Undisclosed HIV infection among MSM in a behavioral surveillance study
Undisclosed HIV infection among MSM in a behavioral surveillance study
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DOI：
10.1097/qad.0000000000002147
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发表时间：
2019-04-01
期刊：
影响因子：
3.8
通讯作者：
West, Tiffany
中科院分区：
文献类型：
--
作者：
Hoots, Brooke E.;Wejnert, Cyprian;West, Tiffany
目的：作为未确诊的艾滋病毒的代理，疾病控制和预防中心的国家艾滋病毒行为监测（NHBS）监测那些报告不知道自己感染的参与者，定义为在采访中自我报告艾滋病毒阴性或未知状态，但艾滋病毒感染检测呈阳性。我们在2014年验证了NHBS对MSM意识的测量。设计：我们对报告不知道自己感染的男男性接触者的干血点进行了7种抗逆转录病毒药物（ARVs）检测。不知道检测到至少一种抗逆转录病毒的男男性行为者被定义为错误报告。方法：计算加权百分比和95%置信区间，比较误报者、非误报者和自报hiv阳性者的特征。病毒载量用一种有效的测定法定量使用干血点。结果：在1818名hiv阳性的MSM中，299名（16%）自我报告为hiv阴性或未知感染状态。在这299例中，145例（49%）被认为是基于ARV检测的误报。在不知情的人群中，误报者比未误报者更有可能是年龄较大且有医疗保险的人。与自我报告艾滋病毒阳性的男男性接触者相比，误报者更有可能是黑人、双性恋者，并且认为受到了歧视。在138例病毒载量数据错误报告中，116例（84%）的病毒载量无法检测到。结论：抗逆转录病毒检测显示，半数被归类为不知道自己感染的男男性行为者误报了自己的感染状况。尽管标签外的暴露前预防使用可能解释了抗逆转录病毒药物的存在，但这是不太可能的，因为许多误报的人病毒受到抑制，这表明他们正在接受艾滋病毒治疗。行为数据的生物标志物验证可以提高NHBS和其他研究的数据质量和有用性。版权所有2019威科健康有限公司版权所有。
Objective: As a proxy for undiagnosed HIV, the Centers for Disease Control and Prevention's National HIV Behavioral Surveillance (NHBS) monitors participants who report being unaware of their infection, defined as self-reporting an HIV-negative or unknown status during the interview but testing positive for HIV infection. We validated the NHBS measure of awareness among MSM in 2014.Design: We tested dried blood spots from MSM who reported being unaware of their infection for seven antiretrovirals (ARVs). MSM unaware with at least one ARV detected were defined as misreporters.Methods: Weighted percentages and 95% confidence intervals were calculated to compare characteristics among misreporters, nonmisreporters, and those who self-reported as HIV-positive. Viral load was quantified with a validated assay using dried blood spots.Results: Of 1818 HIV-positive MSM, 299 (16%) self-reported as HIV-negative or unknown infection status. Of these 299, 145 (49%) were considered misreporters based on ARV detection. Among the unaware, misreporters were more likely than nonmisreporters to be older and have health insurance. Compared with self-reported HIV-positive MSM, misreporters were more likely to be black, be bisexual, and have perceived discrimination. Of 138 misreporters with viral load data, 116 (84%) had an undetectable viral load.Conclusion: ARV testing revealed that half of MSM classified as unaware of their infection misreported their status. Although off-label preexposure prophylaxis use might explain the presence of ARVs, it is unlikely as many misreporters were virally suppressed, suggesting they were on HIV therapy. Biomarker validation of behavioral data can improve data quality and usefulness in NHBS and other studies. Copyright (C) 2019 Wolters Kluwer Health, Inc. All rights reserved.