scholarly journals Changing Patterns of Undiagnosed HIV Infection in the Netherlands: Who Benefits Most from Intensified HIV Test and Treat Policies?

PLoS ONE ◽  
2015 ◽  
Vol 10 (7) ◽  
pp. e0133232 ◽  
Author(s):  
Eline L. M. Op de Coul ◽  
Imke Schreuder ◽  
Stefano Conti ◽  
Ard van Sighem ◽  
Maria Xiridou ◽  
...  
Keyword(s):  
The Netherlands ◽  
Hiv Infection ◽  
Test And Treat ◽  
Hiv Test ◽  
Undiagnosed Hiv ◽  
Changing Patterns

scholarly journals Promoting HIV indicator condition-guided testing in hospital settings (PROTEST 2.0): study protocol for a multicentre interventional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saskia J. Bogers ◽  
Maarten F. Schim van der Loeff ◽  
Udi Davidovich ◽  
Anders Boyd ◽  
Marc van der Valk ◽  
...  
Keyword(s):  
The Netherlands ◽  
Hiv Testing ◽  
Quantitative Methods ◽  
Hospital Setting ◽  
Audit And Feedback ◽  
Interventional Study ◽  
Hiv Diagnosis ◽  
Post Intervention ◽  
Hiv Test ◽  
Undiagnosed Hiv

Abstract Background Late presentation remains a key barrier towards controlling the HIV epidemic. Indicator conditions (ICs) are those that are AIDS-defining, associated with a prevalence of undiagnosed HIV > 0.1%, or whose clinical management would be impeded if an HIV infection were undiagnosed. IC-guided HIV testing is an effective strategy in identifying undiagnosed HIV, but opportunities for earlier HIV diagnosis through IC-guided testing are being missed. We present a protocol for an interventional study to improve awareness of IC-guided testing and increase HIV testing in patients presenting with ICs in a hospital setting. Methods We designed a multicentre interventional study to be implemented at five hospitals in the region of Amsterdam, the Netherlands. Seven ICs were selected for which HIV test ratios (proportion of patients with an IC tested for HIV) will be measured: tuberculosis, cervical/vulvar cancer or high-grade cervical/vulvar dysplasia, malignant lymphoma, hepatitis B and C, and peripheral neuropathy. Prior to the intervention, a baseline assessment of HIV test ratios across ICs will be performed in eligible patients (IC diagnosed January 2015 through May 2020, ≥18 years, not known HIV positive) and an assessment of barriers and facilitators for HIV testing amongst relevant specialties will be conducted using qualitative (interviews) and quantitative methods (questionnaires). The intervention phase will consist of an educational intervention, including presentation of baseline results as competitive graphical audit and feedback combined with discussion on implementation and opportunities for improvement. The effect of the intervention will be assessed by comparing HIV test ratios of the pre-intervention and post-intervention periods. The primary endpoint is the HIV test ratio within ±3 months of IC diagnosis. Secondary endpoints are the HIV test ratio within ±6 months of diagnosis, ratio ever tested for HIV, HIV positivity percentage, proportion of late presenters and proportion with known HIV status prior to initiating treatment for their IC. Discussion This protocol presents a strategy aimed at increasing awareness of the benefits of IC-guided testing and increasing HIV testing in patients presenting with ICs in hospital settings to identify undiagnosed HIV in Amsterdam, the Netherlands. Trial registration Dutch trial registry: NL7521. Registered 14 February 2019.

scholarly journals 969. TNF-alpha inhibition in the setting of undiagnosed HIV infection: a call for enhanced screening guidelines

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S514-S514
Author(s):  
Jennifer Claytor ◽  
Omar Viramontes ◽  
Stephanie Conner ◽  
Kwun Wah Wen ◽  
Kendall Beck ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Hiv Testing ◽  
Kaposi Sarcoma ◽  
Screening Guidelines ◽  
Persistent Symptoms ◽  
Hiv Test ◽  
Undiagnosed Hiv ◽  
Inflammatory Bowel ◽  
Sex With Men ◽  
Chronic Hiv Infection

