XVIII International AIDS Conference

Abstract

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The value of self-reported last HIV test result to predict current lab-confirmed HIV status in MSM and TG of Lima, Peru

R.F. Sandler1,2, E. Segura2, S. Leon2, J. Galea3, C. Caceres2, T. Coates3

1University of Iowa, Carver College of Medicine, Iowa City, United States, 2Universidad Peruana Cayetano Heredia, Lima, Peru, 3UCLA School of Medicine, Los Angeles, United States

Background: In Lima, Peru, within the MSM population the prevalence of HIV/AIDS has been reported at rates up to 22% as compared to rates of less than 1% in the general population. Because of this elevated risk for these diseases, efforts have been made to promote HIV testing in this population. However, the association between self-reported previous test results and current laboratory-based HIV tests has not been studied in this population.
Methods: A secondary and exploratory analysis of the cross-sectional data from the baseline measurement of a 2x2 factorial, randomized clustered, community-based trial conducted in Lima, Peru was performed. HIV ELISA tests were performed with confirmatory Western Blots.
Results: The study population consisted of 658 MSM and TG ranging in age from 19 to 45 years and living in low-income neighborhoods in Lima, Peru. 80% of those surveyed reported having had a previous HIV test. There was no significant difference in rates of HIV between those who reported previous testing and those who had not (14.0% vs. 15.3%, p>0.05). In those subjects reporting a previous positive test result, 63.6% (21 subjects) tested positive for HIV and were more likely to test positive than subjects reporting previous negative test results (OR 16.92 95% CI 7.74-36.98). Of those subjects who self-reported previous negative test results, 9.4% (39 subjects) had positive HIV test results, which indicates a 90.6% negative predictive value for a self-reported negative HIV test.
Conclusions: Differential rates of HIV were demonstrated based upon the results of previous self-reported HIV testing. However, the absolute number of current HIV diagnoses was higher among subjects reporting negative previous test results. Self-reported testing results should be considered when evaluating new patients, but confirmed with a current HIV test to improve the accuracy of diagnosis and subsequent treatment.


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