Beyond Social Desirability Bias: Investigating Inconsistencies in Self-Reported HIV Testing and Treatment Behaviors Among HIV-Positive Adults in North West Province, South Africa

Mooney, Alyssa; Campbell, Chadwick K.; Ratlhagana, Mary-Jane; Grignon, Jessica; Mazibuko, Sipho; Agnew, Emily; Gilmore, Hailey; Barnhart, Scott; Puren, Adrian; Shade, Starley B.; Liegler, Teri; Lippman, Sheri A.

doi:10.1007/s10461-018-2155-9

Cited by 47 publications

(44 citation statements)

References 36 publications

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“…First, information on HIV testing in the past year is not used in model calibration due to evidence that this likely overstates the true annual testing rate [14,35] , perhaps due to "telescoping bias" in which respondents may inadvertently recall testing that occurred beyond the last 12 months [36] (see supplemental materials, Text S3). Second, information on self-reported awareness of HIV-positive status, even when partially adjusted for detection of ART among PLHIV who report not knowing their status, is not incorporated due to evidence of systematic nondisclosure of knowledge of status [9,10,[37][38][39][40][41][42][43][44] . In particular, non-disclosure of HIV status was found to be 1.4 times higher among individuals not on ART in Mozambique [38] compared to those on ART.…”

Section: Data Sources Likelihood Function and Model Calibrationmentioning

confidence: 99%

“…There are few empirical estimates of awareness status among PLHIV and, as described above, these estimates are likely to reflect substantial underreporting of HIV awareness [9,10,[37][38][39][40][41][42][43][44] . We therefore validated the F90 model by performing both in-sample comparisons (A) and out-ofsample predictions (B and C) of the proportion of the population ever tested for HIV (stratified by sex and HIV status).…”

Section: Model Validationmentioning

confidence: 99%

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National HIV testing and diagnosis coverage in sub-Saharan Africa: a new modeling tool for estimating the “first 90” from program and survey data

Maheu‐Giroux

Marsh

Doyle

et al. 2019

Preprint

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Objective: HIV testing services (HTS) are a crucial component of national HIV responses. Learning one's HIV diagnosis is the entry point to accessing life-saving antiretroviral treatment and care. Recognizing the critical role of HTS, the Joint United Nations Programme on HIV/AIDS (UNAIDS) launched the 90-90-90 targets stipulating that by 2020, 90% of people living with HIV know their status, 90% of those who know their status receive antiretroviral therapy, and 90% of those on treatment have a suppressed viral load. Countries will need to regularly monitor progress on these three indicators. Estimating the proportion of people living with HIV who know their status (i.e., the "first 90"), however, is difficult. Methods:We developed a mathematical model (henceforth referred to as "F90") that formally synthesizes population-based survey and HTS program data to estimate HIV status awareness over time. The proposed model uses country-specific HIV epidemic parameters from the standard UNAIDS Spectrum model to produce outputs that are consistent with other national HIV estimates. The F90 model provides estimates of HIV testing history, diagnosis rates, and knowledge of HIV status by age and sex. We validate the F90 model using both in-sample comparisons and out-of-sample predictions using data from three countries: Côte d'Ivoire, Malawi, and Mozambique. Results: In-sample comparisons suggest that the F90 model can accurately reproduce longitudinal sex-specific trends in HIV testing. Out-of-sample predictions of the fraction of PLHIV ever tested over a 4-to-6-year time horizon are also in good agreement with empirical survey estimates. Importantly, out-of-sample predictions of HIV knowledge are consistent (i.e., within 4% points) with those of the fully calibrated model in the three countries, when HTS program data are included. The F90 model's predictions of knowledge of status are higher than available selfreported HIV awareness estimates, however, suggesting -in line with previous studies-that these self-reports could be affected by non-disclosure of HIV status awareness. Conclusion: Knowledge of HIV status is a key indicator to monitor progress, identify bottlenecks, and target HIV responses. The F90 model can help countries track progress towards their "first 90" by leveraging surveys of HIV testing behaviors and annual HTS program data.

