Interpreting declines in HIV test positivity: an analysis of routine data from Zimbabwe's national sex work programme, 2009–2019. Issue 7 (30th June 2022)
- Record Type:
- Journal Article
- Title:
- Interpreting declines in HIV test positivity: an analysis of routine data from Zimbabwe's national sex work programme, 2009–2019. Issue 7 (30th June 2022)
- Main Title:
- Interpreting declines in HIV test positivity: an analysis of routine data from Zimbabwe's national sex work programme, 2009–2019
- Authors:
- Jones, Harriet S.
Hensen, Bernadette
Musemburi, Sithembile
Chinyanganya, Lilian
Takaruza, Albert
Chabata, Sungai T.
Matambanadzo, Primrose
Rice, Brian
Cowan, Frances M.
Hargreaves, James R. - Abstract:
- Abstract: Introduction: Early diagnosis of HIV is critical for epidemic control. To achieve this, successful testing programmes are essential and test positivity is often used as a marker of their performance. The aim of this study was to analyse trends and predictors of HIV test positivity over time and explore how an understanding of seroconversion rates could build on our interpretation of this indicator among female sex workers in Zimbabwe. Methods: We analysed HIV test data from Zimbabwe's nationally scaled sex work programme between 2009 and 2019. We defined test positivity as the proportion of all tests that were HIV positive and measured new diagnoses by estimating seroconversion rates among women with repeat tests, defined as an HIV‐positive test after at least one HIV‐negative test in the programme. We used logistic regression to analyse test positivity over three time‐periods: 2009–2013, 2014–2017 and 2018–2019, adjusting for potential confounding by demographic factors and the mediating effects of time since last HIV test. We calculated the seroconversion rates for the same time‐periods. Results: During the 10‐year study period, 54, 503 tests were recorded in 39, 462 women. Between 2009 and 2013, 18% of tests were among women who reported testing in the previous 6 months. By 2018–2019, this had increased to 57%. Between 2018 and 2019, test positivity was 9.6%, compared to 47.9% for 2009–2013 (aOR 6.08 95% CI 5.52–6.70) and 18.8% for 2014–2017 (aOR 2.17 95% CIAbstract: Introduction: Early diagnosis of HIV is critical for epidemic control. To achieve this, successful testing programmes are essential and test positivity is often used as a marker of their performance. The aim of this study was to analyse trends and predictors of HIV test positivity over time and explore how an understanding of seroconversion rates could build on our interpretation of this indicator among female sex workers in Zimbabwe. Methods: We analysed HIV test data from Zimbabwe's nationally scaled sex work programme between 2009 and 2019. We defined test positivity as the proportion of all tests that were HIV positive and measured new diagnoses by estimating seroconversion rates among women with repeat tests, defined as an HIV‐positive test after at least one HIV‐negative test in the programme. We used logistic regression to analyse test positivity over three time‐periods: 2009–2013, 2014–2017 and 2018–2019, adjusting for potential confounding by demographic factors and the mediating effects of time since last HIV test. We calculated the seroconversion rates for the same time‐periods. Results: During the 10‐year study period, 54, 503 tests were recorded in 39, 462 women. Between 2009 and 2013, 18% of tests were among women who reported testing in the previous 6 months. By 2018–2019, this had increased to 57%. Between 2018 and 2019, test positivity was 9.6%, compared to 47.9% for 2009–2013 (aOR 6.08 95% CI 5.52–6.70) and 18.8% for 2014–2017 (aOR 2.17 95% CI 2.06–2.28). Adjusting for time since last test reduced effect estimates for 2009–2013 (aOR 4.03 95% CI 3.64–4.45) and 2014–2017 (aOR 1.97 95% CI 1.86–2.09) compared to 2018–2019. Among 7573 women with an initial HIV‐negative test in the programme and at least one subsequent test, 464 tested HIV positive at a rate of 3.9 per 100 pyar (95% CI 3.5–4.2). Conclusions: Test positivity decreased among women testing through the programme over time, while seroconversion rates remained high. These declines were partly driven by changes in individual testing history, reflecting comprehensive coverage of testing services and greater knowledge of HIV status, but not necessarily declining rates of seroconversion. Understanding testing history and monitoring new HIV infections from repeat tests could strengthen the interpretation of test positivity and provide a better understanding of programme performance. … (more)
- Is Part Of:
- Journal of the International AIDS Society. Volume 25:Issue 7(2022)
- Journal:
- Journal of the International AIDS Society
- Issue:
- Volume 25:Issue 7(2022)
- Issue Display:
- Volume 25, Issue 7 (2022)
- Year:
- 2022
- Volume:
- 25
- Issue:
- 7
- Issue Sort Value:
- 2022-0025-0007-0000
- Page Start:
- n/a
- Page End:
- n/a
- Publication Date:
- 2022-06-30
- Subjects:
- Africa -- HIV epidemiology -- HIV prevention -- key and vulnerable populations -- sex workers -- testing
AIDS (Disease) -- Periodicals
HIV infections -- Periodicals
616.9792005 - Journal URLs:
- http://archive.biomedcentral.com/1758-2652/content ↗
http://rave.ohiolink.edu/ejournals/issn/17582652/ ↗
http://www.jiasociety.org/ ↗
http://www.ncbi.nlm.nih.gov/pmc/journals/790/ ↗
http://onlinelibrary.wiley.com/ ↗ - DOI:
- 10.1002/jia2.25943 ↗
- Languages:
- English
- ISSNs:
- 1758-2652
- Deposit Type:
- Legaldeposit
- View Content:
- Available online (eLD content is only available in our Reading Rooms) ↗
- Physical Locations:
- British Library DSC - BLDSS-3PM
British Library HMNTS - ELD Digital store - Ingest File:
- 23027.xml