STI Patients Are Effective Recruiters of Undiagnosed Cases of HIV: Results of a Social Contact Recruitment Study in Malawi
Identifieur interne : 001B06 ( Main/Exploration ); précédent : 001B05; suivant : 001B07STI Patients Are Effective Recruiters of Undiagnosed Cases of HIV: Results of a Social Contact Recruitment Study in Malawi
Auteurs : Nora E. Rosenberg [États-Unis, Malawi] ; Gift Kamanga [Malawi, États-Unis] ; Audrey E. Pettifor [États-Unis] ; Naomi Bonongwe [Malawi] ; Clement Mapanje [Malawi] ; Sarah E. Rutstein [États-Unis] ; Michelle Ward [États-Unis] ; Irving F. Hoffman [Malawi, États-Unis] ; Francis Martinson [Malawi, États-Unis] ; William C. Miller [États-Unis]Source :
- 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
Affiliations:
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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>
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