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Section: Data Sources Likelihood Function and Model Calibrationmentioning

confidence: 99%

Section: Model Validationmentioning

confidence: 99%

National HIV testing and diagnosis coverage in sub-Saharan Africa: a new modeling tool for estimating the “first 90” from program and survey data

Maheu‐Giroux

Marsh

Doyle

et al. 2019

Preprint

View full text Add to dashboard Cite

show abstract

“…There may also be a social desirability bias present: patients are not inclined to declare their non-adherence to a healthcare professional. 13 This bias may have led patients to give negative responses in the face-to-face interview simply to avoid judgment by a healthcare professional. In the future, it may be interesting to investigate the extent of the social desirability bias in face-to-face interviews that use the MAQ.…”

Section: Discussionmentioning

confidence: 99%

<p>Assessment of Non-Adherence to Oral Metformin and Atorvastatin Therapies: A Cross-Sectional Survey in Piedmont (Italy)</p>

Parente¹,

Pignata²,

Gnavi

et al. 2020

PPA

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It is not possible to recover from chronic diseases; however, a healthy lifestyle and correct adherence to therapy can avoid complications and co-morbidities. The aim of this study was the cross-sectional evaluation, by means of a questionnaire, of realworld data on the prevalence of non-adherence to metformin and atorvastatin oral therapies in a sample of patients that attend community pharmacies in the Piedmont Region. The secondary aim was to evaluate the presence of correlations between non-adherence and a number of variables detected by the questionnaire. Materials and Methods: Data were gathered from face-to-face interviews in six community pharmacies in Piedmont. The questionnaire was divided into two sections: the first included the Morisky, Green and Levine Medication Adherence Questionnaire (MAQ) (to assess therapy adherence); the second included questions on gender, age, level of education and the pharmacy in which the questionnaire was administered. Comparisons between proportions and mean values were performed using the χ2 test. Modified Poisson regression with robust standard errors was used for multivariate analysis. The level of significance was fixed at 0.05, CI at 95%. Results: The sample analysed was composed of 408 subjects (receiving either metformin or atorvastatin). According to MAQ, 62 patients were non-adherent (15% of the total cohort). Crude and multivariate analysis did not show any statistically significant correlation between gender, age, level of education and non-adherence. It emerged that there was a correlation between non-adherence and being a customer of two of the pharmacies involved [PR = 3.31 (p=0.028) and PR = 3.11 (p=0.027)]. Conclusions: Community pharmacies can be an appropriate setting to identify non-adherent patients. Therefore, healthcare professionals could realize an integrated and structured intervention to improve adherence. However, MAQ could underestimate the number of nonadherent patients. Further studies to test the association between non-adherence prevalence and being the customer of a specific pharmacy should be performed.

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“…In this stigmatized group, the fear of discrimination and lack of trust towards health care workers could certainly be driving some of the misreporting. However, poor understanding of HIV care from PWID may have also played a role [20]. To overcome these difficulties, it was suggested that: (i) questionnaires could be administrated by peers, (ii) and run outside the health service system and (iii) data should come from population-based surveys [15].…”

Section: Discussionmentioning

confidence: 99%

“…Using the same design, i.e. comparing selfdeclaration of HIV testing and plasma ARV detection, they found that the level of discrepancies ranged from 18% to 41% [20,26]. Among the factors associated with misreporting, they identified "being a man" as a positive risk.…”

Section: Discussionmentioning

confidence: 99%

An improved HIV care cascade to assess HIV control programs among people who inject drugs.

Molès

Peries

Huong

et al. 2019

Preprint

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Background Achievement of HIV control among key populations through universal access to antiretroviral treatment (ART) requires a precise evaluation of the cascade of care. One of the main difficulties in obtaining an accurate community-based cascade of care is misreporting, which could represent one of the most important bias for people suffering from stigma. The primary objective was to estimate the added value of plasma antiretroviral concentration to improve the estimation of HIV cascade of careMethods We constructed the cascade of HIV care among persons who inject drugs (PWID) living in Hai Phong, Vietnam, using a community-based survey. First and second line HIV treatment contained fixed dose of lamivudine. Misreporting of HIV status and ART were identified by plasma lamivudine detection. We then compared the two methods for estimating the cascade of HIV careResults The proportion of misreporting was estimated at 30% among PWID. No specific PWID profile could be identified as associated with misreporting.Conclusions Adding plasma ARV detection to the routine data collection strongly improved the accuracy of the HIV cascade of care.

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Beyond Social Desirability Bias: Investigating Inconsistencies in Self-Reported HIV Testing and Treatment Behaviors Among HIV-Positive Adults in North West Province, South Africa

Cited by 47 publications

References 36 publications

National HIV testing and diagnosis coverage in sub-Saharan Africa: a new modeling tool for estimating the “first 90” from program and survey data

National HIV testing and diagnosis coverage in sub-Saharan Africa: a new modeling tool for estimating the “first 90” from program and survey data

<p>Assessment of Non-Adherence to Oral Metformin and Atorvastatin Therapies: A Cross-Sectional Survey in Piedmont (Italy)</p>

An improved HIV care cascade to assess HIV control programs among people who inject drugs.

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