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Ye J, Lan Y, Wang J, Feng Y, Lin Y, Zhou Y, Liu J, Yuan D, Lu X, Guo W, Zheng M, Song X, Zhou Q, Yang H, Zheng C, Guo Q, Yang X, Yang K, Zhang L, Ge Z, Liu L, Yu F, Han Y, Huang H, Hao M, Chen Q, Ling X, Ruan Y, Dong Y, Zhou C, Liu X, Bai J, Tong X, Gao Y, Yang Z, Wang A, Wei W, Mei F, Qiao R, Luo X, Huang X, Chen J, Hu F, Shen X, Tan W, Tu A, Zhang X, He S, Ning Z, Fan J, Liu C, Xu C, Ren X, Sun Y, Li Y, Liu G, Li X, Li J, Duan J, Huang T, Liu S, Yu G, Wu D, Shao Y, Pan Q, Zhang L, Su B, Wu J, Jiang T, Zhao H, Zhang T, Chen F, Cai K, Hu B, Wang H, Zhao J, Gao B, Sun W, Ning T, Li J, Liang S, Huo Y, Fu G, Chen X, Li F, Xing H, Lu H. Improvement in the 95-95-95 Targets Is Accompanied by a Reduction in Both the Human Immunodeficiency Virus Transmission Rate and Incidence in China. J Infect Dis 2024:jiae302. [PMID: 39186695 DOI: 10.1093/infdis/jiae302] [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: 12/02/2023] [Accepted: 06/04/2024] [Indexed: 08/28/2024] Open
Abstract
BACKGROUND In 2016, China has implemented the World Health Organization's "treat all" policy. We aimed to assess the impact of significant improvements in the 95-95-95 targets on population-level human immunodeficiency virus (HIV) transmission dynamics and incidence. METHODS We focused on 3 steps of the HIV care continuum: diagnosed, on antiretroviral therapy, and achieving viral suppression. The molecular transmission clusters were inferred using HIV-TRACE. New HIV infections were estimated using the incidence method in the European Centre for Disease Prevention and Control HIV Modelling Tool. RESULTS Between 2004 and 2023, the national HIV epidemiology database recorded 2.99 billion person-times of HIV tests and identified 1 976 878 new diagnoses. We noted a roughly "inverted-V" curve in the clustering frequency, with the peak recorded in 2014 (67.1% [95% confidence interval, 63.7%-70.5%]), concurrent with a significant improvement in the 95-95-95 targets from 10-13-<71 in 2005 to 84-93-97 in 2022. Furthermore, we observed a parabolic curve for a new infection with the vertex occurring in 2010. CONCLUSIONS In general, it was suggested that the improvements in the 95-95-95 targets were accompanied by a reduction in both the population-level HIV transmission rate and incidence. Thus, China should allocate more effort to the first "95" target to achieve a balanced 95-95-95 target.
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Affiliation(s)
- Jingrong Ye
- Institute for HIV/AIDS and STD Prevention and Control, Beijing Center for Disease Control and Prevention (CDC), Beijing Academy of Preventive Medicine, Beijing
| | - Yun Lan
- Institute of Infectious Diseases, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou
| | - Juan Wang
- Institute for HIV/AIDS and STD Prevention and Control, Beijing Center for Disease Control and Prevention (CDC), Beijing Academy of Preventive Medicine, Beijing
| | - Yi Feng
- Division of Virology and Immunology, State Key Laboratory for Infectious Disease Prevention and Control and National Center for AIDS/STD Prevention and Control, China CDC, Beijing
| | - Yi Lin
- Division of Tuberculosis and HIV/AIDS Prevention, Shanghai CDC
- Shanghai Institutes of Preventive Medicine
- Shanghai Center for AIDS Research, Shanghai
| | - Ying Zhou
- Institute of AIDS/STD Control and Prevention, Jiangsu CDC, Nanjing
| | - Jinjin Liu
- Center for Translational Medicine, Affiliated Infectious Diseases Hospital of Zhengzhou University (Henan Infectious Diseases Hospital, The Sixth People's Hospital of Zhengzhou), Zhengzhou
| | - Dan Yuan
- Center for AIDS/STD Control and Prevention, Sichuan CDC, Chengdu
| | - Xinli Lu
- Department of AIDS Research, Hebei Key Laboratory of Pathogen and Epidemiology of Infectious Disease, Hebei CDC, Shijiazhuang
| | - Weigui Guo
- Institute of HIV/AIDS Prevention and Control, Beihai CDC, Beihai
| | - Minna Zheng
- Department of STDs/AIDS Control and Prevention, Tianjin CDC, Tianjin
| | - Xiao Song
- Institute for HIV/AIDS and STD Prevention and Control, Heilongjiang CDC, Harbin
| | - Quanhua Zhou
- Institute of Microbiology, Chongqing CDC, Chongqing
| | - Hong Yang
- STD/AIDS Prevention and Control Institute, Inner Mongolia CDC (Inner Mongolia Academy of Preventive Medicine), Hohhot
| | - Chenli Zheng
- Department of HIV/AIDS Control and Prevention, Shenzhen CDC, Shenzhen
| | - Qi Guo
- Virology Laboratory, Jilin CDC, Changchun
| | - Xiaohui Yang
- Institute for HIV/AIDS and STD Prevention and Control, Fuyang CDC, Fuyang
| | | | - Lincai Zhang
- Institute for HIV/AIDS and STD Prevention and Control, Gansu CDC, Lanzhou
| | - Zhangwen Ge
- Guizhou Provincial People's Hospital, Affiliated Hospital of Guizhou University, Guiyang
| | - Lifeng Liu
- Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing
| | - Fengting Yu
- Clinical and Research Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing
| | - Yang Han
- Department of Infectious Disease, Peking Union Medical College Hospital, Beijing
| | - Huihuang Huang
- Treatment and Research Center for Infectious Diseases, The Fifth Medical Center of People's Liberation Army General Hospital, Beijing
| | - Mingqiang Hao
- Institute for HIV/AIDS and STD Prevention and Control, Beijing Center for Disease Control and Prevention (CDC), Beijing Academy of Preventive Medicine, Beijing
| | - Qiang Chen
- Institute for HIV/AIDS and STD Prevention and Control, Beijing Center for Disease Control and Prevention (CDC), Beijing Academy of Preventive Medicine, Beijing
| | - Xuemei Ling
- Institute of Infectious Diseases, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou
| | - Yuhua Ruan
- Division of Virology and Immunology, State Key Laboratory for Infectious Disease Prevention and Control and National Center for AIDS/STD Prevention and Control, China CDC, Beijing
| | - Yuan Dong
- Division of Tuberculosis and HIV/AIDS Prevention, Shanghai CDC
- Shanghai Institutes of Preventive Medicine
- Shanghai Center for AIDS Research, Shanghai
| | - Chang Zhou
- Center for AIDS/STD Control and Prevention, Sichuan CDC, Chengdu
| | - Xuangu Liu
- Institute of HIV/AIDS Prevention and Control, Beihai CDC, Beihai
| | - Jianyun Bai
- Department of STDs/AIDS Control and Prevention, Tianjin CDC, Tianjin
| | - Xue Tong
- Institute for HIV/AIDS and STD Prevention and Control, Heilongjiang CDC, Harbin
| | - Ya Gao
- STD/AIDS Prevention and Control Institute, Inner Mongolia CDC (Inner Mongolia Academy of Preventive Medicine), Hohhot
| | - Zhengrong Yang
- Department of HIV/AIDS Control and Prevention, Shenzhen CDC, Shenzhen
| | - Ao Wang
- Virology Laboratory, Jilin CDC, Changchun
| | - Wei Wei
- Institute for HIV/AIDS and STD Prevention and Control, Fuyang CDC, Fuyang
| | | | - Ruijuan Qiao
- Institute for HIV/AIDS and STD Prevention and Control, Gansu CDC, Lanzhou
| | - Xinhua Luo
- Guizhou Provincial People's Hospital, Affiliated Hospital of Guizhou University, Guiyang
| | - Xiaojie Huang
- Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing
| | - Jing Chen
- Institute for HIV/AIDS and STD Prevention and Control, Beijing Center for Disease Control and Prevention (CDC), Beijing Academy of Preventive Medicine, Beijing
| | - Fengyu Hu
- Institute of Infectious Diseases, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou
