Abstract
Serological tests can distinguish recent (in the prior 12 months) from long-term HIV infection. Integrating recency testing into routine HIV testing services (HTS) can provide important information on transmission clusters and prioritize clients for partner testing. This study assessed the feasibility and use of integrating HIV recency into routine testing. We conducted a multi-method study at 14 facilities in Kenya, and key informant interviews with health care providers. We abstracted clinical record data, collected specimens, tested specimens for recent infection, returned results to participants, and conducted a follow-up survey for those recently infected. From March to October 2018, we enrolled 532 clients who were diagnosed HIV-positive for the first time. Of these, 46 (8.6%) were recently infected. Women aged 15-24 years had 2.9 (95% confidence interval: 1.46 to 5.78) times higher adjusted odds of recent infection compared with 15-24-year-old men and those tested within the past 12 months having 2.55 (95% confidence interval: 0.38 to 4.70) times higher adjusted odds compared with those tested ≥12 months previously. Fourteen of 17 providers interviewed found the integration of recency testing into routine HTS services acceptable and feasible. Among clients who completed the follow-up interview, most (92%) felt that the recency results were useful. Integrating recent infection testing into routine HTS services in Kenya is feasible and largely acceptable to clients and providers. More studies should be done on possible physical and social harms related to returning results, and the best uses of the recent infection data at an individual and population level.
Highlights
UNAIDS has set global goals for 95% of all people living with HIV (PLHIV) to be diagnosed, 95% of these to be initiated and retained on antiretroviral therapy (ART), and 95% of these to be virally suppressed (95-95-95) by 2030.1
viral load (VL) testing was conducted at the Eastern Deanery AIDS Relief Programme (EDARP) laboratory in Nairobi, LAg testing was conducted at the National HIV Reference Laboratory in Nairobi, and ARV metabolite testing was conducted at the University of Cape Town in South Africa
A higher proportion of recent infection was found among women [adjusted odds ratio = 4.20, P, 0.001], those under 25-years-old, and those who had been tested in the prior 12 months
Summary
UNAIDS has set global goals for 95% of all people living with HIV (PLHIV) to be diagnosed, 95% of these to be initiated and retained on antiretroviral therapy (ART), and 95% of these to be virally suppressed (95-95-95) by 2030 (see Supplemental Digital Content 1, http://links.lww.com/QAI/ B439).[1] Achieving 95% diagnosis will require new approaches to maximize case finding. This study assessed the feasibility and use of integrating HIV recency into routine testing
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: JAIDS Journal of Acquired Immune Deficiency Syndromes
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
