Epidemiological factors associated with recent HIV infection among newly-diagnosed cases in Singapore, 2013-2017
Autor: | Vernon J. Lee, Raymond Tzer-Pin Lin, Carmen Low, Angela Chow, Matthias Paul Han Sim Toh, Yee Sin Leo, Irving Charles Boudville, Sophia Archuleta, Chen Seong Wong, Li Wei Ang |
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Přispěvatelé: | Lee Kong Chian School of Medicine (LKCMedicine), National Centre for Infectious Diseases, Tan Tock Seng Hospital, National University of Singapore |
Rok vydání: | 2020 |
Předmět: |
Adult
Male medicine.medical_specialty Adolescent Epidemiology Sexual Behavior HIV Infections Logistic regression Recent HIV infection 03 medical and health sciences Young Adult 0302 clinical medicine Interquartile range Risk Factors Internal medicine medicine Odds Ratio Recent HIV Infection Humans Medicine [Science] 030212 general & internal medicine 030304 developmental biology 0303 health sciences Singapore business.industry Epidemiological Factors Public health lcsh:Public aspects of medicine Public Health Environmental and Occupational Health lcsh:RA1-1270 Odds ratio Modifiable behaviors Confidence interval Newly diagnosed HIV testing Female Biostatistics business Newly Diagnosed Research Article |
Zdroj: | BMC Public Health BMC Public Health, Vol 21, Iss 1, Pp 1-12 (2021) |
ISSN: | 1471-2458 |
Popis: | BackgroundEarly diagnosis is crucial in securing optimal outcomes in the HIV care cascade. Recent HIV infection (RHI) serves as an indicator of early detection in the course of HIV infection. Surveillance of RHI is important in uncovering at-risk groups in which HIV transmission is ongoing. The study objectives are to estimate the proportion of RHI among persons newly-diagnosed in 2013–2017, and to elucidate epidemiological factors associated with RHI in Singapore.MethodsAs part of the National HIV Molecular Surveillance Programme, residual plasma samples of treatment-naïve HIV-1 positive individuals were tested using the biotinylated peptide-capture enzyme immunoassay with a cutoff of normalized optical density ≤ 0.8 for evidence of RHI. A recent infection testing algorithm was applied for the classification of RHI. We identified risk factors associated with RHI using logistic regression analyses.ResultsA total of 701 newly-diagnosed HIV-infected persons were included in the study. The median age at HIV diagnosis was 38 years (interquartile range, 28–51). The majority were men (94.2%), and sexual route was the predominant mode of HIV transmission (98.3%). Overall, 133/701 (19.0, 95% confidence interval [CI] 16.2–22.0%) were classified as RHI. The proportions of RHI in 2015 (31.1%) and 2017 (31.0%) were significantly higher than in 2014 (11.2%). A significantly higher proportion of men having sex with men (23.4, 95% CI 19.6–27.6%) had RHI compared with heterosexual men (11.1, 95% CI 7.6–15.9%). Independent factors associated with RHI were: age 15–24 years (adjusted odds ratio [aOR] 4.18, 95% CI 1.69–10.31) compared with ≥55 years; HIV diagnosis in 2015 (aOR 2.36, 95% CI 1.25–4.46) and 2017 (aOR 2.52, 95% CI 1.32–4.80) compared with 2013–2014; detection via voluntary testing (aOR 1.91, 95% CI 1.07–3.43) compared with medical care; and self-reported history of HIV test(s) prior to diagnosis (aOR 1.72, 95% CI 1.06–2.81).ConclusionAlthough there appears to be an increasing trend towards early diagnosis, persons with RHI remain a minority in Singapore. The strong associations observed between modifiable behaviors (voluntary testing and HIV testing history) and RHI highlight the importance of increasing the accessibility to HIV testing for at-risk groups. |
Databáze: | OpenAIRE |
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