Abstract
Screening and linkage to care are core, foundational strategies for HIV transmission prevention and for identifying People Living with HIV (PLHIV). In Romania – with an atypical experience in the HIV/AIDS epidemic – providing care for HIV+ patients identified early is a priority, though screening and testing can pose a challenge in some areas.MethodsA survey of 125 clinical providers to explore important dimensions of HIV/ AIDS clinical care was conducted in Transylvania and Moldavia, where clinicians identified poor/ latent screening as a major problem in providing timely care and in preventing the spread of disease. We analyzed determinants of offering HIV screening/testing to patients using Pearson Chi-square analysis and logistic regression. Logistic regression generated Odds Ratios (OR) to reflect the magnitude of association between the relevant variables, with 95% confidence interval (95% CI) indicating statistical range.ResultsIn total, 40.8% of providers did not provide HIV screening/testing to at least one segment of the population. Hospital-based providers were significantly more likely to offer HIV screening/testing to all segments than were non-hospital-based providers (58.1% v. 35.5%, respectively; p < .05). Providers located within institutions with screening/testing policies were more likely to offer such services to their patients (p < .05). Overall, 94.4% of providers indicated interest in more training around HIV screening/testing.DiscussionReaching Romanian and global goals for reducing HIV require more timely screening and action based on positive status. Romanian clinicians are interested in expanding HIV screening/testing and are interested in participating in training that helps them feel more prepared to undertake this work.
Highlights
The World Health Organization (WHO) estimates that 40% of people infected with HIV do not know their HIV status [1]
* Correspondence: Tim_dye@urmc.rochester.edu 1University of Rochester School of Medicine and Dentistry, Rochester, New York 1464, USA Full list of author information is available at the end of the article their status directly affects the latter two goals, the last of which means that 90% of People Living with HIV (PLHIV) are unlikely to transmit HIV
Overall, 125 participants responded to the assessment of which two-thirds (62.9%), lived in Transylvania, threefourths (75%) work in hospitals and the vast majority (81.5%) were physicians (Table 1)
Summary
The World Health Organization (WHO) estimates that 40% of people infected with HIV do not know their HIV status [1]. The Joint United Nations Program on HIV/ AIDS (UNAIDS) 90–90-90 goal is to have 90% of people with HIV knowing their status, 90% of patients on antiretroviral therapy (ART) treatment, and 90% with viral suppression by 2020, with all three goals sequentially contingent [2]. In regions with more concentrated epidemics, the WHO only recommends testing in high risk clinical settings [3]. Those considered high risk, such as partners of PLHIV, men who have sex with men (MSM), intravenous drug users (IDU), sex workers, and prisoners, should be tested at least once a year. The European Centers for Disease Control (ECDC) emphasizes the importance of testing these vulnerable groups at higher frequencies, and both the WHO and ECDC emphasize the importance of testing pregnant women in addition [3, 4]
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