High risk exposure to HIV among sexually active individuals who tested negative on rapid HIV Tests in the Tshwane District of South Africa-The importance of behavioural prevention measures.

Autor: Mayaphi SH; Department of Medical Virology, University of Pretoria, City of Tshwane, South Africa.; National Health Laboratory Service-Tshwane Academic Division (NHLS-TAD), City of Tshwane, South Africa., Martin DJ; Department of Medical Virology, University of Pretoria, City of Tshwane, South Africa.; Toga Laboratories, Johannesburg, South Africa., Olorunju SAS; Biostatistics unit, Medical Research Council, City of Tshwane, South Africa., Williams BG; South African Centre for Epidemiological Modelling and Analysis, Stellenbosch, South Africa., Quinn TC; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America.; Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America., Stoltz AC; Division of Infectious Diseases, Department of Internal Medicine, University of Pretoria, City of Tshwane, South Africa.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2018 Feb 02; Vol. 13 (2), pp. e0192357. Date of Electronic Publication: 2018 Feb 02 (Print Publication: 2018).
DOI: 10.1371/journal.pone.0192357
Abstrakt: Objective: To assess the prevalence of HIV risk behaviour among sexually active HIV sero-negative individuals in the Tshwane district of South Africa (SA).
Methods: Demographic and HIV risk behaviour data were collected on a questionnaire from participants of a cross-sectional study that screened for early HIV infection using pooled nucleic acid amplification testing (NAAT). The study enrolled individuals who tested negative on rapid HIV tests performed at five HIV counseling and testing (HCT) clinics, which included four antenatal clinics and one general HCT clinic.
Results: The study enrolled 9547 predominantly black participants (96.6%) with a median age of 27 years (interquartile range [IQR]: 23-31). There were 1661 non-pregnant and 7886 pregnant participants largely enrolled from the general and antenatal HCT clinics, respectively. NAAT detected HIV infection in 61 participants (0.6%; 95% confidence interval [CI]: 0.4-0.8) in the whole study. A high proportion of study participants, 62.8% and 63.0%, were unaware of their partner's HIV status; and also had high prevalence, 88.5% and 99.5%, of recent unprotected sex in the general and pregnant population, respectively. Consistent use of condoms was associated with protection against HIV infection in the general population. Trends of higher odds for HIV infection were observed with most demographic and HIV risk factors at univariate analysis, however, multivariate analysis did not show statistical significance for almost all these factors. A significantly lower risk of HIV infection was observed in circumcised men (p <0.001).
Conclusions: These data show that a large segment of sexually active people in the Tshwane district of SA have high risk exposure to HIV. The detection of newly diagnosed HIV infections in all study clinics reflects a wide distribution of individuals who are capable of sustaining HIV transmission in the setting where HIV risk behaviour is highly prevalent. A questionnaire that captures HIV risk behaviour would be useful during HIV counselling and testing to ensure that there is a systematic way of identifying HIV risk factors and that counselling is optimised for each individual. HIV risk behaviour surveillance could be used to inform relevant HIV prevention interventions that could be implemented at a community or population level.
Databáze: MEDLINE
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