Emmanuel Singogo, Sharon S Weir, Evaristar Kudowa, Maganizo Chagomerana, John Chapola, Jessie K Edwards, Confidence Banda, Gift Kawalazira, Yohane Kamgwira, Andreas Jahn, Sarah Bourdin, Thomas Hartney, Lucy Platt, Brian Rice, James R Hargreaves, Mina C Hosseinipour
{"title":"马拉维布兰太尔的艾滋病毒感染风险、治疗差距以及通过基于场地的外展和临床服务所覆盖人群的特征:全区 CLOVE 研究的结果。","authors":"Emmanuel Singogo, Sharon S Weir, Evaristar Kudowa, Maganizo Chagomerana, John Chapola, Jessie K Edwards, Confidence Banda, Gift Kawalazira, Yohane Kamgwira, Andreas Jahn, Sarah Bourdin, Thomas Hartney, Lucy Platt, Brian Rice, James R Hargreaves, Mina C Hosseinipour","doi":"10.1097/QAI.0000000000003493","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>In 2017, Blantyre district had the highest adult HIV prevalence in Malawi (17.7%) and lowest viral suppression (60%). In response, the Ministry of Health expanded prevention and treatment services. We assessed whether outreach to social venues could identify individuals with increased HIV acquisition risk or with unsuppressed HIV not currently reached by clinic-based services.</p><p><strong>Methods: </strong>We conducted a cross-sectional biobehavioral survey in Blantyre, Malawi, from January to March 2022. We visited social venues where people meet new sexual partners and government clinics providing HIV testing or STI screening. Participants older than 15 years were interviewed and tested for HIV infection if not on ART. HIV recency tests were performed on those testing positive, and dried blood spots (DBS) were collected to quantify viral load and also to identify acute infection in those with HIV- results.</p><p><strong>Results: </strong>HIV prevalence (18.5% vs 8.3%) and unsuppressed HIV infection (3.9% vs 1.7%) were higher among venue-recruited (n = 1802) than among clinic-recruited participants (n = 2313). Among PLHIV at both clinics (n = 199) and venues (n = 289), 79% were virally suppressed. Few had acute (n = 1) or recent infection (n = 8). Among women, HIV prevalence was 4 times higher (38.9% venue vs 8.9% clinic). At clinics, PLHIV reporting visiting venues were less likely to be suppressed (54.6 vs 82.6%). More men at venues than at clinics reported paying for sex (49% vs 30%) or having multiple sex partners in the past 4 weeks (32% vs 16%).</p><p><strong>Conclusions: </strong>Enhanced venue-based prevention and testing for men and women could reduce treatment lapses, onward transmission, and improve HIV treatment outcomes.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":"315-324"},"PeriodicalIF":2.9000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11500693/pdf/","citationCount":"0","resultStr":"{\"title\":\"Characterizing HIV Acquisition Risk, Treatment Gaps, and Populations Reached Through Venue-Based Outreach and Clinical Services in Blantyre, Malawi: Findings From a District-wide CLOVE Study.\",\"authors\":\"Emmanuel Singogo, Sharon S Weir, Evaristar Kudowa, Maganizo Chagomerana, John Chapola, Jessie K Edwards, Confidence Banda, Gift Kawalazira, Yohane Kamgwira, Andreas Jahn, Sarah Bourdin, Thomas Hartney, Lucy Platt, Brian Rice, James R Hargreaves, Mina C Hosseinipour\",\"doi\":\"10.1097/QAI.0000000000003493\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>In 2017, Blantyre district had the highest adult HIV prevalence in Malawi (17.7%) and lowest viral suppression (60%). In response, the Ministry of Health expanded prevention and treatment services. We assessed whether outreach to social venues could identify individuals with increased HIV acquisition risk or with unsuppressed HIV not currently reached by clinic-based services.</p><p><strong>Methods: </strong>We conducted a cross-sectional biobehavioral survey in Blantyre, Malawi, from January to March 2022. We visited social venues where people meet new sexual partners and government clinics providing HIV testing or STI screening. Participants older than 15 years were interviewed and tested for HIV infection if not on ART. HIV recency tests were performed on those testing positive, and dried blood spots (DBS) were collected to quantify viral load and also to identify acute infection in those with HIV- results.