Details:

Alternative Title:
AIDS Care
Publisher's site:
http://dx.doi.org/10.1080/09540121.2017.1316356
Personal Author:
Dasgupta, Sharoda ; Hall, H. Irene ; Hernandez, Angela L. ; Ocfemia, M. Cheryl Bañez ; Saduvala, Neeraja ; ... More +
Dasgupta, Sharoda ; Hall, H. Irene ; Hernandez, Angela L. ; Ocfemia, M. Cheryl Bañez ; Saduvala, Neeraja ; Oster, Alexandra M. Less -
Description:
The Department of Health and Human Services recommends drug resistance testing at linkage to HIV care. Because receipt and timing of testing are not well characterized, we examined testing patterns among persons with diagnosed HIV who are linked to care. Using surveillance data in six jurisdictions for persons aged ≥13 years with HIV infection diagnosed in 2013, we assessed the proportion receiving testing, and among these, the proportion receiving testing at linkage. Multivariable log-binomial regression modeling estimated associations between selected characteristics and receipt of testing (1) overall, and (2) at linkage among those tested. Of 9,408 persons linked to care, 66% received resistance testing, among whom 68% received testing at linkage. Less testing was observed among male persons who inject drugs (PWID), compared with men who have sex with men (adjusted prevalence ratio [aPR]: 0.88; 95% confidence interval [CI]: 0.81-0.97) and persons living in areas with population <500,000 compared with those in areas with population ≥2,500,000 (aPR: 0.88; CI: 0.84-0.93). In certain jurisdictions, testing was lower for persons with initial CD4 counts ≥500 cells/mm|, compared with those with CD4 counts <200 cells/mm| (aPR range: 0.80-0.85). Of those tested, testing at linkage was lower among male PWID (aPR: 0.85; CI: 0.75-0.95) and, in some jurisdictions, persons with CD4 counts ≥500 cells/mm| (aPR range: 0.63-0.73). Two-thirds of persons with diagnosed HIV who were linked to care received resistance testing, and most received testing at linkage as recommended. Improving receipt and timing of testing among male PWID, persons in less populous settings, and in all jurisdictions, regardless of CD4 count, may improve care outcomes.
Subject:
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Adolescent
Adult
Anti-Retroviral Agents
CD4 Lymphocyte Count
Drug Resistance
Female
HIV Infections
Humans
Male
Mass Screening
Middle Aged
Patient Acceptance Of Health Care
Population Surveillance
Prevalence
Serologic Tests
Time Factors

Source:
AIDS Care. 29(12):1567-1575.
Pubmed ID:
28464705
Pubmed Central ID:
PMC5685490
Document Type:
Journal Article
Funding:
CC999999/ImCDC/Intramural CDC HHS/United States
Place as Subject:
United States
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:786287f915999df51f838a3058af264b236ca88c5456125a1383358e05564fa1
File Type:

Supporting Files

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