Recent HIV Infection among men who have sex with men and transgender women in Tijuana

Skaathun, Britt; Pines, Heather A.; Patterson, Thomas L.; Semple, Shirley J.; Pekar, Jonathan E.; Vera, Alicia; Rangel, Gudelia; Mehta, Sanjay R.

doi:10.11606/s1518-8787.2020054002179

Cited by 6 publications

(4 citation statements)

References 33 publications

(29 reference statements)

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“…MAAs have also been used in research studies to identify and characterize individuals with recent HIV infection [ 10 – 13 ]. Other studies have noted the potential to use MAAs in real-time to inform persons of their recency status [ 14 , 15 ], to identify patients with recent infection for clinical purposes [ 16 ], or to inform epidemiologic surveillance studies and public health responses to the HIV epidemic [ 17 , 18 ]. However, there are limited data assessing the performance of MAAs for individual-level recency assessments [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of multi-assay algorithms for identifying individuals with recent HIV infection: HPTN 071 (PopART)

et al. 2021

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Background Assays and multi-assay algorithms (MAAs) have been developed for population-level cross-sectional HIV incidence estimation. These algorithms use a combination of serologic and/or non-serologic biomarkers to assess the duration of infection. We evaluated the performance of four MAAs for individual-level recency assessments. Methods Samples were obtained from 220 seroconverters (infected <1 year) and 4,396 non-seroconverters (infected >1 year) enrolled in an HIV prevention trial (HPTN 071 [PopART]); 28.6% of the seroconverters and 73.4% of the non-seroconverters had HIV viral loads ≤400 copies/mL. Samples were tested with two laboratory-based assays (LAg-Avidity, JHU BioRad-Avidity) and a point-of-care assay (rapid LAg). The four MAAs included different combinations of these assays and HIV viral load. Seroconverters on antiretroviral treatment (ART) were identified using a qualitative multi-drug assay. Results The MAAs identified between 54 and 100 (25% to 46%) of the seroconverters as recently-infected. The false recent rate of the MAAs for infections >2 years duration ranged from 0.2%-1.3%. The MAAs classified different overlapping groups of individuals as recent vs. non-recent. Only 32 (15%) of the 220 seroconverters were classified as recent by all four MAAs. Viral suppression impacted the performance of the two LAg-based assays. LAg-Avidity assay values were also lower for seroconverters who were virally suppressed on ART compared to those with natural viral suppression. Conclusions The four MAAs evaluated varied in sensitivity and specificity for identifying persons infected <1 year as recently infected and classified different groups of seroconverters as recently infected. Sensitivity was low for all four MAAs. These performance issues should be considered if these methods are used for individual-level recency assessments.

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Section: Introductionmentioning

confidence: 99%

Evaluation of multi-assay algorithms for identifying individuals with recent HIV infection: HPTN 071 (PopART)

et al. 2021

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“…Among the 31 articles describing non-incidence use cases, 24 used recency testing to assess risk factors predicting recent infection [126][127][128]149,150,[152][153][154][155][156][157][158][159][160][161][162][163][164][165][166][167][168][169][170] for purposes of targeted prevention planning. A total of 6 used recency testing as part of cluster identification or analysis (including 5 that also used recency assays for determining risk factors associated with recency) [153,154,161,162,167,171], 2 used recency testing for geographic comparisons or hotspot mapping [172,173], and 5 used it for other purposes, including examining recency trends in the same population over time [166] and evaluating patterns of drug resistance [151,[174][175][176].…”

Section: Xsl • Fomentioning

confidence: 99%

“…As many as 19 of these studies used a recency assay as part of a RITA (along with at least one other recency assay, viral load, CD4, or similar) to help reduce misclassification rates [126,127,[151][152][153][154][155][156]159,163,165,167,168,170,[172][173][174][175][176]. Three studies adjusted their recency calculations in some other way (eg, incorporating sensitivity or specificity of the assay into estimates) [149,158,180] and the remaining 9 used the assay results according to a prespecified cut-off with no further adjustment [150,157,[160][161][162]164,166,169,171]. Recency proportions were typically presented as [number recent]/[number tested with recency assays] × 100%, with no articles reporting original results that discussed a strategic choice of denominator to improve validity.…”

Section: Non-incidence Surveillance Use Cases Of Hiv Recency Assaysmentioning

confidence: 99%

Use of HIV Recency Assays for HIV Incidence Estimation and Other Surveillance Use Cases: Systematic Review

