnosed infections. Modeled estimates were then triangulated with programmatic data on harm reduction services, HIV testing, and ART. RESULTS From 2007 to 2016, HIV incidence decreased in Estonia by 61% overall, for all exposure groups, and particularly for male PWID (97%), except men who have sex with men, where it increased by 418%. In Latvia, it increased by 72% overall. Median time to diagnosis decreased for male PWID in Estonia, from 3.5 to 2.6 years, but not in Latvia. In 2016, most new and undiagnosed infections, ∼50% in Latvia and ∼75% in Estonia, affected individuals reporting heterosexual transmission, showing a gradual shift toward heterosexual route as the main reported exposure mode. Coverage of services had been higher in Estonia; for example, by 2016, for PWID, there were >200 needles and syringes distributed per PWID annually, and HIV testing and ART coverage reached ∼50% and 76%, respectively, in Estonia, against respectively less than 100%, 10% and 27% in Latvia. CONCLUSIONS Estonia has turned the tide of its epidemic - large scale-up of prevention and care programs probably contributed to it - whereas in Latvia it remains very active.
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Affiliation(s)
- Lise Marty
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Liis Lemsalu
- National Institute for Health Development, Tallinn, Estonia
| | | | - Dominique Costagliola
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Ruta Kaupe
- Department of Public Health and Epidemiology, Riga Stradins University
- NGO 'DIA+LOGS'
| | - Indra Linina
- Department of Public Health and Epidemiology, Riga Stradins University
| | - Inga Upmace
- Department of Public Health and Epidemiology, Riga Stradins University
- NGO 'Baltic HIV Association', Riga, Latvia
| | - Kristi Rüütel
- National Institute for Health Development, Tallinn, Estonia
| | - Virginie Supervie
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
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