STI Patients Are Effective Recruiters of Undiagnosed Cases of HIV: Results of a Social Contact Recruitment Study in Malawi
Identifieur interne : 001926 ( Pmc/Corpus ); précédent : 001925; suivant : 001927STI Patients Are Effective Recruiters of Undiagnosed Cases of HIV: Results of a Social Contact Recruitment Study in Malawi
Auteurs : Nora E. Rosenberg ; Gift Kamanga ; Audrey E. Pettifor ; Naomi Bonongwe ; Clement Mapanje ; Sarah E. Rutstein ; Michelle Ward ; Irving F. Hoffman ; Francis Martinson ; William C. MillerSource :
- Journal of acquired immune deficiency syndromes (1999) [ 1525-4135 ] ; 2014.
Abstract
Patients with newly diagnosed HIV may be part of social networks with elevated prevalence of undiagnosed HIV infection. Social network recruitment by persons with newly diagnosed HIV may efficiently identify undiagnosed cases of HIV infection. We assessed social network recruitment as a strategy for identifying undiagnosed cases of HIV infection.
In an STI clinic in Lilongwe, Malawi, three groups of 45 “seeds” were enrolled: STI patients with newly diagnosed HIV, STI patients who were HIV-uninfected, and community controls. Seeds were asked to recruit up to 5 social “contacts” (sexual or non-sexual). Mean number of contacts recruited per group was calculated. HIV prevalence ratios and number of contacts needed to test to identify one new case of HIV were compared between groups using generalized estimating equations with exchangeable correlation matrices.
Mean number of contacts recruited was 1.3 for HIV-infected clinic seeds, 1.8 for HIV-uninfected clinic seeds and 2.3 for community seeds. Contacts of HIV-infected clinic seeds had a higher HIV prevalence (PR: 3.2, 95% CI: 1.3, 7.8) than contacts of community seeds, but contacts of HIV-uninfected clinic seeds did not (PR: 1.1, 95% CI: 0.4, 3.3). Results were similar when restricted to non-sexual contacts. To identify one new case of HIV it was necessary to test 8 contacts of HIV-infected clinic seeds, 10 contacts of HIV-uninfected clinic seeds, and 18 contacts of community seeds.
Social contact recruitment by newly diagnosed STI patients efficiently led to new HIV diagnoses. Research to replicate findings and guide implementation is needed.
Url:
DOI: 10.1097/QAI.0000000000000066
PubMed: 24759065
PubMed Central: 3999477
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PMC:3999477Le document en format XML
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<author><name sortKey="Rosenberg, Nora E" sort="Rosenberg, Nora E" uniqKey="Rosenberg N" first="Nora E." last="Rosenberg">Nora E. Rosenberg</name>
<affiliation><nlm:aff id="A1">Department of Epidemiology, UNC Chapel Hill, Chapel Hill, USA</nlm:aff>
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<affiliation><nlm:aff id="A2">UNC Project, Lilongwe, Malawi</nlm:aff>
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<author><name sortKey="Kamanga, Gift" sort="Kamanga, Gift" uniqKey="Kamanga G" first="Gift" last="Kamanga">Gift Kamanga</name>
<affiliation><nlm:aff id="A2">UNC Project, Lilongwe, Malawi</nlm:aff>
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<affiliation><nlm:aff id="A3">Department of Health Policy and Management, UNC Chapel Hill, Chapel Hill, USA</nlm:aff>
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<author><name sortKey="Pettifor, Audrey E" sort="Pettifor, Audrey E" uniqKey="Pettifor A" first="Audrey E." last="Pettifor">Audrey E. Pettifor</name>
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<author><name sortKey="Bonongwe, Naomi" sort="Bonongwe, Naomi" uniqKey="Bonongwe N" first="Naomi" last="Bonongwe">Naomi Bonongwe</name>
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<author><name sortKey="Mapanje, Clement" sort="Mapanje, Clement" uniqKey="Mapanje C" first="Clement" last="Mapanje">Clement Mapanje</name>
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<author><name sortKey="Rutstein, Sarah E" sort="Rutstein, Sarah E" uniqKey="Rutstein S" first="Sarah E." last="Rutstein">Sarah E. Rutstein</name>
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<author><name sortKey="Miller, William C" sort="Miller, William C" uniqKey="Miller W" first="William C." last="Miller">William C. Miller</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">STI Patients Are Effective Recruiters of Undiagnosed Cases of HIV: Results of a Social Contact Recruitment Study in Malawi</title>
<author><name sortKey="Rosenberg, Nora E" sort="Rosenberg, Nora E" uniqKey="Rosenberg N" first="Nora E." last="Rosenberg">Nora E. Rosenberg</name>
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<affiliation><nlm:aff id="A2">UNC Project, Lilongwe, Malawi</nlm:aff>
</affiliation>
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<author><name sortKey="Kamanga, Gift" sort="Kamanga, Gift" uniqKey="Kamanga G" first="Gift" last="Kamanga">Gift Kamanga</name>
<affiliation><nlm:aff id="A2">UNC Project, Lilongwe, Malawi</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A3">Department of Health Policy and Management, UNC Chapel Hill, Chapel Hill, USA</nlm:aff>
