Characteristics of new HIV diagnoses over 1995-2019: A clinic-based study in Montréal, Canada.

<h4>Background</h4>Characterization of populations at risk of acquiring HIV is required to inform the public health response to HIV. To identify potential changing needs in HIV prevention and care cascade, we aim to describe how the demographic profiles and exposure categories of newly d...

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Autores principales:	Katia Giguère, Maliheh Vaziri, Clément Olivier, Louise Charest, Jason Szabo, Réjean Thomas, Mathieu Maheu-Giroux
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/c76178f62287415fa4cd8451e97db721
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spelling	oai:doaj.org-article:c76178f62287415fa4cd8451e97db7212021-12-02T20:17:11ZCharacteristics of new HIV diagnoses over 1995-2019: A clinic-based study in Montréal, Canada.1932-620310.1371/journal.pone.0258383https://doaj.org/article/c76178f62287415fa4cd8451e97db7212021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0258383https://doaj.org/toc/1932-6203<h4>Background</h4>Characterization of populations at risk of acquiring HIV is required to inform the public health response to HIV. To identify potential changing needs in HIV prevention and care cascade, we aim to describe how the demographic profiles and exposure categories of newly diagnosed HIV positive individuals attending a large sexual health clinic in Montréal (Canada) evolved since the beginning of the antiretroviral therapy era in the mid-1990s.<h4>Methods</h4>Using diagnosis data from participants of the Clinique médicale l'Actuel cohort of HIV-positive patients, we examined the distribution of exposure categories (sexual orientation, sexual behaviours, injection drug use, being born in an HIV-endemic country) by gender and year of diagnosis. Time trends in mean age and in the proportion of patients with late (CD4 <350 cells/μL) or advanced stage (CD4 <200 cells/μL) of HIV infection at diagnosis were assessed through meta-regressions.<h4>Results</h4>A total of 2,612 patients diagnosed with HIV between January 1st, 1995 and December 31st, 2019 were included. Overall, mean age was 35 years (standard deviation: 10 years) and remained stable over time. The proportion of patients with advanced stage of HIV infection decreased from 16% in 1995 to 4% in 2019. Although men who have sex with men (MSM) consistently accounted for the highest proportion of new diagnoses (77%, 2,022/2,612 overall), their proportion decreased since 2013. There was also a concomitant decrease in the proportion of people who inject drugs, with none of the newly diagnosed participants reporting injection drug use since 2017, and an important increase in the proportion of patients born in an HIV-endemic country (24%, 7/29 in 2019), especially among women. Compared to patients from non-endemic countries, those from HIV-endemic countries were characterized by higher proportions of heterosexuals (88% vs 17%) and of women (52% vs 7%), and were twice likely to get diagnosed at an advanced stage of HIV infection (32% vs 15%).<h4>Conclusions</h4>In absolute numbers, MSM continue to account for the largest exposure category. However, patients from HIV-endemic countries, who tend to be diagnosed at later stages of HIV infection, constitute an increasing proportion of newly diagnosed individuals. These persons could face distinct barriers to rapid diagnosis. Tailoring HIV testing strategies and other prevention interventions to the specific unmet prevention needs of these individuals is warranted.Katia GiguèreMaliheh VaziriClément OlivierLouise CharestJason SzaboRéjean ThomasMathieu Maheu-GirouxPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 10, p e0258383 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Katia Giguère Maliheh Vaziri Clément Olivier Louise Charest Jason Szabo Réjean Thomas Mathieu Maheu-Giroux Characteristics of new HIV diagnoses over 1995-2019: A clinic-based study in Montréal, Canada.
description	<h4>Background</h4>Characterization of populations at risk of acquiring HIV is required to inform the public health response to HIV. To identify potential changing needs in HIV prevention and care cascade, we aim to describe how the demographic profiles and exposure categories of newly diagnosed HIV positive individuals attending a large sexual health clinic in Montréal (Canada) evolved since the beginning of the antiretroviral therapy era in the mid-1990s.<h4>Methods</h4>Using diagnosis data from participants of the Clinique médicale l'Actuel cohort of HIV-positive patients, we examined the distribution of exposure categories (sexual orientation, sexual behaviours, injection drug use, being born in an HIV-endemic country) by gender and year of diagnosis. Time trends in mean age and in the proportion of patients with late (CD4 <350 cells/μL) or advanced stage (CD4 <200 cells/μL) of HIV infection at diagnosis were assessed through meta-regressions.<h4>Results</h4>A total of 2,612 patients diagnosed with HIV between January 1st, 1995 and December 31st, 2019 were included. Overall, mean age was 35 years (standard deviation: 10 years) and remained stable over time. The proportion of patients with advanced stage of HIV infection decreased from 16% in 1995 to 4% in 2019. Although men who have sex with men (MSM) consistently accounted for the highest proportion of new diagnoses (77%, 2,022/2,612 overall), their proportion decreased since 2013. There was also a concomitant decrease in the proportion of people who inject drugs, with none of the newly diagnosed participants reporting injection drug use since 2017, and an important increase in the proportion of patients born in an HIV-endemic country (24%, 7/29 in 2019), especially among women. Compared to patients from non-endemic countries, those from HIV-endemic countries were characterized by higher proportions of heterosexuals (88% vs 17%) and of women (52% vs 7%), and were twice likely to get diagnosed at an advanced stage of HIV infection (32% vs 15%).<h4>Conclusions</h4>In absolute numbers, MSM continue to account for the largest exposure category. However, patients from HIV-endemic countries, who tend to be diagnosed at later stages of HIV infection, constitute an increasing proportion of newly diagnosed individuals. These persons could face distinct barriers to rapid diagnosis. Tailoring HIV testing strategies and other prevention interventions to the specific unmet prevention needs of these individuals is warranted.
format	article
author	Katia Giguère Maliheh Vaziri Clément Olivier Louise Charest Jason Szabo Réjean Thomas Mathieu Maheu-Giroux
author_facet	Katia Giguère Maliheh Vaziri Clément Olivier Louise Charest Jason Szabo Réjean Thomas Mathieu Maheu-Giroux
author_sort	Katia Giguère
title	Characteristics of new HIV diagnoses over 1995-2019: A clinic-based study in Montréal, Canada.
title_short	Characteristics of new HIV diagnoses over 1995-2019: A clinic-based study in Montréal, Canada.
title_full	Characteristics of new HIV diagnoses over 1995-2019: A clinic-based study in Montréal, Canada.
title_fullStr	Characteristics of new HIV diagnoses over 1995-2019: A clinic-based study in Montréal, Canada.
title_full_unstemmed	Characteristics of new HIV diagnoses over 1995-2019: A clinic-based study in Montréal, Canada.
title_sort	characteristics of new hiv diagnoses over 1995-2019: a clinic-based study in montréal, canada.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/c76178f62287415fa4cd8451e97db721
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_version_	1718374430201085952

Characteristics of new HIV diagnoses over 1995-2019: A clinic-based study in Montréal, Canada.

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