Targeting screening and social marketing to increase detection of acute HIV infection in men who have sex with men in Vancouver, British Columbia

Abstract

Objectives:The contribution of acute HIV infection (AHI) to transmission is widely recognized, and increasing AHI diagnosis capacity can enhance HIV prevention through subsequent behavior change or intervention. We examined the impact of targeted pooled nucleic acid amplification testing (NAAT) and social marketing to increase AHI diagnosis among men who have sex with men (MSM) in Vancouver.Design:Observational study.Methods:We implemented pooled NAAT following negative third-generation enzyme immunoassay (EIA) testing for males above 18 years in six clinics accessed by MSM, accompanied by two social marketing campaigns developed by a community gay men's health organization. We compared test volume and diagnosis rates for pre-implementation (April 2006–March 2009) and post-implementation (April 2009–March 2012) periods. After implementation, we used linear regression to examine quarterly trends and calculated diagnostic yield.Results:After implementation, the AHI diagnosis rate significantly increased from 1.03 to 1.84 per 1000 tests, as did quarterly HIV test volumes and acute to non-acute diagnosis ratio. Of the 217 new HIV diagnoses after implementation, 54 (24.9%) were AHIs (25 detected by pooled NAAT only) for an increased diagnostic yield of 11.5%. The average number of prior negative HIV tests (past 2 years) increased significantly for newly diagnosed MSM at the six study clinics compared to other newly diagnosed MSM in British Columbia, per quarter.Conclusion:Targeted implementation of pooled NAAT at clinics accessed by MSM is effective in increasing AHI diagnoses compared to third-generation EIA testing. Social marketing campaigns accompanying pooled NAAT implementation may contribute to increasing AHI diagnoses and frequency of HIV testing.

Becoming “Undetectable”: Longitudinal Narratives of Gay Men's Sex Lives After a Recent HIV Diagnosis

“…Our analysis complements public health arguments regarding the importance of timely diagnosis of HIV-positive individuals through the use of enhanced testing technologies (Gilbert et al, 2013). This data adds to research literature that indicates men who receive an HIV-positive diagnosis are concerned about the sexual health of their partners and typically take steps to reduce the possibility of transmitting HIV (Grace et al, 2014).…”

The Association of HIV Stigma and HIV/STD Knowledge With Sexual Risk Behaviors Among Adolescent and Adult Men Who Have Sex With Men in Ghana, West Africa

“…HIV risk is influenced by the intersection of psychological (e.g., HIV/STD knowledge), biological (e.g., cognitive development, untreated STDs), environmental (e.g., HIV stigma, institutionalized homophobia), and behavioral (e.g., sexual behavior, condom use) factors (Crepaz & Marks, ; Tucker, Simpson, Huang, Roth, & Stewart, ). In settings across sub‐Saharan Africa, behavioral risk factors influencing HIV infection included substance use, number of sex partners, untreated STDs, unprotected anal intercourse, commercial sex work, and unprotected sex with known HIV‐positive partners (Gilbert et al, ; Merrigan et al, ; Sabin et al, ). Other teams across the globe have identified similar risk behavior patterns (Koblin et al, ; Ma et al, ; Millett, Flores, Peterson, & Bakeman, ).…”

Diagnostic Technologies in Practice

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