Abstract Background Despite the risks of immunosuppression, recommendations regarding screening for HIV infection prior to initiation of biologic therapies targeting common autoimmune disorders, including inflammatory bowel disease (IBD) and inflammatory arthritides, are limited. Few cases of patients started on biologics while living with undiagnosed HIV have been reported. Methods We report 3 cases of patients initiated on biologics in the absence of recent or concurrent HIV screening who developed refractory disease or unanticipated complications and were later found to have undiagnosed chronic HIV infection. Results In Case 1, a 53-year-old man who has sex with men (MSM) with negative HIV testing 10 years prior presented with presumed rheumatoid arthritis. He did not respond to methotrexate (MTX), so adalimumab (ADA) was started. HIV testing to evaluate persistent symptoms was positive 9 months later; CD4 was 800 cells/uL. Antiretroviral therapy (ART) resulted in resolution of symptoms, which were attributed to HIV-associated arthropathy. In Case 2, a 55-year-old woman with injection drug use in remission and no prior HIV testing presented with Hidradenitis Suppurativa (HS). She was initiated on infliximab (IFX) and MTX with good response. After she developed weight loss and lymphopenia, an HIV test was positive; CD4 was 334 cells/uL. Biologic HS therapy was discontinued, with subsequent poor HS control. In Case 3, a 32-year-old MSM with no prior HIV testing presented with presumed IBD; IFX and steroids were started. Symptoms progressed despite IBD-directed therapy, and he was diagnosed with extensive Kaposi Sarcoma (KS) with visceral and cutaneous involvement likely exacerbated by immunosuppression. HIV testing was positive; CD4 was 250 cells/uL. KS initially worsened due to ART-associated immune reconstitution inflammatory syndrome. He is now improving with systemic chemotherapy and ART. HIV-associated KS is presumed to be hte underlying diagnosis. Conclusion All 3 patients had elevated risk for HIV infection, and 2 had final diagnoses attributed to chronic HIV infection, not warranting therapeutic immunosuppression. Screening for HIV infection prior to initiation of biologic therapy should be incorporated into clinical practice guidelines. Disclosures All Authors: No reported disclosures

scholarly journals Do I Have HIV or Not? Lack of RNA Detection and the Case for Sensitive DNA Testing

2020 ◽  
Vol 7 (11) ◽  
Author(s):  
Sandra A Springer ◽  
Silvina Masciotra ◽  
Jeffrey A Johnson ◽  
Sheldon Campbell
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Viral Rna ◽  
Infection Status ◽  
Test Results ◽  
Dna Testing ◽  
Rna Detection ◽  
Hiv Test

Abstract We present a case of a 20-year-old male who had ambiguous HIV test results after entering new provider care and whose status was later complicated by undetectable viral RNA off antiretroviral therapy (ART). Verifying HIV infection status may occasionally require sensitive DNA testing that might need to be considered in diagnostic guidelines to resolve diagnosis and ensure appropriate ART management.

Cost-effectiveness of Using Social Networks to Identify Undiagnosed HIV Infection Among Minority Populations

2010 ◽  
Vol 16 (5) ◽  
pp. 457-464 ◽  
Author(s):  
Ram K. Shrestha ◽  
Stephanie L. Sansom ◽  
Lisa Kimbrough ◽  
Angela B. Hutchinson ◽  
Daniel Daltry ◽  
...  
Keyword(s):  
Social Networks ◽  
Cost Effectiveness ◽  
Hiv Infection ◽  
Minority Populations ◽  
Undiagnosed Hiv

scholarly journals Reaching people with undiagnosed HIV infection through assisted partner notification

AIDS ◽  
2017 ◽  
Vol 31 (17) ◽  
pp. 2436-2437 ◽  
Author(s):  
Shona Dalal ◽  
Cheryl Johnson ◽  
Virginia Fonner ◽  
Caitlin E. Kennedy ◽  
Nandi Siegfried ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Partner Notification ◽  
Undiagnosed Hiv

scholarly journals “How can I tell?” Consequences of HIV status disclosure among couples in eastern African communities in the context of an ongoing HIV “test-and-treat” trial

AIDS Care ◽  
2016 ◽  
Vol 28 (sup3) ◽  
pp. 59-66 ◽  
Author(s):  
Irene Maeri ◽  
Alison El Ayadi ◽  
Monica Getahun ◽  
Edwin Charlebois ◽  
Cecilia Akatukwasa ◽  
...  
Keyword(s):  
Hiv Status ◽  
Test And Treat ◽  
Hiv Test ◽  
Hiv Status Disclosure ◽  
Status Disclosure

scholarly journals Predictors Of Provider-Initiated Hiv Testing In Heterosexuals At Increased Risk Of Hiv (Het) In Puerto Rico: Data From Nhbs-Het Cycle 2016

2020 ◽  
Author(s):  
Maureen Marie Canario de la Torre ◽  
Ivony Yireth Agudelo Salas ◽  
Sandra Miranda de León ◽  
Yadira Rolón Colón ◽  
María Pabón Martínez ◽  
...  
Keyword(s):  
Sexual Behavior ◽  
Puerto Rico ◽  
Hiv Infection ◽  
Hiv Testing ◽  
Perceived Risk ◽  
Healthcare Providers ◽  
World Health ◽  
Healthcare Settings ◽  
Hiv Test ◽  
Increased Risk

Abstract The Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) have established guidelines for HIV testing in healthcare settings. The aim of this study was to identify the sociodemographic, healthcare, and sexual-behavior predictors of provider-initiated HIV testing (PIHT) using data from the Puerto Rico National HIV Behavioral Surveillance (PR-NHBS) 2016 cycle directed towards heterosexuals at increased risk of HIV infection (HET). A total sample of 531 eligible participants were recruited through respondent-driven sampling (RDS). Logistic regression models assessed the associations between sociodemographic, healthcare, and sexual-behavior predictors, whilst adjusting for sex and age. The majority of the participants were women (66.1%), with 72.7% reporting having received healthcare services in the past year. Of them, 18.7% had received an HIV-test offer from their healthcare providers. More than half of the participants (65.2%) reported a low perceived risk of getting infected with HIV in the next 12 months. Results suggest an overall low prevalence of PIHT among HET in PR who exhibited a relatively high prevalence of low perceived risk of HIV infection. Furthermore, the assessed predictors show that individuals who engaged in high-risk sexual behaviors (AOR = 0.52; 95% CI: 0.30–0.90) were less likely to receive HIV-test offers from their providers. This study further emphasizes the need for healthcare providers to follow recommended guidelines for HIV testing in healthcare settings as a means of establishing preventive measures to further counteract the HIV epidemic in Puerto Rico, specifically among HET.