| | - Xin Shen
- Division of Tuberculosis and HIV/AIDS Prevention, Shanghai CDC
- Shanghai Institutes of Preventive Medicine
- Shanghai Center for AIDS Research, Shanghai
| | - Wei Tan
- Department of HIV/AIDS Control and Prevention, Shenzhen CDC, Shenzhen
| | - Aixia Tu
- Institute for HIV/AIDS and STD Prevention and Control, Gansu CDC, Lanzhou
| | - Xinhui Zhang
- Institute for Infectious Disease Prevention and Control, Guizhou CDC, Guiyang
| | - Shufang He
- Institute for HIV/AIDS and STD Prevention and Control, Beijing Center for Disease Control and Prevention (CDC), Beijing Academy of Preventive Medicine, Beijing
| | - Zhen Ning
- Division of Tuberculosis and HIV/AIDS Prevention, Shanghai CDC
- Shanghai Institutes of Preventive Medicine
- Shanghai Center for AIDS Research, Shanghai
| | | | | | - Conghui Xu
- Institute for HIV/AIDS and STD Prevention and Control, Beijing Center for Disease Control and Prevention (CDC), Beijing Academy of Preventive Medicine, Beijing
| | - Xianlong Ren
- Institute for HIV/AIDS and STD Prevention and Control, Beijing Center for Disease Control and Prevention (CDC), Beijing Academy of Preventive Medicine, Beijing
| | - Yanming Sun
- Institute for HIV/AIDS and STD Prevention and Control, Beijing Center for Disease Control and Prevention (CDC), Beijing Academy of Preventive Medicine, Beijing
| | - Yang Li
- Institute for HIV/AIDS and STD Prevention and Control, Beijing Center for Disease Control and Prevention (CDC), Beijing Academy of Preventive Medicine, Beijing
| | - Guowu Liu
- Institute for HIV/AIDS and STD Prevention and Control, Beijing Center for Disease Control and Prevention (CDC), Beijing Academy of Preventive Medicine, Beijing
| | - Xiyao Li
- Institute for HIV/AIDS and STD Prevention and Control, Beijing Center for Disease Control and Prevention (CDC), Beijing Academy of Preventive Medicine, Beijing
| | - Jie Li
- Institute for HIV/AIDS and STD Prevention and Control, Beijing Center for Disease Control and Prevention (CDC), Beijing Academy of Preventive Medicine, Beijing
| | - Junyi Duan
- Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing
| | - Tao Huang
- Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing
| | - Shuiqing Liu
- Department of Infectious Diseases, Guiyang Public Health Clinical Center, Guiyang
| | - Guolong Yu
- Institute of Pathogenic Microbiology, Guangdong CDC, Guangzhou
| | - Donglin Wu
- Virology Laboratory, Jilin CDC, Changchun
| | - Yiming Shao
- Division of Virology and Immunology, State Key Laboratory for Infectious Disease Prevention and Control and National Center for AIDS/STD Prevention and Control, China CDC, Beijing
| | - Qichao Pan
- Division of Tuberculosis and HIV/AIDS Prevention, Shanghai CDC
- Shanghai Institutes of Preventive Medicine
- Shanghai Center for AIDS Research, Shanghai
| | - Linglin Zhang
- Center for AIDS/STD Control and Prevention, Sichuan CDC, Chengdu
| | - Bin Su
- Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing
| | - Jianjun Wu
- Institute for HIV/AIDS and STD Prevention and Control, Anhui CDC, Hefei
| | - Tianjun Jiang
- Treatment and Research Center for Infectious Diseases, The Fifth Medical Center of People's Liberation Army General Hospital, Beijing
| | - Hongxin Zhao
- Clinical and Research Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing
| | - Tong Zhang
- Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing
| | - Faqing Chen
- Institute for HIV/AIDS and STD Prevention and Control, Gansu CDC, Lanzhou
| | | | - Bing Hu
- Institute for HIV/AIDS and STD Prevention and Control, Fuyang CDC, Fuyang
| | - Hui Wang
- Virology Laboratory, Jilin CDC, Changchun
| | - Jin Zhao
- Department of HIV/AIDS Control and Prevention, Shenzhen CDC, Shenzhen
| | - Baicheng Gao
- STD/AIDS Prevention and Control Institute, Inner Mongolia CDC (Inner Mongolia Academy of Preventive Medicine), Hohhot
| | - Wei Sun
- Institute for HIV/AIDS and STD Prevention and Control, Heilongjiang CDC, Harbin
| | - Tielin Ning
- Department of STDs/AIDS Control and Prevention, Tianjin CDC, Tianjin
| | - Jianjun Li
- Institute of HIV/AIDS Prevention and Control, Guangxi CDC, Nanning
| | - Shu Liang
- Center for AIDS/STD Control and Prevention, Sichuan CDC, Chengdu
| | - Yuqi Huo
- Center for Translational Medicine, Affiliated Infectious Diseases Hospital of Zhengzhou University (Henan Infectious Diseases Hospital, The Sixth People's Hospital of Zhengzhou), Zhengzhou
| | - Gengfeng Fu
- Institute of AIDS/STD Control and Prevention, Jiangsu CDC, Nanjing
| | - Xin Chen
- Division of Tuberculosis and HIV/AIDS Prevention, Shanghai CDC
- Shanghai Institutes of Preventive Medicine
- Shanghai Center for AIDS Research, Shanghai
| | - Feng Li
- Institute of Infectious Diseases, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou
| | - Hui Xing
- Division of Virology and Immunology, State Key Laboratory for Infectious Disease Prevention and Control and National Center for AIDS/STD Prevention and Control, China CDC, Beijing
| | - Hongyan Lu
- Institute for HIV/AIDS and STD Prevention and Control, Beijing Center for Disease Control and Prevention (CDC), Beijing Academy of Preventive Medicine, Beijing
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Jacques-Aviñó C, Alarcón Guitiérrez M, Barbera MJ, Fuertes I, Martin-Ezquerra G, Lopez-Contreras J, Vives Á, Rodriguez R, Ros M, Rius C, de Olalla PG. Epidemiological Characteristics and Factors Associated with Repeat Sexually Transmitted Infections in Barcelona, Spain Over a Decade. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:735-744. [PMID: 37875628 PMCID: PMC10844332 DOI: 10.1007/s10508-023-02711-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 09/12/2023] [Accepted: 09/15/2023] [Indexed: 10/26/2023]
Abstract
In the last few years, the frequency of sexually transmitted infections (STI) has increased, as has the number of people with multiple infections. The aim of our study was to describe the epidemiological characteristics of persons with repeated bacterial STI and to determine the risk factors for these episodes in persons living in Barcelona during the period 2007-2018. We studied all cases of bacterial STI included in the STI registry of Barcelona. Repeated STI were defined as a diagnosis of gonorrhea, syphilis, or lymphogranuloma venereum (LGV) after a first episode of one of these infections. Analysis was stratified by sex and place of birth. The factors associated with time to reinfection were determined by Kaplan-Meier estimates, while the factors associated with risk of infection were determined by a Cox proportional hazards model. Of 9927 persons with a diagnosis of bacterial STI, 1690 (17.0%) had at least two episodes of STI during the study period. On multivariate analysis, repeat STI were independently associated with male sex assigned at birth (HR: 3.45; 95%CI 2.22-5.36), age less than 34 years (HR: 1.22; 95%CI 1.10-1.35); gay, bisexual, and other men who have sex with men, and transgender o transsexual woman (GBSMS/Trans) (HR: 4.03; 95%CI 3.24-5.03), having gonorrhea as first diagnosis (HR:1.49, 95%CI 1.34-1.66) or LGV (HR:1.75; 95%CI 1.47-2.08) and coinfection with HIV (HR:1.98; 95%CI 1.78-2.21). Sexual health programs should be strengthened to prevent STI and reinfection in key populations.