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<author><name sortKey="Pettifor, Audrey E" sort="Pettifor, Audrey E" uniqKey="Pettifor A" first="Audrey E." last="Pettifor">Audrey E. Pettifor</name>
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</affiliation>
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<author><name sortKey="Bonongwe, Naomi" sort="Bonongwe, Naomi" uniqKey="Bonongwe N" first="Naomi" last="Bonongwe">Naomi Bonongwe</name>
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</affiliation>
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<author><name sortKey="Mapanje, Clement" sort="Mapanje, Clement" uniqKey="Mapanje C" first="Clement" last="Mapanje">Clement Mapanje</name>
<affiliation><nlm:aff id="A2">UNC Project, Lilongwe, Malawi</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Rutstein, Sarah E" sort="Rutstein, Sarah E" uniqKey="Rutstein S" first="Sarah E." last="Rutstein">Sarah E. Rutstein</name>
<affiliation><nlm:aff id="A3">Department of Health Policy and Management, UNC Chapel Hill, Chapel Hill, USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Ward, Michelle" sort="Ward, Michelle" uniqKey="Ward M" first="Michelle" last="Ward">Michelle Ward</name>
<affiliation><nlm:aff id="A4">Department of Medicine, UNC Chapel Hill, Chapel Hill, USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Hoffman, Irving F" sort="Hoffman, Irving F" uniqKey="Hoffman I" first="Irving F." last="Hoffman">Irving F. Hoffman</name>
<affiliation><nlm:aff id="A2">UNC Project, Lilongwe, Malawi</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A4">Department of Medicine, UNC Chapel Hill, Chapel Hill, USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Martinson, Francis" sort="Martinson, Francis" uniqKey="Martinson F" first="Francis" last="Martinson">Francis Martinson</name>
<affiliation><nlm:aff id="A2">UNC Project, Lilongwe, Malawi</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A4">Department of Medicine, UNC Chapel Hill, Chapel Hill, USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Miller, William C" sort="Miller, William C" uniqKey="Miller W" first="William C." last="Miller">William C. Miller</name>
<affiliation><nlm:aff id="A1">Department of Epidemiology, UNC Chapel Hill, Chapel Hill, USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A4">Department of Medicine, UNC Chapel Hill, Chapel Hill, USA</nlm:aff>
</affiliation>
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<series><title level="j">Journal of acquired immune deficiency syndromes (1999)</title>
<idno type="ISSN">1525-4135</idno>
<idno type="eISSN">1944-7884</idno>
<imprint><date when="2014">2014</date>
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title>
<p id="P1">Patients with newly diagnosed HIV may be part of social networks with elevated prevalence of undiagnosed HIV infection. Social network recruitment by persons with newly diagnosed HIV may efficiently identify undiagnosed cases of HIV infection. We assessed social network recruitment as a strategy for identifying undiagnosed cases of HIV infection.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">In an STI clinic in Lilongwe, Malawi, three groups of 45 “seeds” were enrolled: STI patients with newly diagnosed HIV, STI patients who were HIV-uninfected, and community controls. Seeds were asked to recruit up to 5 social “contacts” (sexual or non-sexual). Mean number of contacts recruited per group was calculated. HIV prevalence ratios and number of contacts needed to test to identify one new case of HIV were compared between groups using generalized estimating equations with exchangeable correlation matrices.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">Mean number of contacts recruited was 1.3 for HIV-infected clinic seeds, 1.8 for HIV-uninfected clinic seeds and 2.3 for community seeds. Contacts of HIV-infected clinic seeds had a higher HIV prevalence (PR: 3.2, 95% CI: 1.3, 7.8) than contacts of community seeds, but contacts of HIV-uninfected clinic seeds did not (PR: 1.1, 95% CI: 0.4, 3.3). Results were similar when restricted to non-sexual contacts. To identify one new case of HIV it was necessary to test 8 contacts of HIV-infected clinic seeds, 10 contacts of HIV-uninfected clinic seeds, and 18 contacts of community seeds.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">Social contact recruitment by newly diagnosed STI patients efficiently led to new HIV diagnoses. Research to replicate findings and guide implementation is needed.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">100892005</journal-id>
<journal-id journal-id-type="pubmed-jr-id">21821</journal-id>
<journal-id journal-id-type="nlm-ta">J Acquir Immune Defic Syndr</journal-id>
<journal-id journal-id-type="iso-abbrev">J. Acquir. Immune Defic. Syndr.</journal-id>
<journal-title-group><journal-title>Journal of acquired immune deficiency syndromes (1999)</journal-title>