</p><p><strong>Results: </strong>HIV prevalence (18.5% vs 8.3%) and unsuppressed HIV infection (3.9% vs 1.7%) were higher among venue-recruited (n = 1802) than among clinic-recruited participants (n = 2313). Among PLHIV at both clinics (n = 199) and venues (n = 289), 79% were virally suppressed. Few had acute (n = 1) or recent infection (n = 8). Among women, HIV prevalence was 4 times higher (38.9% venue vs 8.9% clinic). At clinics, PLHIV reporting visiting venues were less likely to be suppressed (54.6 vs 82.6%). More men at venues than at clinics reported paying for sex (49% vs 30%) or having multiple sex partners in the past 4 weeks (32% vs 16%).</p><p><strong>Conclusions: </strong>Enhanced venue-based prevention and testing for men and women could reduce treatment lapses, onward transmission, and improve HIV treatment outcomes.</p>\",\"PeriodicalId\":14588,\"journal\":{\"name\":\"JAIDS Journal of Acquired Immune Deficiency Syndromes\",\"volume\":\" \",\"pages\":\"315-324\"},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2024-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11500693/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"JAIDS Journal of Acquired Immune Deficiency Syndromes\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/QAI.0000000000003493\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"IMMUNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"JAIDS Journal of Acquired Immune Deficiency Syndromes","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/QAI.0000000000003493","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
Characterizing HIV Acquisition Risk, Treatment Gaps, and Populations Reached Through Venue-Based Outreach and Clinical Services in Blantyre, Malawi: Findings From a District-wide CLOVE Study.
Background: In 2017, Blantyre district had the highest adult HIV prevalence in Malawi (17.7%) and lowest viral suppression (60%). In response, the Ministry of Health expanded prevention and treatment services. We assessed whether outreach to social venues could identify individuals with increased HIV acquisition risk or with unsuppressed HIV not currently reached by clinic-based services.
Methods: We conducted a cross-sectional biobehavioral survey in Blantyre, Malawi, from January to March 2022. We visited social venues where people meet new sexual partners and government clinics providing HIV testing or STI screening. Participants older than 15 years were interviewed and tested for HIV infection if not on ART. HIV recency tests were performed on those testing positive, and dried blood spots (DBS) were collected to quantify viral load and also to identify acute infection in those with HIV- results.
Results: HIV prevalence (18.5% vs 8.3%) and unsuppressed HIV infection (3.9% vs 1.7%) were higher among venue-recruited (n = 1802) than among clinic-recruited participants (n = 2313). Among PLHIV at both clinics (n = 199) and venues (n = 289), 79% were virally suppressed. Few had acute (n = 1) or recent infection (n = 8). Among women, HIV prevalence was 4 times higher (38.9% venue vs 8.9% clinic). At clinics, PLHIV reporting visiting venues were less likely to be suppressed (54.6 vs 82.6%). More men at venues than at clinics reported paying for sex (49% vs 30%) or having multiple sex partners in the past 4 weeks (32% vs 16%).
Conclusions: Enhanced venue-based prevention and testing for men and women could reduce treatment lapses, onward transmission, and improve HIV treatment outcomes.
期刊介绍:
JAIDS: Journal of Acquired Immune Deficiency Syndromes seeks to end the HIV epidemic by presenting important new science across all disciplines that advance our understanding of the biology, treatment and prevention of HIV infection worldwide.
JAIDS: Journal of Acquired Immune Deficiency Syndromes is the trusted, interdisciplinary resource for HIV- and AIDS-related information with a strong focus on basic and translational science, clinical science, and epidemiology and prevention. Co-edited by the foremost leaders in clinical virology, molecular biology, and epidemiology, JAIDS publishes vital information on the advances in diagnosis and treatment of HIV infections, as well as the latest research in the development of therapeutics and vaccine approaches. This ground-breaking journal brings together rigorously peer-reviewed articles, reviews of current research, results of clinical trials, and epidemiologic reports from around the world.