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Affiliation(s)
- Constanza Jacques-Aviñó
- Servei d'Epidemiologia, Agència de Salut Pública de Barcelona, Barcelona, Spain.
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Gran Via Corts Catalanes, 587, àtic, 08007, Barcelona, Spain.
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès (Barcelona), Bellaterra, Spain.
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain.
| | - Miguel Alarcón Guitiérrez
- Servei d'Epidemiologia, Agència de Salut Pública de Barcelona, Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès (Barcelona), Bellaterra, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain
| | - María Jesús Barbera
- Department of Infectious Diseases, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Irene Fuertes
- Dermatology Department, Hospital Clinic, Barcelona, Spain
| | - Gemma Martin-Ezquerra
- Dermatology Department, Institut Hospital del Mar d'Investigacions Mèdiques, Hospital del Mar, Barcelona, Spain
| | - Joaquín Lopez-Contreras
- Infectious Diseases Unit-Internal Medicine Department, Hospital de la Santa Creu i Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain
| | | | - Raquel Rodriguez
- Servei d'Epidemiologia, Agència de Salut Pública de Barcelona, Barcelona, Spain
| | - Miriam Ros
- Servei d'Epidemiologia, Agència de Salut Pública de Barcelona, Barcelona, Spain
| | - Cristina Rius
- Servei d'Epidemiologia, Agència de Salut Pública de Barcelona, Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain
- Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Patricia Garcia de Olalla
- Servei d'Epidemiologia, Agència de Salut Pública de Barcelona, Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain
- Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
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3
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Shobowale O, Schmidt AJ, Meireles P, Rojas Castro D, Detandt S, Stutterheim SE, Weatherburn P, Jonas KJ. Determinants of HIV Testing Among Migrant Men Who Have Sex With Men from Sub-Saharan Africa and Other Regions Residing in 10 European Countries. AIDS Behav 2024; 28:488-506. [PMID: 38326669 PMCID: PMC10876736 DOI: 10.1007/s10461-023-04239-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2023] [Indexed: 02/09/2024]
Abstract
Migrant men who have sex with men (mMSM) from sub-Saharan Africa (SSA) and other regions outside Europe are highly vulnerable to HIV. However, research on the determinants of HIV testing among mMSM from SSA, and how these differ across the categories of mMSM living in Europe, is limited. Using data from the European MSM Internet Survey (EMIS-2017), we assessed HIV testing prevalence and recency in mMSM from SSA and other mMSM residing in ten European countries, as well as the determinants of HIV testing across different mMSM categories with logistic regression analyses. Ever-testing for HIV was slightly higher in mMSM from SSA (83%) compared to other mMSM categories (75-80%), except for mMSM from Latin America and Caribbean region (84%). Overall, 20% of mMSM had never tested. In multivariable analysis, higher age (adjusted odds ratio [AOR] 1.05, 95% confidence interval [CI] 1.01-1.10), higher HIV knowledge (AOR 1.45, 95%-CI 1.11-1.90), and residence in smaller settlements (AOR 0.45, 95%-CI 0.21-0.96) were significantly associated with ever testing for HIV in mMSM from SSA. Comparing mMSM from SSA to mMSM from other regions, we found varying significant similarities (higher age, residence in smaller settlements and HIV knowledge) and differences (lower educational attainment, not identifying as gay, being a student, and limited disclosure of homosexual attraction) in the determinants of ever-testing for HIV. Community-specific interventions addressing identified sociodemographic and behavioral determinants to increase HIV testing uptake in the different mMSM categories and better data for further research are warranted.
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Affiliation(s)
- Oladipupo Shobowale
- Department of Work and Social Psychology, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, The Netherlands.
| | - Axel J Schmidt
- London School of Hygiene & Tropical Medicine (LSHTM), Sigma Research, London, UK
| | - Paula Meireles
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | | | - Sandrine Detandt
- Faculty of Psychology, Observatoire du Sida et des Sexualités Research Center, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Sarah E Stutterheim
- Department of Health Promotion, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Peter Weatherburn
- London School of Hygiene & Tropical Medicine (LSHTM), Sigma Research, London, UK
| | - Kai J Jonas
- Department of Work and Social Psychology, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, The Netherlands
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4
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Stengaard AR, Combs L, Supervie V, Croxford S, Desai S, Sullivan AK, Jakobsen SF, Santos Q, Simões D, Casabona J, Lazarus JV, de Wit JBF, Amort FM, Pharris A, Nerlander L, Raben D. HIV seroprevalence in five key populations in Europe: a systematic literature review, 2009 to 2019. EURO SURVEILLANCE : BULLETIN EUROPEEN SUR LES MALADIES TRANSMISSIBLES = EUROPEAN COMMUNICABLE DISEASE BULLETIN 2021; 26. [PMID: 34823636 PMCID: PMC8619876 DOI: 10.2807/1560-7917.es.2021.26.47.2100044] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Background In Europe, HIV disproportionately affects men who have sex with men (MSM), people who inject drugs (PWID), prisoners, sex workers, and transgender people. Epidemiological data are primarily available from national HIV case surveillance systems that rarely capture information on sex work, gender identity or imprisonment. Surveillance of HIV prevalence in key populations often occurs as independent studies with no established mechanism for collating such information at the European level. Aim We assessed HIV prevalence in MSM, PWID, prisoners, sex workers, and transgender people in the 30 European Union/European Economic Area countries and the United Kingdom. Methods We conducted a systematic literature review of peer-reviewed studies published during 2009–19, by searching PubMed, Embase and the Cochrane Library. Data are presented in forest plots by country, as simple prevalence or pooled across multiple studies. Results Eighty-seven country- and population-specific studies were identified from 23 countries. The highest number of studies, and the largest variation in HIV prevalence, were identified for MSM, ranging from 2.4–29.0% (19 countries) and PWID, from 0.0–59.5% (13 countries). Prevalence ranged from 0.0–15.6% in prisoners (nine countries), 1.1–8.5% in sex workers (five countries) and was 10.9% in transgender people (one country). Individuals belonging to several key population groups had higher prevalence. Conclusion This review demonstrates that HIV prevalence is highly diverse across population groups and countries. People belonging to multiple key population groups are particularly vulnerable; however, more studies are needed, particularly for sex workers, transgender people and people with multiple risks.
