Survival Analysis of Time to Retest for HIV Among Men Who Have Sex with Men from Metro Manila, Philippines: A Single-Center Prospective Study
Abstract
Background: Regular HIV testing means early detection of the virus and prompt access to treatment. However, factors affecting retesting following receipt of a non-reactive test result are not yet well understood. This study aims to determine the predictors of time to repeat HIV testing among men who have sex with men (MSM) from Metro Manila, Philippines within six months following receipt of a non-reactive test result.
Methods: A prospective study was implemented at a community-based HIV testing and counseling center. A total of 250 non-reactive MSM from Metro Manila and with a recent risk of acquiring HIV were the respondents. At baseline, data on socio-demographic factors were gathered; while at follow-up, repeat test status of each participant within six months after baseline was collected.
Results: Two retests per 1,000 person-weeks were recorded. Mean survival time was 23.93 weeks, 95% CI: [23.18 - 24.68]. Cox proportional hazards regression demonstrated that statistically significant factors of time to retest were age (HR = 0.90, 95% CI [0.85, 0.96]) and number of tests in lifetime (HR = 1.12, 95%CI [1.06, 1.18]).
Conclusion: Although the average time to return is within the recommended period of three to six months, the low return rate suggests the call for encouraging repeat HIV testing among MSM with non-reactive results and recent risk of acquiring HIV. Repeat testing has been shown to be facilitated by age and previous testing history. HIV/AIDS counselors and program administrators can aim for MSM who are older and with relatively low testing history to help meet the global target of ending the HIV/AIDS global epidemic.
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References
Andrews, B. E. (2011). Prevalence and correlates of HIV testing among Caribbean youth. International Journal of STD & AIDS, 22(12): 722-726. https://doi.org/10.1258/ijsa.2011.011088.
Ajzen, I. (2002). Residual Effects of Past on Later Behavior: Habituation and Reasoned Action Perspectives. Personality and Social Psychology Review,6(2), 107–122.
Ajzen, I. (2011). The theory of planned behaviour: Reactions and reflections. Psychology & Health, 26, 1,113-1,127. https://doi.org/10.1080/08870446.2011.613995
Brown, B., Marg, L., LeComte-Hinely, J., Brinkman, D., Zhang, Z., & Sullivan, G. (2018). Indicators of self-reported human immunodeficiency virus risk and differences in willingness to get tested by age and ethnicity: An observational study. Medicine (Baltimore), 97(31), e11690. https://doi.org/10.1097/MD.0000000000011690.
Burchell, A. N., Calzavara, L. M., Myers T., Schlossberg, J., Millson, M., Escobar, M., Walace, E., & Major C. (2003). Voluntary HIV testing among inmates: sociodemographic, behavioral risk, and attitudinal correlates. Journal of Acquired Immune Deficiency Syndromes 32(5), 534-41.
Centers for Disease Control and Prevention. (2018). HIV testing 101. Division of HIV/AIDS Prevention. https://www.cdc.gov/hiv/pdf/library/factsheets/hiv-testing-101-info-sheet.pdf
Conserve, D., Sevilla, L., Mbwambo, J. & King, G. (2013). Determinants of Previous HIV Testing and Knowledge of Partner's HIV Status Among Men Attending a Voluntary Counseling and Testing Clinic in Dar es Salaam, Tanzania. American Journal of Men's Health, 7(6), 450-460. https://doi.org/10.1177/1557988312468146.
Davis, D. H. J., Smith, R., Brown, A., Rice, B., Yin, Z., Delpech, V. (2013). Early diagnosis and treatment of HIV infection: magnitude of benefit on short-term mortality is greatest in older adults. Age and Ageing, 42(4), 520–526. https://doi.org/10.1093/ageing/aft052
De Allegri, M., Agier, I., Tiendrebeogo, J., Louis, V.R., Yé, M., Mueller, O., & Sarker, M. (2015). Factors Affecting the Uptake of HIV Testing among Men: A Mixed Method Study in Rural Burkina Faso. PLoS one, 10(7), 2-15. https://doi.org/10.1371/journal.pone.0130216.
den Daas, C.. Doppen, M., Martine, S., & de Coul, E. (2016). Determinants of Never Having Tested For HIV Among MSM in the Netherlands. BMJ Open, 6(1), e009480. http://dx.doi.org/10.1136/bmjopen-2015-009480.
Department of Health (DOH). (2015). 2015 Integrated HIV Behavioral and Serologic Surveillance. Manila: Department of Health Epidemiology Bureau.
Department of Health (DOH). (2019). HIV/AIDS & ART Registry of the Philippines. Manila: Department of Health Epidemiology Bureau.