Facente¹,

Grebe²,

Maher³

et al. 2022

JMIR Public Health Surveill

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Background HIV assays designed to detect recent infection, also known as “recency assays,” are often used to estimate HIV incidence in a specific country, region, or subpopulation, alone or as part of recent infection testing algorithms (RITAs). Recently, many countries and organizations have become interested in using recency assays within case surveillance systems and routine HIV testing services to measure other indicators beyond incidence, generally referred to as “non-incidence surveillance use cases.” Objective This review aims to identify published evidence that can be used to validate methodological approaches to recency-based incidence estimation and non-incidence use cases. The evidence identified through this review will be used in the forthcoming technical guidance by the World Health Organization (WHO) and United Nations Programme on HIV/AIDS (UNAIDS) on the use of HIV recency assays for identification of epidemic trends, whether for HIV incidence estimation or non-incidence indicators of recency. Methods To identify the best methodological and field implementation practices for the use of recency assays to estimate HIV incidence and trends in recent infections for specific populations or geographic areas, we conducted a systematic review of the literature to (1) understand the use of recency testing for surveillance in programmatic and laboratory settings, (2) review methodologies for implementing recency testing for both incidence estimation and non-incidence use cases, and (3) assess the field performance characteristics of commercially available recency assays. Results Among the 167 documents included in the final review, 91 (54.5%) focused on assay or algorithm performance or methodological descriptions, with high-quality evidence of accurate age- and sex-disaggregated HIV incidence estimation at national or regional levels in general population settings, but not at finer geographic levels for prevention prioritization. The remaining 76 (45.5%) described the field use of incidence assays including field-derived incidence (n=45), non-incidence (n=25), and both incidence and non-incidence use cases (n=6). The field use of incidence assays included integrating RITAs into routine surveillance and assisting with molecular genetic analyses, but evidence was generally weaker or only reported on what was done, without validation data or findings related to effectiveness of using non-incidence indicators calculated through the use of recency assays as a proxy for HIV incidence. Conclusions HIV recency assays have been widely validated for estimating HIV incidence in age- and sex-specific populations at national and subnational regional levels; however, there is a lack of evidence validating the accuracy and effectiveness of using recency assays to identify epidemic trends in non-incidence surveillance use cases. More research is needed to validate the use of recency assays within HIV testing services, to ensure findings can be accurately interpreted to guide prioritization of public health programming.

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“…In Mexico, the study of unprotected anal sex in MSM as a risk factor for HIV infection has been mainly done using cross-sectional analyses of the adjusted effect of individual psychosocial stressors. One study found a positive association with depressive symptoms and sexual compulsivity [ 11 ], while another found it with cocaine use and with the experience of sexual abuse by MSM with recent HIV infection [ 32 ]. Just one study conducted in the border city of Tijuana approached the subject using a syndemic focus of psychosocial stressors reporting a dose-response pattern between the presence of more syndemic conditions and a higher frequency of unprotected anal sex with casual partners [ 33 ].…”

Section: Introductionmentioning

confidence: 99%

Factors Associated with Unprotected Anal Sex among Men Who Have Sex with Men in Mexico

Caballero-Hoyos

Monárrez‐Espino

Ramírez-Ortíz

et al. 2022

Infectious Disease Reports

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The global prevalence of HIV is notably higher in men who have sex with men (MSM) compared with other male populations. Unprotected anal intercourse is the riskiest sexual behavior for HIV acquisition and/or transmission among this minority population. The purpose of the study was to identify if the syndemic of psychosocial stressors and experienced stigma are predictors of unprotected anal sex in Mexican MSM. A cross-sectional analytic study was carried out. It included adults residing in Manzanillo, Mexico, with oral/anal sex practices within the last year. Informed consent was given by 142 participants selected using snowball sampling. Collected data included sociodemographic characteristics, psychosocial stressors, experienced stigma, HIV knowledge, knowing a friend/acquaintance living with HIV/AIDS, and sexual risk behaviors. Adjusted logistic regression was used to identify predictors of unprotected anal sex within the last six months. Presence of syndemic of psychosocial stressors, drug use during sex, having friends/acquaintances with HIV/AIDS, and experiencing high stigma were positively associated; high level of HIV knowledge was negatively linked. Reducing psychosocial stressors and integrating stigma-mitigation strategies are key elements to reduce HIV transmission.

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Recent HIV Infection among men who have sex with men and transgender women in Tijuana

Cited by 6 publications

References 33 publications

Evaluation of multi-assay algorithms for identifying individuals with recent HIV infection: HPTN 071 (PopART)

Evaluation of multi-assay algorithms for identifying individuals with recent HIV infection: HPTN 071 (PopART)

Use of HIV Recency Assays for HIV Incidence Estimation and Other Surveillance Use Cases: Systematic Review

Factors Associated with Unprotected Anal Sex among Men Who Have Sex with Men in Mexico

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