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Affiliation(s)
- Annemarie Rinder Stengaard
- Centre of Excellence for Health, Immunity and Infections (CHIP), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Lauren Combs
- Centre of Excellence for Health, Immunity and Infections (CHIP), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Virginie Supervie
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | | | | | - Ann K Sullivan
- Directorate of HIV and Sexual Health, Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom
| | - Stine Finne Jakobsen
- Centre of Excellence for Health, Immunity and Infections (CHIP), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Quenia Santos
- Centre of Excellence for Health, Immunity and Infections (CHIP), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Daniel Simões
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, Porto, Portugal.,Grupo de Ativistas em Tratamentos (GAT), Lisboa, Portugal
| | - Jordi Casabona
- Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Jeffrey V Lazarus
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - John B F de Wit
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, Netherlands
| | - Frank M Amort
- FH JOANNEUM, University of Applied Sciences, Bad Gleichenberg, Austria
| | - Anastasia Pharris
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Lina Nerlander
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Dorthe Raben
- Centre of Excellence for Health, Immunity and Infections (CHIP), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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Vourli G, Katsarolis I, Pantazis N, Touloumi G. HIV continuum of care: expanding scope beyond a cross-sectional view to include time analysis: a systematic review. BMC Public Health 2021; 21:1699. [PMID: 34535096 PMCID: PMC8447660 DOI: 10.1186/s12889-021-11747-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 08/29/2021] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION The continuum of care (CoC) model has been used to describe the main pillars of HIV care. This study aims to systematically review methods and elucidate gaps in the CoC analyses, especially in terms of the timing of the progression through steps, recognized nowadays as a critical parameter for an effective response to the epidemic. METHODS A PubMed and EMBASE databases search up to December 2019 resulted in 1918 articles, of which 209 were included in this review; 84 studies presented in major HIV conferences were also included. Studies that did not provide explicit definitions, modelling studies and those reporting only on metrics for subpopulations or factors affecting a CoC stage were excluded. Included articles reported results on 1 to 6 CoC stages. RESULTS Percentage treated and virally suppressed was reported in 78%, percentage diagnosed and retained in care in 58%, percentage linked to care in 54% and PLHIV in 36% of the articles. Information for all stages was provided in 23 studies. Only 6 articles use novel CoC estimates: One presents a dynamic CoC based on multistate analysis techniques, two base their time-to-next-stage estimates on a risk estimation method based on the cumulative incidence function, weighted for confounding and censoring and three studies estimated the HIV infection time based on mathematical modelling. CONCLUSION A limited number of studies provide elaborated time analyses of the CoC. Although time analyses lack the straightforward interpretation of the cross-sectional CoC, they provide valuable insights for the timely response to the HIV epidemic. A future goal would be to develop a model that retains the simplicity of the cross-sectional CoC but also incorporates timing between stages.
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Affiliation(s)
- Georgia Vourli
- Department of Hygiene, Epidemiology & Medical Statistics, Medical School, National and Kapodistrian University of Athens, M. Asias 75, 115 27, Athens, Greece.
| | | | - Nikos Pantazis
- Department of Hygiene, Epidemiology & Medical Statistics, Medical School, National and Kapodistrian University of Athens, M. Asias 75, 115 27, Athens, Greece
| | - Giota Touloumi
- Department of Hygiene, Epidemiology & Medical Statistics, Medical School, National and Kapodistrian University of Athens, M. Asias 75, 115 27, Athens, Greece
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Palacio-Vieira J, Reyes-Urueña JM, Imaz A, Bruguera A, Force L, Llaveria AO, Llibre JM, Vilaró I, Borràs FH, Falcó V, Riera M, Domingo P, de Lazzari E, Miró JM, Casabona J. Strategies to reengage patients lost to follow up in HIV care in high income countries, a scoping review. BMC Public Health 2021; 21:1596. [PMID: 34454444 PMCID: PMC8403456 DOI: 10.1186/s12889-021-11613-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 08/06/2021] [Indexed: 11/18/2022] Open
Abstract
Background Despite remarkable achievements in antiretroviral therapy (ART), losses to follow-up (LTFU) might prevent the long-term success of HIV treatment and might delay the achievement of the 90–90-90 objectives. This scoping review is aimed at the description and analysis of the strategies used in high-income countries to reengage LTFU in HIV care, their implementation and impact. Methods A scoping review was done following Arksey & O′Malley’s methodological framework and recommendations from Joanna Briggs Institute. Peer reviewed articles were searched for in Pubmed, Scopus and Web of Science; and grey literature was searched for in Google and other sources of information. Documents were charted according to the information presented on LTFU, the reengagement procedures used in HIV units in high-income countries, published during the last 15 years. In addition, bibliographies of chosen articles were reviewed for additional articles. Results Twenty-eight documents were finally included, over 80% of them published in the United States later than 2015. Database searches, phone calls and/or mail contacts were the most common strategies used to locate and track LTFU, while motivational interviews and strengths-based techniques were used most often during reengagement visits. Outcomes like tracing activities efficacy, rates of reengagement and viral load reduction were reported as outcome measures. Conclusions This review shows a recent and growing trend in developing and implementing patient reengagement strategies in HIV care. However, most of these strategies have been implemented in the United States and little information is available for other high-income countries. The procedures used to trace and contact LTFU are similar across reviewed studies, but their impact and sustainability are widely different depending on the country studied. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11613-y.
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Affiliation(s)
- Jorge Palacio-Vieira
- Centre for Epidemiological Studies on Sexually Transmitted Infections and HIV/AIDS of Catalonia (CEEISCAT), Badalona, Spain. .,CIBER Epidemiologia y Salud Pública (CIBERESP), Barcelona, Spain. .,Hospital Clinic-Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain.
| | - Juliana Maria Reyes-Urueña
- Centre for Epidemiological Studies on Sexually Transmitted Infections and HIV/AIDS of Catalonia (CEEISCAT), Badalona, Spain.,CIBER Epidemiologia y Salud Pública (CIBERESP), Barcelona, Spain.,Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain
| | - Arkaitz Imaz
- HIV and STI Unit, Department of Infectious Diseases, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Andreu Bruguera
- Centre for Epidemiological Studies on Sexually Transmitted Infections and HIV/AIDS of Catalonia (CEEISCAT), Badalona, Spain.,Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain
| | - Luis Force
- Internal Medicine, Hospital de Mataró-Consorci Sanitari del Maresme, Mataró, Spain
| | - Amat Orti Llaveria
- Internal Medicine, Hospital Verge de la Cinta de Tortosa, Tortosa, Spain
| | - Josep M Llibre
- Infectious Diseases and "Fight AIDS" Foundation, University Hospital Germans Trias i Pujol, Badalona, Spain
| | | | | | - Vicenç Falcó
- Vall d'Hebron Hospital Universitari, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | | | | | - Josep M Miró
- HIV/AIDS Unit. Hospital Clinic, Barcelona, Spain
| | - Jordi Casabona
- Centre for Epidemiological Studies on Sexually Transmitted Infections and HIV/AIDS of Catalonia (CEEISCAT), Badalona, Spain.,CIBER Epidemiologia y Salud Pública (CIBERESP), Barcelona, Spain.,Hospital Clinic-Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain
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7
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Medu O, Lawal A, Coyle D, Pottie K. Economic evaluation of HIV testing options for low-prevalence high-income countries: a systematic review. HEALTH ECONOMICS REVIEW 2021; 11:19. [PMID: 34100138 PMCID: PMC8186150 DOI: 10.1186/s13561-021-00318-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 05/10/2021] [Indexed: 06/12/2023]
Abstract
INTRODUCTION This study reviewed the economic evidence of rapid HIV testing versus conventional HIV testing in low-prevalence high-income countries; evaluated the methodological quality of existing economic evaluations of HIV testing studies; and made recommendations on future economic evaluation directions of HIV testing approaches. METHODS A systematic search of selected databases for relevant English language studies published between Jan 1, 2001, and Jan 30, 2019, was conducted. The methodological design quality was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) and the Drummond tool. We reported the systematic review according to the PRISMA guidelines. RESULTS Five economic evaluations met the eligibility criteria but varied in comparators, evaluation type, perspective, and design. The methodologic quality of the included studies ranged from medium to high. We found evidence to support the cost-effectiveness of rapid HIV testing approaches in low-prevalence high-income countries. Rapid HIV testing was associated with cost per adjusted life year (QALY), ranging from $42,768 to $90,498. Additionally, regardless of HIV prevalence, rapid HIV testing approaches were the most cost-effective option. CONCLUSIONS There is evidence for the cost-effectiveness of rapid HIV testing, including the use of saliva-based testing compared to usual care or hospital-based serum testing. Further studies are needed to draw evidence on the relative cost-effectiveness of the distinct options and contexts of rapid HIV testing.
