评价尼日利亚艾滋病指标和影响调查（2018 年）中自我报告的 HIV 和抗逆转录病毒治疗状况的准确性和表现。
Evaluation of accuracy and performance of self-reported HIV and antiretroviral therapy status in the Nigeria AIDS Indicator and Impact Survey (2018).
机构信息
Centers for Disease Control and Prevention, Division of Global HIV and TB, Center for Global Health-Nigeria, Abuja, Federal Capital Territory, Nigeria.
Maryland Global Initiatives, Abuja, Federal Capital Territory, Nigeria.
出版信息
PLoS One. 2022 Aug 29;17(8):e0273748. doi: 10.1371/journal.pone.0273748. eCollection 2022.
BACKGROUND
Data on awareness of HIV status among people living with HIV (PLHIV) are critical to estimating progress toward epidemic control. To ascertain the accuracy of self-reported HIV status and antiretroviral drug (ARV) use in the Nigeria HIV/AIDS Indicator and Impact Survey (NAIIS), we compared self-reported HIV status with HIV rapid diagnostic test (RDT) results and self-reported ARV use with detectable blood ARV levels.
METHODS
On the basis of responses and test results, participants were categorized by HIV status and ARV use. Self-reported HIV status and ARV use performance characteristics were determined by estimating sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Proportions and other analyses were weighted to account for complex survey design.
RESULTS
During NAIIS, 186,405 participants consented for interview out of which 58,646 reported knowing their HIV status. Of the 959 (weighted, 1.5%) who self-reported being HIV-positive, 849 (92.1%) tested HIV positive and 64 (7.9%) tested HIV negative via RDT and polymerase chain reaction test for discordant positive results. Of the 849 who tested HIV positive, 743 (89.8%) reported using ARV and 72 (10.2%) reported not using ARV. Of 57,687 who self-reported being HIV negative, 686 (1.2%) tested HIV positive via RDT, with ARV biomarkers detected among 195 (25.1%). ARV was detected among 94.5% of those who self-reported using ARV and among 42.0% of those who self-reported not using ARV. Overall, self-reported HIV status had sensitivity of 52.7% (95% confidence interval [CI]: 49.4%-56.0%) with specificity of 99.9% (95% CI: 99.8%-99.9%). Self-reported ARV use had sensitivity of 95.2% (95% CI: 93.6%-96.7%) and specificity of 54.5% (95% CI: 48.8%-70.7%).
CONCLUSIONS
Self-reported HIV status and ARV use screening tests were found to be low-validity measures during NAIIS. Laboratory tests to confirm self-reported information may be necessary to determine accurate HIV and clinical status for HIV studies in Nigeria.
背景
了解艾滋病毒感染者（PLHIV）对自身艾滋病毒状况的认识，对于评估控制艾滋病疫情的进展至关重要。为了确定尼日利亚艾滋病毒/艾滋病指标和影响调查（NAIIS）中自我报告的艾滋病毒状况和抗逆转录病毒药物（ARV）使用的准确性，我们将自我报告的艾滋病毒状况与艾滋病毒快速诊断检测（RDT）结果进行了比较，并将自我报告的 ARV 使用与可检测到的血液 ARV 水平进行了比较。
方法
根据应答和检测结果，参与者按艾滋病毒状况和 ARV 使用情况进行分类。通过估计敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV），确定自我报告的艾滋病毒状况和 ARV 使用的性能特征。为了考虑到复杂的调查设计，采用了加权的比例和其他分析。
结果
在 NAIIS 期间，有 186405 名参与者同意接受访谈，其中 58646 名报告了解自己的艾滋病毒状况。在 959 名（加权，1.5%）自我报告为艾滋病毒阳性的人中，849 名（92.1%）通过 RDT 和聚合酶链反应检测呈艾滋病毒阳性，64 名（7.9%）呈艾滋病毒阴性，对于不一致的阳性结果进行了检测。在 849 名艾滋病毒检测呈阳性的人中，743 名（89.8%）报告使用了 ARV，72 名（10.2%）报告未使用 ARV。在 57687 名自我报告为艾滋病毒阴性的人中，有 686 名（1.2%）通过 RDT 检测呈艾滋病毒阳性，其中 195 名（25.1%）检测到 ARV 生物标志物。在自我报告使用 ARV 的人中，有 94.5%检测到 ARV，在自我报告未使用 ARV 的人中，有 42.0%检测到 ARV。总的来说，自我报告的艾滋病毒状况的敏感性为 52.7%（95%置信区间[CI]：49.4%-56.0%），特异性为 99.9%（95% CI：99.8%-99.9%）。自我报告的 ARV 使用的敏感性为 95.2%（95% CI：93.6%-96.7%），特异性为 54.5%（95% CI：48.8%-70.7%）。
结论
在 NAIIS 期间，自我报告的艾滋病毒状况和 ARV 使用筛查测试被发现是低有效性的措施。为了确定尼日利亚艾滋病毒和临床状况的准确性，可能需要进行实验室检测来确认自我报告的信息。
Zotero 插件