Accuracy of Self-Reported HIV Status Among African Men and Transgender Women Who Have Sex with Men Who were Screened for Participation in a Research Study: HPTN 075

Fogel, Jessica M.; Sandfort, Theodorus; Zhang, Yinfeng; Guo, Xingzhong; Clarke, William; Breaud, Autumn; Cummings, Vanessa; Hamilton, Erica L.; Ogendo, Arthur; Kayange, Noel; Panchia, Ravindre; Dominguez, Karen; Chen, Ying Qing; Eshleman, Susan H.

doi:10.1007/s10461-018-2231-1

Cited by 18 publications

(22 citation statements)

References 20 publications

(26 reference statements)

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“…For instance, the odds of never having tested for HIV are higher in all sites compared to Kisumu, Kenya, but only the odds for Cape Town, South Africa are significant; it is likely that with a larger cohort, the other odds would have been significant as well. Third, the discrepancy between the self-reported HIV status and the results of ARV drug testing indicate that the accuracy of self-report is limited [42]. This discrepancy also indicates that the number of persons who were previously diagnosed with HIV infection but had not yet started ART, might actually be higher.…”

Section: Discussionmentioning

confidence: 99%

“…ARV drug testing and HIV viral load testing were only performed for participants who tested positive for HIV infection at the screening visit. ARV drug testing was performed using a qualitative assay that detects 20 ARV drugs in five drug classes [42]. Viral load testing was performed using the RealTime HIV-1 Viral Load Assay (Abbott Molecular, Abbott Park, IL).…”

Section: Methodsmentioning

confidence: 99%

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HIV testing and the HIV care continuum among sub-Saharan African men who have sex with men and transgender women screened for participation in HPTN 075

et al. 2019

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Throughout the world, men who have sex with men (MSM) are at increased risk for HIV infection compared to heterosexual men. Little is known about awareness of HIV infection and other gaps in the HIV care continuum for MSM, especially in sub-Saharan Africa (SSA). This information is urgently needed to address the HIV epidemic in this population. This study assessed gaps in the HIV care continuum among persons screened for participation in a multi-country prospective study that evaluated the feasibility of recruiting and retaining MSM for HIV prevention studies in SSA (HIV Prevention Trials Network (HPTN) 075, conducted in four cities in Kenya, Malawi, and South Africa). Participants were recruited using site-specific strategies, that included outreach and informal networks. Transgender women (TW) were eligible to participate. During screening, 601 MSM and TW were tested for HIV infection and asked about prior HIV testing, HIV status, engagement in care, and HIV treatment. Viral load testing and retrospective antiretroviral (ARV) drug testing were performed for HIV-infected participants. Most participants (92.2%) had a prior HIV test; 42.1% were last tested >6 months earlier. HIV prevalence was 30.4%. HIV infection was associated with older age and identifying as female or transgender; 43.7% of the HIV-infected participants were newly diagnosed, especially younger persons and persons with a less recent HIV test. Almost a third of previously-diagnosed participants were not linked to care. Most participants (88.7%) in care were on ARV treatment (ART). Only about one-quarter of all HIV-infected participants were virally suppressed. These findings demonstrate substantial prevalence of undiagnosed HIV infection and sub-optimal HIV care engagement among MSM and TW in SSA. Increased HIV testing frequency and better linkage to care represent critical steps in preventing further HIV transmission in this population. Once in care, gaps in the HIV care continuum appear less critical.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

HIV testing and the HIV care continuum among sub-Saharan African men who have sex with men and transgender women screened for participation in HPTN 075

et al. 2019

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“…Foremost among these was differential under-reporting of status awareness and anti-retroviral use in surveys and with care providers. This phenomenon has been reported by a few other population-based studies and has the potential to significantly distort interpretation of cascade measures 40,41 and underscores the need for verification of self-reported measures wherever possible.…”

Section: Discussionmentioning

confidence: 61%

Age-dependent inequalities in HIV/STI burden and care receipt among men and transgender persons who have sex with men in Nairobi