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Affiliation(s)
| | | | - Doug Coyle
- University of Ottawa School of Epidemiology and Public Health, Ottawa, Canada
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8
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Fernàndez-López L, Reyes-Urueña J, Conway A, Saz J, Morales A, Quezadas J, Baroja J, Rafel A, Pazos A, Avellaneda A, Meroño M, Andreo L, Romero L, Lara A, Otón A, Rifà B, Mansilla R, Colom J, Casabona J. The contribution of HIV point-of-care tests in early HIV diagnosis: community-based HIV testing monitoring in Catalonia, 1995 to 2018. ACTA ACUST UNITED AC 2021; 25. [PMID: 33124552 PMCID: PMC7596919 DOI: 10.2807/1560-7917.es.2020.25.43.1900424] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background Community-based HIV testing services combined with the use of point-of-care tests (POCT) have the potential to improve early diagnosis through increasing availability, accessibility and uptake of HIV testing. Aim To describe community-based HIV testing activity in Catalonia, Spain, from 1995 to 2018, and to evaluate the impact of HIV POCT on the HIV continuum of care. Methods A community-based network of voluntary counselling and testing services in Catalonia, Spain has been collecting systematic data on activity, process and results since 1995. A descriptive analysis was performed on pooled data, describing the data in terms of people tested and reactive screening test results. Results Between 1995 and 2018, 125,876 HIV tests were performed (2.1% reactive). Since the introduction of HIV POCT in 2007, a large increase in the number of tests performed was observed, reaching 14,537 tests alone in 2018 (1.3% reactive). Men who have sex with men (MSM), as a proportion of all people tested, has increased greatly over time reaching 74.7% in 2018. The highest percentage of reactive tests was found in people who inject drugs followed by MSM. The contribution of community-based HIV testing to the overall total notified cases in the Catalonia HIV registry has gradually increased, reaching 37.9% in 2018, and 70% of all MSM cases. In 2018, the percentage of individuals with a reactive screening test who were linked to care was 89.0%. Conclusion Our study reinforces the important role that community-based HIV POCT has on the diagnosis of HIV in key populations.
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Affiliation(s)
- Laura Fernàndez-López
- Centros de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Spain.,Centre for Epidemiological Studies on Sexually Transmitted Infections and HIV/AIDS of Catalonia (CEEISCAT), Catalan Health Department, Barcelona, Spain
| | - Juliana Reyes-Urueña
- Centros de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Spain.,Centre for Epidemiological Studies on Sexually Transmitted Infections and HIV/AIDS of Catalonia (CEEISCAT), Catalan Health Department, Barcelona, Spain
| | - Anna Conway
- The Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain.,Centre for Epidemiological Studies on Sexually Transmitted Infections and HIV/AIDS of Catalonia (CEEISCAT), Catalan Health Department, Barcelona, Spain
| | | | | | - Jaime Quezadas
- Associació Ciutadana Antisida de Catalunya (ACASC), Barcelona, Spain
| | - Jordi Baroja
- Centre Jove d'Atenció a les Sexualitats (CJAS), Barcelona, Spain
| | - Anna Rafel
- Associació Antisida de Lleida, Lleida, Spain
| | | | | | | | - Lorena Andreo
- CAS/ARD Lluís Companys, Creu Roja Barcelona, Barcelona, Spain
| | - Lluís Romero
- Assexora'Tgn (Associacio Comunitària de Salut Sexual del Camp de Tarragona), Tarragona, Spain
| | - Anna Lara
- Associació Comunitària Anti Sida de Girona (ACAS), Girona, Spain
| | | | - Benet Rifà
- Programme for Prevention, Control and Treatment of HIV, STIs and Viral Hepatitis, Public Health Agency of Catalonia, Barcelona, Spain.,Section for Surveillance, Prevention and Control of Sexually Transmitted Infections and HIV, Public Health Agency of Catalonia, Barcelona, Spain
| | - Rosa Mansilla
- Programme for Prevention, Control and Treatment of HIV, STIs and Viral Hepatitis, Public Health Agency of Catalonia, Barcelona, Spain.,Section for Surveillance, Prevention and Control of Sexually Transmitted Infections and HIV, Public Health Agency of Catalonia, Barcelona, Spain
| | - Joan Colom
- Programme for Prevention, Control and Treatment of HIV, STIs and Viral Hepatitis, Public Health Agency of Catalonia, Barcelona, Spain
| | - Jordi Casabona
- Department of Paediatrics, Obstetrics and Gynaecology, and Preventive Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain.,Centros de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Spain.,Centre for Epidemiological Studies on Sexually Transmitted Infections and HIV/AIDS of Catalonia (CEEISCAT), Catalan Health Department, Barcelona, Spain
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Middleton M, Somerset S, Evans C, Blake H. Test@Work Texts: Mobile Phone Messaging to Increase Awareness of HIV and HIV Testing in UK Construction Employees during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7819. [PMID: 33114546 PMCID: PMC7672579 DOI: 10.3390/ijerph17217819] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 10/18/2020] [Accepted: 10/22/2020] [Indexed: 12/11/2022]
Abstract
Background: HIV poses a threat to global health. With effective treatment options available, education and testing strategies are essential in preventing transmission. Text messaging is an effective tool for health promotion and can be used to target higher risk populations. This study reports on the design, delivery and testing of a mobile text messaging SMS intervention for HIV prevention and awareness, aimed at adults in the construction industry and delivered during the COVID-19 pandemic. Method: Participants were recruited at Test@Work workplace health promotion events (21 sites, n = 464 employees), including health checks with HIV testing. Message development was based on a participatory design and included a focus group (n = 9) and message fidelity testing (n = 291) with assessment of intervention uptake, reach, acceptability, and engagement. Barriers to HIV testing were identified and mapped to the COM-B behavioural model. 23 one-way push SMS messages (19 included short web links) were generated and fidelity tested, then sent via automated SMS to two employee cohorts over a 10-week period during the COVID-19 pandemic. Engagement metrics measured were: opt-outs, SMS delivered/read, number of clicks per web link, four two-way pull messages exploring repeat HIV testing, learning new information, perceived usefulness and behaviour change. Results: 291 people participated (68.3% of eligible attendees). A total of 7726 messages were sent between March and June 2020, with 91.6% successfully delivered (100% read). 12.4% of participants opted out over 10 weeks. Of delivered messages, links were clicked an average of 14.4% times, max 24.1% for HIV related links. The number of clicks on web links declined over time (r = -6.24, p = 0.01). Response rate for two-way pull messages was 13.7% of participants. Since the workplace HIV test offer at recruitment, 21.6% reported having taken a further HIV test. Qualitative replies indicated behavioural influence of messaging on exercise, lifestyle behaviours and intention to HIV test. Conclusions: SMS messaging for HIV prevention and awareness is acceptable to adults in the construction industry, has high uptake, low attrition and good engagement with message content, when delivered during a global pandemic. Data collection methods may need refinement for audience, and effect of COVID-19 on results is yet to be understood.
