Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Nov;7(6):580-8.
doi: 10.2174/157016209789973646.

Relationship of self-reported prior testing history to undiagnosed HIV positivity and HIV risk

Michael S Lyons  1 , Christopher J Lindsell, Andrew H Ruffner, Alexander T Trott, Carl J Fichtenbaum
Affiliations

Relationship of self-reported prior testing history to undiagnosed HIV positivity and HIV risk

Michael S Lyons et al. Curr HIV Res. 2009 Nov.

Abstract

Screening everyone for HIV at least once is estimated to be cost-effective. Screening in health care settings is recommended to help achieve that goal. Health care settings often encounter the same patient repeatedly, and it is unknown if limited resources are better allocated to conduct repeat screening, or to screen patients not yet tested. We reviewed data for a targeted ED based HIV screening program for 2003-2007. The role of prior testing history as a predictor of undiagnosed HIV positivity was assessed using a negative binomial model adjusted for demographics and risk behaviors. HIV testing was provided to 8,450 unique patients. There were 5,781 (70%) self-reporting a prior HIV test. Compared with patients reporting no prior test, the relative risk of HIV positivity for those reporting a test within the prior year was 0.90 (95%CI 0.48-1.66), and for those reporting a prior test more than a year previously the relative risk was 0.91 (95%CI 0.48-1.73). Among patients testing positive, those who did not report a prior test had a median CD4 count that was 228 cells/mm(3) lower than those with a prior test (CI(95) of the difference in medians 20-436 cells/mm(3)). Diagnosis of prevalent HIV among those who are at risk but have never been tested should be a priority. However, repeat screening of target populations for incident infection remains important and results in earlier diagnosis. Recent self-reported testing history is not associated with undiagnosed positivity among targeted patients irrespective of the timing of the prior test.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Flow diagram depicting patient enrollment and allocation of patients within analysis plan by prior testing history and test result.
See this image and copyright information in PMC

References

    1. Sanders GD, Bayoumi AM, Sundaram V, et al. Cost-Effectiveness of Screening for HIV in the Era of Highly Active Antiretroviral Therapy. N Engl J Med. 2005;352(6):570–85. - PubMed
    1. Paltiel AD, Weinstein MC, Kimmel AD, et al. Expanded Screening for HIV in the United States -- An Analysis of Cost-Effectiveness. N Engl J Med. 2005;352(6):586–95. - PubMed
    1. Anderson JE, Carey JW, Taveras S. HIV testing among the general US population and persons at increased risk: information from national surveys, 1987–1996. Am J Public Health. 2000;90(7):1089–95. - PMC - PubMed
    1. Ostermann J, Kumar V, Pence BW, et al. Trends in HIV testing and differences between planned and actual testing in the United States, 2000–2005. Arch Intern Med. 2007;167(19):2128–35. - PubMed
    1. HIV prevalence estimates--United States, 2006. MMWR Morb Mortal Wkly Rep. 2008;57(39):1073–6. - PubMed

Publication types