Use of viral load to improve survey estimates of known HIV-positive status and antiretroviral treatment coverage

Details

• Alternative Title:
  AIDS
• Personal Author:
  YOUNG, Peter W. ; ZIELINSKI-GUTIERREZ, Emily ; WAMICWE, Joyce ; MUKUI, Irene ; KIM, Andrea A. ; WARURU, Anthony ; ZEH, Clement ; KRETZSCHMAR, Mirjam E. ; DE COCK, Kevin M.
• Description:
  Objective:
  
  To compare alternative methods of adjusting self-reported knowledge of HIV-positive status and antiretroviral (ARV) therapy use based on undetectable viral load (UVL) and ARV detection in blood.
  
  Design:
  
  Post hoc analysis of nationally-representative household survey to compare alternative biomarker-based adjustments to population HIV indicators.
  
  Methods:
  
  We reclassified HIV-positive participants aged 15–64 years in the 2012 Kenya AIDS Indicator Survey (KAIS) that were unaware of their HIV-positive status by self-report as aware and on antiretroviral treatment if either ARVs were detected or viral load was undetectable (<550 copies/mL) on dried blood spots. We compared self-report to adjustments for ARVs measurement, UVL, or both.
  
  Results:
  
  Treatment coverage among all HIV-positive respondents increased from 31.8% for self-report to 42.5% [95% confidence interval (CI) 37.4–47.8] based on ARV detection alone, to 42.8% (95% CI 37.9–47.8) when ARV-adjusted, 46.2% (95% CI 41.3–51.1) when UVL-adjusted and 48.8% (95% CI 43.9–53.8) when adjusted for either ARV or UVL. Awareness of positive status increased from 46.9% for self-report to 56.2% (95% CI 50.7–61.6) when ARV-adjusted, 57.5% (95% CI 51.9–63.0) when UVL-adjusted, and 59.8% (95% CI 54.2–65.1) when adjusted for either ARV or UVL.
  
  Conclusions:
  
  Undetectable viral load, which is routinely measured in surveys, may be a useful adjunct or alternative to ARV detection for adjusting survey estimates of knowledge of HIV status and antiretroviral treatment coverage.
  
  
• Subjects:
  Adolescent Adult Antiretroviral Therapy, Highly Active Antiretroviral Treatment Article Biomarkers Female HIV Infections HIV Surveillance Humans Kenya Male Middle Aged Population Surveys Self Report Viral Load Young Adult

  More +
• Source:
  AIDS. 34(4):631-636
• Pubmed ID:
  31794520
• Pubmed Central ID:
  PMC8157159
• Document Type:
  Journal Article
• Funding:
  U19 GH000069/GH/CGH CDC HHS/United States ; U2G PS001805/PS/NCHHSTP CDC HHS/United States ; U2G PS001814/PS/NCHHSTP CDC HHS/United States
• Volume:
  34
• Issue:
  4
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:4c7653f205eff2f2b08c895e9973f85cfd67c961207ab3da8a3009933fb97115
• Download URL:
  https://stacks.cdc.gov/view/cdc/106686/cdc_106686_DS1.pdf
• File Type:
  [PDF - 331.24 KB ]