Smith

Fearon

Kibuti

et al. 2021

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Background Gay, bisexual and other men who have sex with men (GBMSM) and transgender persons (TP) bear high burdens of HIV and other sexually transmitted infections (STIs) in sub-Saharan Africa, yet evidence of HIV care coverage for these groups is sparse from the region despite prevailing stigma and discrimination towards these groups. Methods 618 GBMSM/TP were recruited in Nairobi between May to December 2017 using respondent-driven sampling. Participants reported recent sexual behaviour, HIV testing and care receipt, and symptoms of STIs. Participants tested for HIV using Kenyan testing algorithms and GeneXpert methods, syphilis, viral hepatitis and ano-genital gonorrhoea and chlamydia. We assessed associations with HIV status and detectable HIV viral load using multivariable robust Poisson regression models. Findings 26.4% (286/618) were HIV positive of whom 76.5% were status aware, 65.3% were on ART, and 47.4% were virally suppressed (<50 copies/ml). Participants 18-22 years old were less likely to be status aware, be receiving ART or to have achieved viral suppression. Mean log viral load was 3.14 log higher in 18-22 year olds compared to older participants. Bacterial STIs were frequently detected at both urethral and rectal sites and a majority of infections at both sites were asymptomatic by self-report (rectal 82.2%, urethral 90.8%). Interpretation Engagement in the HIV diagnosis and care cascade among GBMSM/TP in Kenya is markedly better than in most sub-Saharan African countries. However it falls short of achievements among the general population in the country and cascades achieved in GBMSM in high income settings. Young men and transgender persons who have sex with men are least well served by the current configuration of adult key population services, and programmes should identify and address the sexual, social and developmental needs of adolescent and young key populations

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“…That half of MSM/TG verified to be virally suppressed did not report currently taking ART and/or did not report being aware of their status suggests that diagnosis and current ART use were under-reported among men testing HIV-positive in our study, discrepancies that we are investigating further [51]. Other surveys and studies using self-reported care cascade indicators have also pointed out this problem [52][53][54][55][56], with social desirability biases and survey misunderstandings posited as possible explanations. Confusion from care interactions have also been reported in South Africa [57].…”

Section: Limitationsmentioning

confidence: 75%

HIV testing, care and viral suppression among men who have sex with men and transgender individuals in Johannesburg, South Africa

et al. 2020

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Introduction Men who have sex with men and transgender individuals (MSM/TG) carry a disproportionately high burden of HIV, including in South Africa. However, there are few empirical population-representative estimates of viral suppression and the HIV care cascade including HIV testing among this population, nor of factors associated with these outcomes. Methods We conducted a respondent driven sampling (RDS) survey among 301 MSM/TG in Johannesburg in 2017. Participants gave blood samples for HIV testing and viral load. Participants self-completed a survey including sociodemographics, HIV testing history, and engagement in care. We calculated RDS-II weighted estimates of the percentage of HIV-negative MSM/ TG reporting HIV testing in the previous 6 months, their testing experience and preferences. Among those HIV-positive, we estimated the percentage status-aware, on ART, and virally suppressed (<50 viral copies/ml plasma). We conducted RDS-weighted robust Poisson regression to obtain weighted prevalence ratios of factors associated with 1) HIV testing among those HIV-negative; and 2) viral suppression among those HIV-positive. Results There were 118/300 HIV-positive MSM/TG, (37.5%). Of the HIV-negative MSM/TG, 61.5% reported that they had tested for HIV in the previous 6 months, which was associated with selling sex to men (Prevalence Ratio = 1.67, 95% CI 1.36-2.05). There were 76/118 HIVpositive MSM/TG (56.5%) who reported having previously tested positive for HIV and 39/ 118 (30.0%) who reported current ART. There were 58/118 HIV-positive MSM/TG with viral loads <50 copies/ml plasma (46.9%). Viral suppression was associated with older age

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Accuracy of Self-Reported HIV Status Among African Men and Transgender Women Who Have Sex with Men Who were Screened for Participation in a Research Study: HPTN 075

Cited by 18 publications

References 20 publications

HIV testing and the HIV care continuum among sub-Saharan African men who have sex with men and transgender women screened for participation in HPTN 075

HIV testing and the HIV care continuum among sub-Saharan African men who have sex with men and transgender women screened for participation in HPTN 075

Age-dependent inequalities in HIV/STI burden and care receipt among men and transgender persons who have sex with men in Nairobi

HIV testing, care and viral suppression among men who have sex with men and transgender individuals in Johannesburg, South Africa

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