Metz Melissa, Among Vivian Hope, Dzinamarira Tafadzwa, Ussery Faith, Nkurunziza Peter, Bahizi Janet, Biraro Samuel, Ogollah Francis M, Musinguzi Joshua, Kirungi Wilford, Naluguza Mary, Mwangi Christina, Birhanu Sehin, Nelson Lisa J, Longwe Herbert, Winterhalter Frieda Sara, Voetsch Andrew C, Parekh Bharat S, Patel Hetal K, Duong Yen T, Bray Rachel, Farley Shannon M
ICAP at Columbia University, New York, NY 10032, USA.
Heart to Heart International, Lenexa, KS 66219, USA.
Trop Med Infect Dis. 2024 Sep 19;9(9):220. doi: 10.3390/tropicalmed9090220.
During population-based HIV impact assessments (PHIAs), some participants who self-reported testing HIV-positive (PSRP) tested negative in one or more subsequent survey HIV tests. These unexpected discrepancies between their self-reported results and the survey results draw into question the validity of either the self-reported status or the test results. We analyzed PSRP with negative test results aged 15-59 years old using data collected from 2015 to 2021 in 13 countries, assessing prevalence, self-report status, survey HIV status, viral load, rapid tests and confirmatory tests, and answers to follow-up questions (such as years on treatment). Across these surveys, 19,026 participants were PSRP, and 256 (1.3%) of these were concluded to be HIV-negative after additional survey-based testing and review. PSRP determined to be HIV-negative trended higher in countries with a higher HIV prevalence, but their number was small enough that accepting self-reported HIV-positive status without testing would not have significantly affected the prevalence estimates for HIV or viral load suppression. Additionally, using more detailed information for Uganda, we examined 107 PSRP with any negative test results and found no significant correlation with years on treatment or age. Using these details, we examined support for the possible reasons for these discrepancies beyond misdiagnosis and false reporting. These findings suggest that those conducting surveys would benefit from a nuanced understanding of HIV testing among PSRP to conduct surveys ethically and produce high-quality results.
在基于人群的艾滋病毒影响评估（PHIA）期间，一些自我报告艾滋病毒检测呈阳性（PSRP）的参与者在随后的一项或多项调查艾滋病毒检测中呈阴性。他们自我报告的结果与调查结果之间这些意想不到的差异，让人质疑自我报告状态或检测结果的有效性。我们使用2015年至2021年在13个国家收集的数据，分析了15至59岁检测结果为阴性的PSRP，评估了患病率、自我报告状态、调查艾滋病毒状态、病毒载量、快速检测和确证检测，以及对后续问题（如治疗年限）的回答。在这些调查中，有19,026名参与者为PSRP，其中256名（1.3%）在经过额外的基于调查的检测和复查后被判定为艾滋病毒阴性。在艾滋病毒患病率较高的国家，被判定为艾滋病毒阴性的PSRP比例有上升趋势，但由于其数量足够少，因此在不进行检测的情况下接受自我报告的艾滋病毒阳性状态，不会对艾滋病毒或病毒载量抑制的患病率估计产生显著影响。此外，利用乌干达更详细的信息，我们检查了107名有任何阴性检测结果的PSRP，发现其与治疗年限或年龄没有显著相关性。利用这些细节，我们研究了除误诊和虚假报告之外，对这些差异可能原因的支持情况。这些发现表明，进行调查的人员若能对PSRP中的艾滋病毒检测有细致入微的理解，将有助于以符合道德规范的方式开展调查并产生高质量的结果。
