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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