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Affiliation(s)
- Matthew Middleton
- School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK;
| | - Sarah Somerset
- School of Health Sciences, University of Nottingham, Nottingham NG7 2HA, UK; (S.S.); (C.E.)
| | - Catrin Evans
- School of Health Sciences, University of Nottingham, Nottingham NG7 2HA, UK; (S.S.); (C.E.)
| | - Holly Blake
- School of Health Sciences, University of Nottingham, Nottingham NG7 2HA, UK; (S.S.); (C.E.)
- NIHR Nottingham Biomedical Research Centre, Nottingham NG7 2UH, UK
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10
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Nguyen LH, Nguyen HLT, Larsson M, Tran BX, L Stein M, Rocha LEC, Strömdahl S. An exploratory assessment of the preference for eHealth interventions to prevent HIV and sexually transmitted infections among men who have sex with men in Hanoi, Vietnam. BMC Public Health 2020; 20:1387. [PMID: 32917157 PMCID: PMC7488431 DOI: 10.1186/s12889-020-09449-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 08/25/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Electronic health (eHealth) interventions are promising in HIV and sexually transmitted infections (STIs) prevention among men who have sex with men (MSM), given a high rate of the Internet use in this population. This study determined the preferences for eHealth interventions to prevent HIV and STIs among MSM in Hanoi, Vietnam to guide the development of future eHealth interventions. METHODS Five focus group discussions (FGD) were conducted with 35 MSM recruited by purposive sampling in January 2018 in Hanoi, Vietnam. The FGDs addressed attitudes towards the feasibility and uptake of HIV/STI interventions via online modalities such as smartphone applications (apps, social network sites, or emails); preferences and concerns regarding an online HIV/STI intervention. FGDs were audio-recorded and transcribed verbatim. Content analysis was used to determine themes. RESULTS MSM reported that they commonly searched for information regarding HIV/STI and sexual health on Facebook and a variety of mobile apps. They perceived a lack of reliable online sources, a high need, and interest for an online intervention. Most of them preferred short and concise messages without perceived sensitive words such as "HIV" or "STI". Diversity of online modalities were preferred with information from credible sources about HIV/STI symptoms, testing and treatment, safe sex practices and testing locations with a focus on safe MSM-friendly clinics. Concerns about the need to trust the organization behind the online information and interventions, and the importance of confidentiality when participating in online interventions were raised. CONCLUSION High acceptance and perceived need for an online HIV/STI intervention were reported. The importance of establishing trust within the MSM community as a reliable source of information was emphasized, as well as the importance of confidentiality.
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Affiliation(s)
- Long Hoang Nguyen
- Department of Global Public Health Sciences, Karolinska Institutet, SE-171 77, Stockholm, Sweden. .,Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam.
| | | | - Mattias Larsson
- Department of Global Public Health Sciences, Karolinska Institutet, SE-171 77, Stockholm, Sweden
| | - Bach Xuan Tran
- Department of Health Economics, Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam.,Department of Health, Behaviours, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Mart L Stein
- National Coordination Centre for Communicable Disease Control, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Luis E C Rocha
- Department of Economics & Department of Physics and Astronomy, Ghent University, Ghent, Belgium
| | - Susanne Strömdahl
- Department of Global Public Health Sciences, Karolinska Institutet, SE-171 77, Stockholm, Sweden.,Department of Medical Sciences, Section of Infectious Diseases, Uppsala University, Uppsala, Sweden
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11
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Sun X, Yang W, Tang S, Shen M, Wang T, Zhu Q, Shen Z, Tang S, Chen H, Ruan Y, Xiao Y. Declining trend in HIV new infections in Guangxi, China: insights from linking reported HIV/AIDS cases with CD4-at-diagnosis data. BMC Public Health 2020; 20:919. [PMID: 32532238 PMCID: PMC7290136 DOI: 10.1186/s12889-020-09021-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Accepted: 06/01/2020] [Indexed: 11/17/2022] Open
Abstract
Background The Guangxi Zhuang Autonomous Region bears a relatively high burden of HIV/AIDS infection. The number of accumulatively reported HIV/AIDS cases in Guangxi is the third highest among 31 provinces or Autonomous Region from 2004 to 2007, changed to the second highest between 2011 and 2013, then returned to the third highest again after 2014. We aim to estimate the new infections and evaluate the real-time HIV epidemic in Guangxi, China, in order to reveal the rule of HIV transmission. Methods Firstly, the number of annually reported HIV and AIDS cases, as well as the number of cases linked with CD4 data are extracted from the HIV/AIDS information system in China. Secondly, two CD4-staged models are formulated by linking the with-host information on CD4 level to between-host transmission and surveillance data. Thirdly, new HIV infections, diagnosis rates and undiagnosed infections over time are estimated by using Bayesian method and Maximum Likelihood Estimation method. Results The data reveal that the newly reported cases have been decreasing since 2011, while lots of cases are identified at late CD4 stage. The data fitted results indicate that both models can describe the trend of the epidemic well. The estimation results show that the new and undiagnosed infections began to decrease from the period2006 - 2008. However, the diagnosis probabilities/rates keep at a very low level, and there are still a large number of infections undiagnosed, most of which have a large probability to be identified at late CD4 stage. Conclusions Our findings suggest that HIV/AIDS epidemic in Guangxi has been controlled to a certain extent, while the diagnosis rate still needs to be improved. More attentions should be paid to identify infections at their early CD4 stages. Meanwhile, comprehensive intervention measures should be continually strengthened in avoid of the rebound of new infections.
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Affiliation(s)
- Xiaodan Sun
- School of Mathematics and Statistics, Xi'an Jiaotong University, Xi'an, 710049, China
| | - Wenmin Yang
- Guangxi Center for Disease Control and Prevention, Nanning, China
| | - Sanyi Tang
- School of Mathematics and Information Science, Shaanxi Normal University, Xi'an, China
| | - Mingwang Shen
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Tianyang Wang
- School of Mathematics and Statistics, Xi'an Jiaotong University, Xi'an, 710049, China
| | - Qiuying Zhu
- Guangxi Center for Disease Control and Prevention, Nanning, China
| | - Zhiyong Shen
- Guangxi Center for Disease Control and Prevention, Nanning, China
| | - Shuai Tang
- Guangxi Center for Disease Control and Prevention, Nanning, China
| | - Huanhuan Chen
- Guangxi Center for Disease Control and Prevention, Nanning, China
| | - Yuhua Ruan
- Guangxi Center for Disease Control and Prevention, Nanning, China. .,State Key Laboratory of Infectious Disease Prevention and Control (SKLID), Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Chinese Center for Disease Control and Prevention (China CDC), Beijing, China.
| | - Yanni Xiao
- School of Mathematics and Statistics, Xi'an Jiaotong University, Xi'an, 710049, China.
