Introduction Knowing the HIV testing frequency and its temporal changes are central to evaluate public adherence to HIV testing recommendations and performance of HIV prevention programs. This study ...intended to estimate the mean HIV inter-test interval (ITI) and monitor its trends among men who have sex with men (MSM); people who inject drugs (PWID); and high-risk heterosexuals (HRH). Methods Using National HIV Behavioral Surveillance data collected during 2008–2015, this analysis estimated the mean HIV ITI for each year by race/ethnicity and age among MSM, PWID, and HRH who reported the most recent HIV test date. Separate statistical models based on renewal process theory were fit using PROC NLIN with Newton–Raphson method. Estimated mean HIV ITI lengths were compared using the z-test. Results Estimated HIV ITI generally decreased in the past decade among MSM, PWID, and HRH who reported the most recent HIV test date. In most recent study years, estimated HIV ITI (in months) ranged from 5.8 to 12.5 among MSM, from 9.0 to 13.1 among PWID, and from 15.3 to 26.7 among HRH. Within each risk group, estimated HIV ITI was shortest among blacks and individuals aged 18–24 years. Conclusions People at high risk for HIV infection who ever tested for HIV tested more frequently in the past decade. Most recently, MSM and PWID largely adhered to the Centers for Disease Control and Prevention’s HIV testing recommendations, but HRH tested less frequently. Identifying factors associated with infrequent testing among HRH may provide information for future HIV testing initiatives.
Abstract Purpose To assess the agreement between self-reported and medical record data on HIV status and dates of first positive and last negative HIV tests. Methods Participants were recruited from ...patients attending Houston health clinics during 2012–2013. Self-reported data were collected using a questionnaire and compared with medical record data. Agreement of HIV status was assessed using kappa statistics and of HIV test dates using concordance correlation coefficient. The extent of difference between self-reported and medical record test dates was determined. Results Agreement between self-reported and medical record data was good on HIV status and date of first positive HIV test, but poor on date of last negative HIV test. About half of participants that self-reported never tested had HIV test results in medical records. Agreement varied by sex, race and/or ethnicity, and medical care facility. For HIV-positive persons, more self-reported first positive HIV test dates preceded medical record dates, with a median difference of 6 months. For HIV-negative persons, more medical record dates of last negative HIV test preceded self-reported dates, with a median difference of 2 months. Conclusions Studies relying on self-reported HIV status other than HIV positive and self-reported date of last negative should consider including information from additional sources to validate the self-reported data.
Purpose To estimate relative survival (RS) after human immunodeficiency virus (HIV) diagnosis, by race/ethnicity and county-level socioeconomic status (SES). Methods We estimated 5-year RS by age, ...race/ethnicity, transmission category, sex, diagnosis year, CD4 count, and by county-level SES variables from the U.S. Census. Data, from the national HIV/AIDS Reporting System, were for HIV-infected persons ages ≥13 years (diagnosis during 1996–2003 and follow-up through 2005). We calculated RS proportions by using a maximum likelihood algorithm and modeled the relative risk of excess death (RR) using generalized linear models, with poverty as a random effect. Results For men, RS was worse in counties with larger proportions of people living below the 2000 U.S. poverty level (87.7% for poverty of ≥20% vs. 90.1% for poverty of <5.0%) and where unemployment was greater (87.8% where unemployment > 7.1% vs. 90.5% where unemployment < 4.0%). The effects of county-level SES on RS of women were similar. In multilevel multivariate models, RR for men and women within 5 years after an HIV diagnosis was significantly worse in counties where 10.0–19.9% (compared with <5.0%) lived below the poverty level (RR = 1.3 95% CI 1.2–1.5 and RR = 1.8 95% CI 1.4–2.2, respectively). Conclusions RS was worse in lower SES areas. To help address the impact of county-level SES, resources for HIV testing, care, and proven economic interventions should be directed to areas with concentrations of economically disadvantaged people.
