Using HIV Sequence and Epidemiologic Data to Assess the Effect of Self-referral Testing for Acute HIV Infection on Incident Diagnoses in San Diego, California
| Autor: | Konrad Scheffler, Ben Murrell, W. Chris Mathews, Lorri Freitas, Jason A. Young, Douglas D. Richman, Sergei L. Kosakovsky Pond, Joel O. Wertheim, Susan J. Little, Sanjay Mehta, Christy M. Anderson, Davey M. Smith |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male 0301 basic medicine Microbiology (medical) medicine.medical_specialty Sexual transmission HIV Infections California Serology 03 medical and health sciences symbols.namesake 0302 clinical medicine Epidemiology medicine Humans Mass Screening 030212 general & internal medicine Poisson regression Referral and Consultation Phylogeny Molecular Epidemiology Molecular epidemiology Sequence Analysis RNA Transmission (medicine) business.industry Incidence Incidence (epidemiology) Public health Virology Phylogeography 030104 developmental biology Infectious Diseases HIV-1 symbols HIV/AIDS Female business Demography |
| Zdroj: | Clinical Infectious Diseases. 63:101-107 |
| ISSN: | 1537-6591 1058-4838 |
| Popis: | Author(s): Mehta, Sanjay R; Murrell, Ben; Anderson, Christy M; Kosakovsky Pond, Sergei L; Wertheim, Joel O; Young, Jason A; Freitas, Lorri; Richman, Douglas D; Mathews, W Chris; Scheffler, Konrad; Little, Susan J; Smith, Davey M | Abstract: BackgroundBecause recently infected individuals disproportionately contribute to the spread of human immunodeficiency virus (HIV), we evaluated the impact of a primary HIV screening program (the Early Test) implemented in San Diego.MethodsThe Early Test program used combined nucleic acid and serology testing to screen for primary infection targeting local high-risk individuals. Epidemiologic, HIV sequence, and geographic data were obtained from the San Diego County Department of Public Health and the Early Test program. Poisson regression analysis was performed to determine whether the Early Test program was temporally and geographically associated with changes in incident HIV diagnoses. Transmission chains were inferred by phylogenetic analysis of sequence data.ResultsOver time, a decrease in incident HIV diagnoses was observed proportional to the number primary HIV infections diagnosed in each San Diego region (P l .001). Molecular network analyses also showed that transmission chains were more likely to terminate in regions where the program was marketed (P = .002). Although, individuals in these zip codes had infection diagnosed earlier (P = .08), they were not treated earlier (P = .83).ConclusionsThese findings suggests that early HIV diagnoses by this primary infection screening program probably contributed to the observed decrease in new HIV diagnoses in San Diego, and they support the expansion and evaluation of similar programs. |
| Databáze: | OpenAIRE |
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