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12
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Marty L, Van Beckhoven D, Ost C, Deblonde J, Costagliola D, Sasse A, Supervie V. Estimates of the HIV undiagnosed population in Belgium reveals higher prevalence for MSM with foreign nationality and for geographic areas hosting big cities. J Int AIDS Soc 2020; 22:e25371. [PMID: 31424626 PMCID: PMC6699451 DOI: 10.1002/jia2.25371] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 07/21/2019] [Indexed: 01/13/2023] Open
Abstract
Introduction Increasing our knowledge on geographic areas and key populations most affected by HIV is essential to improve prevention and care and to ensure a more focused HIV response. Here, we estimated the prevalence of undiagnosed HIV infections in Belgium and its distribution across geographic areas and exposure groups. Methods We used surveillance data on newly diagnosed HIV cases and a previously developed back‐calculation model to estimate number and prevalence rates (per 10000) of undiagnosed HIV infections by exposure group at national and subnational levels. Belgium consists of three regions: Flanders, Brussels‐Capital Region and Wallonia. We produced estimates for Brussels‐Capital Region and Wallonia. For Flanders, we produced estimates for two sub‐regional areas: the province of Antwerp and the other provinces, because Antwerp is the second largest city after Brussels. Population sizes were determined using data from the Belgian Statistical Office and surveys on sexual behaviour and drug use. Results In Belgium, in 2015, an estimated 2818 (95% confidence interval: 2494 to 3208) individuals were living with undiagnosed HIV, that is, 15% of individuals living with HIV. The Brussels‐Capital Region and the province of Antwerp, which host the two biggest cities, accounted for ~60% of the undiagnosed infections, and had the highest undiagnosed prevalence rates per 10000: 12.0 (9.4 to 15.3) and 7.4 (5.6 to 9.8) respectively. Individuals with foreign nationality accounted for 56% of the total number of undiagnosed infections, and were the most affected populations in all areas in terms of undiagnosed prevalence rates. Specifically, men who have sex with men (MSM) with non‐European nationality were the most affected population in the province of Antwerp (853.4 (408.2 to 1641.9) undiagnosed infections per 10000), the Brussels‐Capital Region (543.9 (289.1 to 1019.1)), and the other provinces of Flanders (691.7 (235.5 to 1442.2)), while in Wallonia, it was heterosexual women with Sub‐Saharan African nationality (132.2 (90.6 to 178.5)). Conclusions Geographic areas hosting the biggest cities in Belgium accounted for the vast majority of undiagnosed HIV infections and individuals with foreign nationality were the most affected, especially MSM with non‐European nationality. This should be accounted for when tailoring prevention and testing programs. Furthermore, MSM with foreign nationality require more attention in Belgium, and certainly more generally in Europe.
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Affiliation(s)
- Lise Marty
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Paris, France
| | - Dominique Van Beckhoven
- Sciensano (Scientific Institute of Public Health), Epidemiology of Infectious Diseases, Brussels, Belgium
| | - Cloë Ost
- Sciensano (Scientific Institute of Public Health), Epidemiology of Infectious Diseases, Brussels, Belgium
| | - Jessika Deblonde
- Sciensano (Scientific Institute of Public Health), Epidemiology of Infectious Diseases, Brussels, Belgium
| | - Dominique Costagliola
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Paris, France
| | - André Sasse
- Sciensano (Scientific Institute of Public Health), Epidemiology of Infectious Diseases, Brussels, Belgium
| | - Virginie Supervie
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Paris, France
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Agustí C, Muñoz R, González V, Villegas L, Fibla J, Meroño M, Capitán A, Fernàndez-López L, Platteau T, Casabona J. Outreach HIV testing using oral fluid and online consultation of the results: Pilot intervention in Catalonia. Enferm Infecc Microbiol Clin 2020; 39:3-8. [PMID: 32151468 DOI: 10.1016/j.eimc.2020.01.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 01/08/2020] [Accepted: 01/13/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION The aim of the intervention was to describe the feasibility and cost-effectiveness of offering HIV testing in outreach interventions and subsequent consultation of the results through a secure web page. METHODS The HIV test was offered "in situ" to men who have sex with men (MSM), migrant sex workers and trans women recruited in places of leisure and sex. Four collaborating NGOs recruited the participants and assisted them to register on the study website (www.swab2know.eu) through a tablet or the smartphone of the same participant. The samples were sent to the reference laboratory and the results were published on the website. RESULTS 834 participants (612 MSMs, 203 women sex workers and 19 trans women) were recruited. In total 22 reagent results (2.6%) were detected: 21 among MSMs (3.4%) and 1 in a trans women (5.3%). While 82.6% of MSMs consulted their outcome, only 39.9% and 26.3% of women sex workers and trans women respectively consulted their outcome CONCLUSIONS: Providing self-sampling in outreach activities, dispatch and analysis in a reference laboratory as well as online communication of test results is feasible. A high proportion of participants with a HIV reactive result were detected among MSMs and trans women.
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Affiliation(s)
- Cristina Agustí
- Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Departament de Salut, Generalitat de Catalunya, Badalona, Barcelona, España; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, España.
| | - Rafael Muñoz
- Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Departament de Salut, Generalitat de Catalunya, Badalona, Barcelona, España
| | - Victoria González
- Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Departament de Salut, Generalitat de Catalunya, Badalona, Barcelona, España; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, España
| | | | - Joan Fibla
- Associació Antisida Lleida, Lleida, España
| | | | | | - Laura Fernàndez-López
- Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Departament de Salut, Generalitat de Catalunya, Badalona, Barcelona, España; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, España
| | - Tom Platteau
- Institute of Tropical Medicine, Department of Clinical Sciences, Antwerp, Bélgica
| | - Jordi Casabona
- Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Departament de Salut, Generalitat de Catalunya, Badalona, Barcelona, España; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, España; Departament de Pediatria, Obstetricia i Ginecologia i de Medicina Preventiva, Universitat Autònoma de Barcelona, Badalona, Barcelona, España
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14
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Ayano G, Haile K, Tesfaye A, Haile K, Demelash S, Tulu M, Tsegaye B, Solomon M, Kebede A, Biru A, Birhanu H, Zenawi G, Habtamu Y, Kibron E, Eshetu S, Sefiw M, Assefa D, Yohannes Z. Undiagnosed HIV, hepatitis B, and hepatitis C infections in people with severe psychiatric disorders in Ethiopia. BMC Infect Dis 2020; 20:180. [PMID: 32106864 PMCID: PMC7045486 DOI: 10.1186/s12879-020-4907-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 02/19/2020] [Indexed: 12/29/2022] Open
Abstract
Background Worldwide, there is limited epidemiologic evidence on the seroprevalence of undiagnosed chronic viral infections including HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV) infections among patients with severe psychiatric disorders. To our knowledge, this is the first study to explore and compare undiagnosed seroprevalence rates of HIV, HBV, and HCV infections among patients with severe psychiatric disorders. Method In this study, we included a random sample of 309 patients with severe psychiatric disorders selected by systematic sampling technique. We used a structured clinical interview for DSM-IV (SCID) to confirm the diagnosis of severe psychiatric disorders among the participants. Binary and multivariable logistic regression models, adjusting for the potential confounding factors was used to explore the potential determinants of chronic viral infections. Result The prevalence estimates of HIV infection among patients with severe psychiatric disorders in this study (3.24%) was roughly 3 times the estimated population prevalence of HIV infection in Ethiopia (1.1%). This study showed that the prevalence rates of HBV and HCV infections among patients with severe psychiatric disorders were 4.85 and 1.29%, respectively. Our results also showed that among patients with chronic viral infections, HIV, HBV and HCV, 76.92, 60, 80, and 75% respectively were undiagnosed. Regarding associated factors, the presence of chronic viral infection was found to be significantly associated with the age of the participants (ranging between 30 and 40 years) after adjusting for the possible confounding factors [AOR = 3.95 (95%CI.18–13.17)]. Conclusion Even though the prevalence estimates of HIV (3.24%), HBV (4.85%), and HCV (1.29%) infections were high among patients with severe psychiatric disorders, the majority of them remained undiagnosed. HBV was found to be the commonly undiagnosed infection (4 out of 5) followed by HCV (3 out of 4) and HIV (6 out of 10). The present study provided evidence of a significant association between the age of the participant (between 30 and 40 years) and chronic viral infections in patients with severe psychiatric disorders. Increasing the awareness of psychiatry professionals and early screening, as well as interventions of chronic viral infections among patients with severe psychiatric disorders are imperative.