Dilernia D. A., Mónaco, D. C., Krolewiecki, A., César, C., Cahn, P., Salomón H. (2010). The importance of early diagnosis for the survival of HIV positive patients. Medicina (B Aires), 70(5), 453-6.
Duffus, W.A., Weis, K., Kettinger, L., Stephens, T., Albrecht, H., Gibson, J.J. (2009). Risk-based HIV testing in South Carolina health care settings failed to identify the majority of infected individuals. AIDS Patient Care STDS, 23(5), 339-45. https://doi.org/10.1089/apc.2008.0193.
Frøslie, K. F., Røislien, J., Laake, P., Henriksen, T., Qvigstad, E., & Veierød, M. B. (2010). Categorisation of continuous exposure variables revisited. A response to the Hyperglycaemia and Adverse Pregnancy Outcome (HAPO) Study. BMC Medical Research Methodology, 10:103. https://doi.org/10.1186/1471-2288-10-103.
Gangcuangco, L. M., Tan, M. L., & Berba, R. P. (2013). Prevalence and risk factors for HIV infection among men having sex with men in Metro Manila, Philippines. Southeast Asian Journal of Tropical Medicine and Public Health, 44(5), 810-7.
Gohil, J., Baja, E. S., Sy, T. R., Guevara, E. G., Hemingway, C., Medina, P. M. B., Coppens, L., Dalmacion, G. V., & Taegtmeyer, M. (2020). Is the Philippines ready for HIV self-testing?. BMC Public Health, 20, 34. https://doi.org/10.1186/s12889-019-8063-8.
Harichund, C., Kunene, P., Simelane, S., Karim, Q. A., & Moshabela, M. (2019). RepeatHIV testing practices in the era of HIV self-testing among adults in KwaZulu-Natal, South Africa. PLoS One, 14(2), e0212343. https://doi.org/10.1371/journal.pone.0212343.
Joint United Nations Programme on HIV/AIDS (UNAIDS). (2014). 90-90-90 An ambitious treatment target to help end the AIDS epidemic. https://www.unaids.org/sites/default/files/media_asset/90-90-90_en.pdf
Joint United Nations Programme on HIV/AIDS. (2018). Undetectable = Untransmittable: Public Health and HIV Viral Load Suppression.https://www.unaids.org/sites/default/files/media_asset/undetectable-untransmittable_en.pdf
Norman, L. R. & Gebre, Y. (2005). Prevalence and correlates of HIV testing: an analysis of university students in Jamaica. Medscape General Medicine, 7(1), 70.
Peltzer, K., & Matseke, G. (2013). Determinants of HIV testing among young people aged 18-24 years in South Africa. African Health Sciences, 13(2), 1012-1020. https://doi.org/10.4314/ahs.v13i4.22.
Philippine Statistics Authority. (2016). Population of the National Capital Region (Based on the 2015 Census of Population). https://psa.gov.ph/content/population-national-capital-region-based-2015-census-population-0.
Puljić, V. M., Ličina, M. L. K., Kavić, M., & Blažić, T. N. (2014) Repeat HIV Testing at Voluntary Testing and Counseling Centers in Croatia: Successful HIV Prevention or Failure to Modify Risk Behaviors? PLoS ONE,9(4), e93734. https://doi.org/10.1371/journal.pone.0093734
R Core Team (2019). R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. https://www.R-project.org/.
Ross, A., Ditangco, R., Belimac, J., Olveda, R., Mercado, E., Chau, T. &Crowe, S. (2015). The Dire Sexual Health Crisis Among MSM in the Philippines: an Exploding HIV Epidemic in the Absence of Essential Health Services. International Journal of Infectious Diseases, 37, 6-8. https://doi.org/10.1016/j.ijid.2015.06.001.
Tenny S. & Hoffman M. R. (2020). Prevalence. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK430867/.
Therneau, T. (2015). A Package for Survival Analysis in R. R version 2.38. https://CRAN.R-project.org/package=survival.
Thiese, M. S., Ronna, B., & Ott, U. (2016). P-value interpretations and considerations. Journal of Thoracic Disease, 8(9): E928–E931. https://doi.org/10.21037/jtd.2016.08.16
World Health Organization. (2010). Delivering HIV test results and messages for re-testing and counselling in adults. https://apps.who.int/iris/bitstream/handle/10665/44278/9789241599115_eng.pdf
World Health Organization. (2015). Consolidated guidelines on HIV testing services: 5Cs: Consent, Confidentiality, Counselling, Correct Results and Connection. https://apps.who.int/iris/bitstream/handle/10665/179870/9789241508926_eng.pdf
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