scholarly journals Dimensions of HIV-related stigma in rural communities in Kenya and Uganda at the start of a large HIV ‘test and treat’ trial

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0249462
Author(s):  
Cecilia Akatukwasa ◽  
Monica Getahun ◽  
Alison M. El Ayadi ◽  
Judith Namanya ◽  
Irene Maeri ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Physical Violence ◽  
Marital Dissolution ◽  
Care Seeking ◽  
Internalized Stigma ◽  
Test And Treat ◽  
Hiv Test ◽  
Related Stigma ◽  
Enacted Stigma ◽  
Anticipated Stigma

HIV-related stigma is a frequently cited barrier to HIV testing and care engagement. A nuanced understanding of HIV-related stigma is critical for developing stigma-reduction interventions to optimize HIV-related outcomes. This qualitative study documented HIV-related stigma across eight communities in east Africa during the baseline year of a large HIV test-and-treat trial (SEARCH, NCT: 01864603), prior to implementation of widespread community HIV testing campaigns and efforts to link individuals with HIV to care and treatment. Findings revealed experiences of enacted, internalized and anticipated stigma that were highly gendered, and more pronounced in communities with lower HIV prevalence; women, overwhelmingly, both held and were targets of stigmatizing attitudes about HIV. Past experiences with enacted stigma included acts of segregation, verbal discrimination, physical violence, humiliation and rejection. Narratives among women, in particular, revealed acute internalized stigma including feelings of worthlessness, shame, embarrassment, and these resulted in anxiety and depression, including suicidality among a small number of women. Anticipated stigma included fears of marital dissolution, verbal and physical abuse, gossip and public ridicule. Anticipated stigma was especially salient for women who held internalized stigma and who had experienced enacted stigma from their partners. Anticipated stigma led to care avoidance, care-seeking at remote facilities, and hiding of HIV medications. Interventions aimed at reducing individual and community-level forms of stigma may be needed to improve the lives of PLHIV and fully realize the promise of test-and-treat strategies.

scholarly journals Love, necessity and opportunity: Changing patterns of marital age homogamy in the Netherlands, 1850–1993

2001 ◽  
Vol 55 (1) ◽  
pp. 1-13 ◽  
Author(s):  
FRANS VAN POPPEL ◽  
AART C. LIEFBROER ◽  
JEROEN K. VERMUNT ◽  
WILMA SMEENK
Keyword(s):  
The Netherlands ◽  
Changing Patterns

The Continuous Surveillance of InSTI resistance could be an important Public Health Tool in the Fight against HIV Infection

2021 ◽  
Vol 19 ◽  
Author(s):  
Giuseppa Visalli ◽  
Alessio Facciolà ◽  
Maria Giovanna Costanzo ◽  
Angela Di Pietro
Keyword(s):  
Drug Resistance ◽  
Hiv Infection ◽  
Hiv Treatment ◽  
Large Cohort ◽  
University Hospital ◽  
Hiv Positive ◽  
Percentage Increase ◽  
Resistance Mutations ◽  
Hiv Test ◽  
Resistance Tests

Aims: To evaluate the frequency of the InSTIs mutations in a large cohort of HIV-infected people. Background: The Highly Active Anti-Retroviral Therapy (HAART) allow turning HIV infection from a fatal disease to a chronic infection and Integrase Strand Transfer Inhibitors (InSTIs) represent the cornerstone of this treatment. However, the spread of HIV-1 drug resistance mutations represents an emerging threat to the long-term success of HIV treatment programs. Objectives: To evaluate the trend of the HIV drug resistance to InSTIs in a large cohort of HIV-positive people in order to assess the risk represented by these subjects in the spread of the HIV infection to the community. Methods: A cross-sectional study was conducted analysing all the InSTIs resistance tests performed in HIV positive subjects in the period 2017-2019 by the HIV Laboratory of the University Hospital "Gaetano Martino" of Messina, Italy. Results: In 2017-2019, 252 InSTIs resistance tests were performed of which 59 (23.4%), 88 (34.9%) and 105 (41.7%) respectively in the three considered years. Overall, 28 (11.1%) samples showed resistance to at least one of the four InSTIs. We observed a significant percentage increase of 95% about the resistance to all the four drugs. Conclusion: Because the InSTI resistance is not rare, a continuous surveillance can represent nowadays, together with an incessant health education and a wide offer of the HIV test, the most important tool in the fight against HIV infection.

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