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Affiliation(s)
- Getinet Ayano
- Research and Training Department, Amanuel Mental Specialized Hospital, PO Box 171, Addis Ababa, Ethiopia. .,School of Public Health, Curtin University, Perth, Westen Australia, Australia.
| | - Kibrom Haile
- Research and Training Department, Amanuel Mental Specialized Hospital, PO Box 171, Addis Ababa, Ethiopia
| | - Abel Tesfaye
- Research and Training Department, Amanuel Mental Specialized Hospital, PO Box 171, Addis Ababa, Ethiopia.,Department of medicine, Hawassa University, Hawassa, Ethiopia
| | - Kelemua Haile
- Research and Training Department, Amanuel Mental Specialized Hospital, PO Box 171, Addis Ababa, Ethiopia
| | | | - Mikias Tulu
- Research and Training Department, Amanuel Mental Specialized Hospital, PO Box 171, Addis Ababa, Ethiopia
| | - Belachew Tsegaye
- Research and Training Department, Amanuel Mental Specialized Hospital, PO Box 171, Addis Ababa, Ethiopia
| | - Melat Solomon
- Research and Training Department, Amanuel Mental Specialized Hospital, PO Box 171, Addis Ababa, Ethiopia
| | - Alem Kebede
- Research and Training Department, Amanuel Mental Specialized Hospital, PO Box 171, Addis Ababa, Ethiopia
| | - Aynalem Biru
- Research and Training Department, Amanuel Mental Specialized Hospital, PO Box 171, Addis Ababa, Ethiopia
| | - Habte Birhanu
- Research and Training Department, Amanuel Mental Specialized Hospital, PO Box 171, Addis Ababa, Ethiopia
| | - Gebresilassie Zenawi
- Research and Training Department, Amanuel Mental Specialized Hospital, PO Box 171, Addis Ababa, Ethiopia
| | - Yodit Habtamu
- Research and Training Department, Amanuel Mental Specialized Hospital, PO Box 171, Addis Ababa, Ethiopia
| | - Esias Kibron
- Research and Training Department, Amanuel Mental Specialized Hospital, PO Box 171, Addis Ababa, Ethiopia
| | - Seneshet Eshetu
- Research and Training Department, Amanuel Mental Specialized Hospital, PO Box 171, Addis Ababa, Ethiopia
| | - Meseret Sefiw
- Research and Training Department, Amanuel Mental Specialized Hospital, PO Box 171, Addis Ababa, Ethiopia
| | - Dawit Assefa
- Research and Training Department, Amanuel Mental Specialized Hospital, PO Box 171, Addis Ababa, Ethiopia
| | - Zegeye Yohannes
- Research and Training Department, Amanuel Mental Specialized Hospital, PO Box 171, Addis Ababa, Ethiopia
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15
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Determinants and Outcomes of Late Presentation of HIV Infection in Migrants in Catalonia, Spain: PISCIS Cohort 2004-2016. J Immigr Minor Health 2020; 21:920-930. [PMID: 30377891 DOI: 10.1007/s10903-018-0834-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
This study using the Catalan PISCIS cohort explores risk factors of migrants' late presentation and the impact of late presentation on their health outcomes. We analyse 9590 new HIV diagnoses enrolled in the cohort between 2004 and 2016. Univariate and multivariate logistic regression models are used to identify risk factors associated with late presentation among migrants, giving crude and adjusted odds ratios and their 95% confidence intervals. Cox regression models are estimated to identify risk factors associated with AIDS/death, and crude and adjusted hazard ratios and 95% confidence intervals are reported. Late presentation is higher in migrants than non-migrants. Among migrants, region of origin is associated with late presentation and AIDS/death during follow-up. The results highlight persisting inequalities in HIV diagnosis and care among migrants in Catalonia. Targeted interventions addressed to specific subgroups in the migrant population are needed.
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16
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Nicolás D, Ambrosioni J, de Lazzari E, Suarez A, Manzardo C, Agüero F, Mosquera MM, Costa J, Ligero C, Marcos MÁ, Sánchez-Palomino S, Fernández E, Plana M, Yerly S, Gatell JM, Miró JM. Epidemiological changes of acute/recent human immunodeficiency virus type 1 infection in Barcelona, Spain (1997-2015): a prospective cohort study. Clin Microbiol Infect 2018; 25:878-884. [PMID: 30472421 DOI: 10.1016/j.cmi.2018.10.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 10/25/2018] [Accepted: 10/31/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To describe the epidemiology of acute/recent human immunodeficiency virus (HIV) infection over two decades in Barcelona (Spain). METHODS Prospective, single-centre cohort including all patients with an acute/recent HIV infection (<180 days) since 1997. Patients were stratified into four periods. Phylogenetic analysis was performed to determine clusters of transmission. RESULTS A total of 346 consecutive acute/recently infected patients were included. The annual proportion of recent infections among total new HIV diagnoses increased over time from 1% (29 out of 1964) to 8% (112 out of 1474) (p <0.001). Proportion of men who have sex with men (MSM) in the cohort increased from 62% (18 out of 29) to 89% (100 out of 112) (p <0.001). The proportion of migrants showed a non-significant increasing trend (24% (7 of 29) to 40% (45 of 112)) likewise the non-B subtype (0% to 22% (22 of 112)). The mean time from infection to diagnosis was 53.6 days (interquartile range (IQR) 50-57), comparable among all periods. Mean time from infection to treatment decreased over the years from 575 (IQR 467-683) to 471 (IQR 394-549) days (p <0.001) without significant differences between migrants and non-migrants (133 (IQR 71-411) versus 208 (IQR 90-523) days p 0.089). Almost 50% (152 of 311) of recently infected individuals were included in a cluster of transmission, and 92% (137 of 149) of them were MSM. CONCLUSION The MSM population has progressively grown within acutely/recently infected patients in Barcelona, and is frequently involved in transmission clusters. Although the time between diagnosis and treatment has been reduced, the time between infection and diagnosis still needs to be shortened.
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Affiliation(s)
- D Nicolás
- Infectious Diseases Service, Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain
| | - J Ambrosioni
- Infectious Diseases Service, Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain
| | - E de Lazzari
- Infectious Diseases Service, Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain
| | - A Suarez
- Infectious Diseases Service, Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain
| | - C Manzardo
- Infectious Diseases Service, Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain
| | - F Agüero
- Infectious Diseases Service, Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain
| | - M M Mosquera
- Laboratory of Virology, Microbiology Service, Hospital Clinic Barcelona, CIBERehd, University of Barcelona, Barcelona, Spain
| | - J Costa
- Laboratory of Virology, Microbiology Service, Hospital Clinic Barcelona, CIBERehd, University of Barcelona, Barcelona, Spain
| | - C Ligero
- Infectious Diseases Service, Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain
| | - M Á Marcos
- Laboratory of Virology, Microbiology Service, Hospital Clinic Barcelona, CIBERehd, University of Barcelona, Barcelona, Spain
| | - S Sánchez-Palomino
- Retrovirology and Viral Immunopathology Laboratory, AIDS Research Group, IDIBAPS, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - E Fernández
- Infectious Diseases Service, Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain
| | - M Plana
- Retrovirology and Viral Immunopathology Laboratory, AIDS Research Group, IDIBAPS, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - S Yerly
- Laboratory of Virology, Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland
| | - J M Gatell
- Infectious Diseases Service, Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain
| | - J M Miró
- Infectious Diseases Service, Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain.
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