</journal-title-group>
<issn pub-type="ppub">1525-4135</issn>
<issn pub-type="epub">1944-7884</issn>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">24759065</article-id>
<article-id pub-id-type="pmc">3999477</article-id>
<article-id pub-id-type="doi">10.1097/QAI.0000000000000066</article-id>
<article-id pub-id-type="manuscript">NIHMS542884</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>STI Patients Are Effective Recruiters of Undiagnosed Cases of HIV: Results of a Social Contact Recruitment Study in Malawi</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Rosenberg</surname>
<given-names>Nora E.</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kamanga</surname>
<given-names>Gift</given-names>
</name>
<xref ref-type="aff" rid="A2">2</xref>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Pettifor</surname>
<given-names>Audrey E.</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Bonongwe</surname>
<given-names>Naomi</given-names>
</name>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Mapanje</surname>
<given-names>Clement</given-names>
</name>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Rutstein</surname>
<given-names>Sarah E.</given-names>
</name>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Ward</surname>
<given-names>Michelle</given-names>
</name>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Hoffman</surname>
<given-names>Irving F.</given-names>
</name>
<xref ref-type="aff" rid="A2">2</xref>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Martinson</surname>
<given-names>Francis</given-names>
</name>
<xref ref-type="aff" rid="A2">2</xref>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Miller</surname>
<given-names>William C.</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
</contrib-group>
<aff id="A1"><label>1</label>
Department of Epidemiology, UNC Chapel Hill, Chapel Hill, USA</aff>
<aff id="A2"><label>2</label>
UNC Project, Lilongwe, Malawi</aff>
<aff id="A3"><label>3</label>
Department of Health Policy and Management, UNC Chapel Hill, Chapel Hill, USA</aff>
<aff id="A4"><label>4</label>
Department of Medicine, UNC Chapel Hill, Chapel Hill, USA</aff>
<author-notes><corresp id="cor1">Corresponding author: Nora E. Rosenberg, PhD, University of North Carolina Project, Tidziwe Centre, Private Bag A-104, Lilongwe, Malawi, +265 (0) 99 109 0676, <email>Nora_Rosenberg@unc.edu</email>
</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>10</day>
<month>1</month>
<year>2014</year>
</pub-date>
<pub-date pub-type="ppub"><day>15</day>
<month>4</month>
<year>2014</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>15</day>
<month>4</month>
<year>2015</year>
</pub-date>
<volume>65</volume>
<issue>5</issue>
<fpage>e162</fpage>
<lpage>e169</lpage>
<pmc-comment>elocation-id from pubmed: 10.1097/QAI.0000000000000066</pmc-comment>
<abstract><sec id="S1"><title>Background</title>
<p id="P1">Patients with newly diagnosed HIV may be part of social networks with elevated prevalence of undiagnosed HIV infection. Social network recruitment by persons with newly diagnosed HIV may efficiently identify undiagnosed cases of HIV infection. We assessed social network recruitment as a strategy for identifying undiagnosed cases of HIV infection.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">In an STI clinic in Lilongwe, Malawi, three groups of 45 “seeds” were enrolled: STI patients with newly diagnosed HIV, STI patients who were HIV-uninfected, and community controls. Seeds were asked to recruit up to 5 social “contacts” (sexual or non-sexual). Mean number of contacts recruited per group was calculated. HIV prevalence ratios and number of contacts needed to test to identify one new case of HIV were compared between groups using generalized estimating equations with exchangeable correlation matrices.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">Mean number of contacts recruited was 1.3 for HIV-infected clinic seeds, 1.8 for HIV-uninfected clinic seeds and 2.3 for community seeds. Contacts of HIV-infected clinic seeds had a higher HIV prevalence (PR: 3.2, 95% CI: 1.3, 7.8) than contacts of community seeds, but contacts of HIV-uninfected clinic seeds did not (PR: 1.1, 95% CI: 0.4, 3.3). Results were similar when restricted to non-sexual contacts. To identify one new case of HIV it was necessary to test 8 contacts of HIV-infected clinic seeds, 10 contacts of HIV-uninfected clinic seeds, and 18 contacts of community seeds.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">Social contact recruitment by newly diagnosed STI patients efficiently led to new HIV diagnoses. Research to replicate findings and guide implementation is needed.</p>
</sec>
</abstract>
<kwd-group><kwd>HIV</kwd>
<kwd>social network</kwd>
<kwd>sexually transmitted infection</kwd>
<kwd>Malawi</kwd>
<kwd>HIV counseling and testing</kwd>
<kwd>syndromic management</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
</record>
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