Recent infections among individuals with a new HIV diagnosis in Rwanda, 2018–2020

<h4>Background</h4> Despite Rwanda’s progress toward HIV epidemic control, 16.2% of HIV-positive individuals are unaware of their HIV positive status. Tailoring the public health strategy could help reach these individuals with new HIV infection and achieve epidemic control. Recency test...

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Autores principales:	Gallican N. Rwibasira, Samuel S. Malamba, Gentille Musengimana, Richard C. M. Nkunda, Jared Omolo, Eric Remera, Vedaste Masengesho, Valens Mbonitegeka, Tafadzwa Dzinamarira, Eugenie Kayirangwa, Placidie Mugwaneza
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/2bfe7300f9364acda95911b5d1a145da
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spelling	oai:doaj.org-article:2bfe7300f9364acda95911b5d1a145da2021-11-25T06:19:48ZRecent infections among individuals with a new HIV diagnosis in Rwanda, 2018–20201932-6203https://doaj.org/article/2bfe7300f9364acda95911b5d1a145da2021-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8598012/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4> Despite Rwanda’s progress toward HIV epidemic control, 16.2% of HIV-positive individuals are unaware of their HIV positive status. Tailoring the public health strategy could help reach these individuals with new HIV infection and achieve epidemic control. Recency testing is primarily for surveillance, monitoring, and evaluation but it’s not for diagnostic purposes. However, it’s important to know what proportion of the newly diagnosed are recent infections so that HIV prevention can be tailored to the profile of people who are recently infected. We therefore used available national data to characterize individuals with recent HIV infection in Rwanda to inform the epidemic response. <h4>Methods</h4> We included all national-level data for recency testing reported from October 2018 to June 2020. Eligible participants were adults (aged ≥15 years) who had a new HIV diagnosis, who self-reported being antiretroviral therapy (ART) naïve, and who had consented to recency testing. Numbers and proportions of recent HIV infections were estimated, and precision around these estimates was calculated with 95% confidence intervals (CI). Logistic regression was used to assess factors associated with being recently (within 12 months) infected with HIV. <h4>Results</h4> Of 7,785 eligible individuals with a new HIV-positive diagnosis, 475 (6.1%) met the criteria for RITA recent infection. The proportion of RITA recent infections among individuals with newly identified HIV was high among those aged 15–24 years (9.6%) and in men aged ≥65 years (10.3%) compared to other age groups; and were higher among women (6.7%) than men (5.1%). Of all recent cases, 68.8% were women, and 72.2% were aged 15–34 years. The Northern province had the fewest individuals with newly diagnosed HIV but had the highest proportion of recent infections (10.0%) compared to other provinces. Recent infections decreased by 19.6% per unit change in time (measured in months). Patients aged ≥25 years were less likely to have recent infection than those aged 15–24 years with those aged 35–49 years being the least likely to have recent infection compared to those aged 15–24 years (adjusted odds ratio [aOR], 0.415 [95% CI: 0.316–0.544]). <h4>Conclusion</h4> Public health surveillance targeting the areas and the identified groups with high risk of recent infection could help improve outcomes.Gallican N. RwibasiraSamuel S. MalambaGentille MusengimanaRichard C. M. NkundaJared OmoloEric RemeraVedaste MasengeshoValens MbonitegekaTafadzwa DzinamariraEugenie KayirangwaPlacidie MugwanezaPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Gallican N. Rwibasira Samuel S. Malamba Gentille Musengimana Richard C. M. Nkunda Jared Omolo Eric Remera Vedaste Masengesho Valens Mbonitegeka Tafadzwa Dzinamarira Eugenie Kayirangwa Placidie Mugwaneza Recent infections among individuals with a new HIV diagnosis in Rwanda, 2018–2020
description	<h4>Background</h4> Despite Rwanda’s progress toward HIV epidemic control, 16.2% of HIV-positive individuals are unaware of their HIV positive status. Tailoring the public health strategy could help reach these individuals with new HIV infection and achieve epidemic control. Recency testing is primarily for surveillance, monitoring, and evaluation but it’s not for diagnostic purposes. However, it’s important to know what proportion of the newly diagnosed are recent infections so that HIV prevention can be tailored to the profile of people who are recently infected. We therefore used available national data to characterize individuals with recent HIV infection in Rwanda to inform the epidemic response. <h4>Methods</h4> We included all national-level data for recency testing reported from October 2018 to June 2020. Eligible participants were adults (aged ≥15 years) who had a new HIV diagnosis, who self-reported being antiretroviral therapy (ART) naïve, and who had consented to recency testing. Numbers and proportions of recent HIV infections were estimated, and precision around these estimates was calculated with 95% confidence intervals (CI). Logistic regression was used to assess factors associated with being recently (within 12 months) infected with HIV. <h4>Results</h4> Of 7,785 eligible individuals with a new HIV-positive diagnosis, 475 (6.1%) met the criteria for RITA recent infection. The proportion of RITA recent infections among individuals with newly identified HIV was high among those aged 15–24 years (9.6%) and in men aged ≥65 years (10.3%) compared to other age groups; and were higher among women (6.7%) than men (5.1%). Of all recent cases, 68.8% were women, and 72.2% were aged 15–34 years. The Northern province had the fewest individuals with newly diagnosed HIV but had the highest proportion of recent infections (10.0%) compared to other provinces. Recent infections decreased by 19.6% per unit change in time (measured in months). Patients aged ≥25 years were less likely to have recent infection than those aged 15–24 years with those aged 35–49 years being the least likely to have recent infection compared to those aged 15–24 years (adjusted odds ratio [aOR], 0.415 [95% CI: 0.316–0.544]). <h4>Conclusion</h4> Public health surveillance targeting the areas and the identified groups with high risk of recent infection could help improve outcomes.
format	article
author	Gallican N. Rwibasira Samuel S. Malamba Gentille Musengimana Richard C. M. Nkunda Jared Omolo Eric Remera Vedaste Masengesho Valens Mbonitegeka Tafadzwa Dzinamarira Eugenie Kayirangwa Placidie Mugwaneza
author_facet	Gallican N. Rwibasira Samuel S. Malamba Gentille Musengimana Richard C. M. Nkunda Jared Omolo Eric Remera Vedaste Masengesho Valens Mbonitegeka Tafadzwa Dzinamarira Eugenie Kayirangwa Placidie Mugwaneza
author_sort	Gallican N. Rwibasira
title	Recent infections among individuals with a new HIV diagnosis in Rwanda, 2018–2020
title_short	Recent infections among individuals with a new HIV diagnosis in Rwanda, 2018–2020
title_full	Recent infections among individuals with a new HIV diagnosis in Rwanda, 2018–2020
title_fullStr	Recent infections among individuals with a new HIV diagnosis in Rwanda, 2018–2020
title_full_unstemmed	Recent infections among individuals with a new HIV diagnosis in Rwanda, 2018–2020
title_sort	recent infections among individuals with a new hiv diagnosis in rwanda, 2018–2020
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/2bfe7300f9364acda95911b5d1a145da
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Recent infections among individuals with a new HIV diagnosis in Rwanda, 2018–2020

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