Gilbert Mark, Hottes Travis S, Lester Richard, Gustafson Réka, Krajden Mel, Ogilvie Gina
BC Centre for Disease Control University of British Columbia.
Can J Public Health. 2014 Feb 3;105(1):e63-8. doi: 10.17269/cjph.105.4262.
Canadian surveys of men who have sex with men (MSM) and people using injection drugs (IDU) demonstrate that most have tested for HIV at least once, but that half or fewer have done so in the previous year. To better inform targeted HIV testing guidelines for these populations, we derived estimates of inter-test interval (ITI) for persons newly diagnosed with HIV in British Columbia (BC) between 2006 and 2011, and assessed variables associated with longer ITI among MSM and IDU.
Provincial HIV case report and testing data were linked by deterministic and probabilistic matching (based on unique personal health number, name, and date of birth). ITI was defined as time from last recorded negative to first positive HIV result; those with ITI ≤30 days were excluded.
Of 2,004 eligible individuals, 1,116 (55.7%) had a recorded negative HIV test result in the previous ten years. Overall median ITI was 20 months with a skewed distribution (inter-quartile range 8-46); median ITI was 15 months for MSM and 21 months for IDU with 41.2% and 33.1% testing in the past year, respectively. Longer ITI was associated with older age for both groups, and among MSM with residence outside Vancouver and not known to have an HIV-positive partner.
These findings highlight potential missed opportunities for earlier detection of HIV and prevention of secondary transmission among newly diagnosed MSM and IDU, and provide evidence to inform recommendations for HIV test frequency and testing strategies for these populations in BC.
对加拿大男男性行为者(MSM)和注射吸毒者(IDU)的调查表明,大多数人至少进行过一次HIV检测,但在前一年进行检测的人数占比仅为一半或更少。为了更好地为针对这些人群的HIV检测指南提供信息,我们估算了2006年至2011年期间不列颠哥伦比亚省(BC)新诊断出HIV的人群的检测间隔时间(ITI),并评估了与MSM和IDU中较长ITI相关的变量。
通过确定性和概率性匹配(基于唯一的个人健康号码、姓名和出生日期)将省级HIV病例报告和检测数据进行关联。ITI定义为从最后一次记录的阴性结果到首次HIV阳性结果的时间;排除ITI≤30天的人群。
在2004名符合条件的个体中,1116人(55.7%)在过去十年中有记录的HIV检测阴性结果。总体中位ITI为20个月,分布呈偏态(四分位间距为8 - 46);MSM的中位ITI为15个月,IDU为21个月,过去一年中分别有41.2%和33.1%的人进行了检测。两组中,较长的ITI均与年龄较大有关,在MSM中,与居住在温哥华以外且不知有HIV阳性伴侣的情况有关。
这些发现突出了在新诊断的MSM和IDU中早期检测HIV及预防二次传播方面可能错失的机会,并为BC省针对这些人群的HIV检测频率和检测策略的建议提供了依据。