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. 2017 Aug 14;12(8):e0181412.
doi: 10.1371/journal.pone.0181412. eCollection 2017.

Missed opportunities for HIV control: Gaps in HIV testing for partners of people living with HIV in Lima, Peru

Ana L Vasquez  1   2 , Renato A Errea  1   2 , Daniel Hoces  1 , Juan Echevarria  1   2   3 , Elsa González-Lagos  1   2 , Eduardo Gotuzzo  1   2   3
Affiliations

Missed opportunities for HIV control: Gaps in HIV testing for partners of people living with HIV in Lima, Peru

Ana L Vasquez et al. PLoS One. .

Abstract

Introduction: Based on the hypothesis that HIV programs struggle to deliver health services that harmonize necessities of treatment and prevention, we described the outcomes of routinely provided HIV testing to partners of people living with HIV (PLWH) through a secondary analysis of routine data collected at a public hospital in Lima, Peru.

Methods: Among PLWH enrolled in the study center's HIV program between 2005 and 2014, we identified index cases (IC): PLWH who reported a unique partner not previously enrolled. We grouped partners according to their HIV status as reported by IC and collected data on HIV testing, clinical characteristics and admissions. The main outcome was the frequency of HIV testing among partners with reported unknown/seronegative HIV status.

Results: Out of 1586 PLWH who reported a unique partner at enrollment, 171 had a previously enrolled partner, leaving 1415 (89%) IC. HIV status of the partner was reported as unknown in 571 (40%), seronegative in 325 (23%) and seropositive in 519 (37%). Out of 896 partners in the unknown/seronegative group, 72 (8%) had HIV testing, 42/72 (58%) tested within three months of IC enrollment. Among the 49/72 (68%) who tested positive for HIV, 33 (67%) were enrolled in the HIV program. The proportion in WHO clinical stage IV was lower in enrolled partners compared to IC (37% vs 9%, p = 0.04). Non-tested partners (824) were likely reachable by the hospital, as 297/824 (36%) of their IC were admitted in the study center at least once, 51/243 (21%) female IC had received pregnancy care at the study center, and 401/692 (64%) of IC on antiretroviral therapy had achieved viral suppression, implying frequent visits to the hospital for pill pick-up.

Conclusion: In this setting, HIV testing of partners of PLWH was suboptimal, illustrating missed opportunities for HIV control. Integration of HIV strategies in primarily clinical-oriented services is a challenging need.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Identification and HIV status of partners.
Fig 2
Fig 2. HIV testing of partners with unknown/seronegative HIV status.
Fig 3
Fig 3. Circumstances and missed opportunities of HIV testing of partners.
Fig 4
Fig 4. Partners with HIV timely testing throughout the 10-year period.
No significant difference in the proportion of partners tested within three months of enrollment of IC and the total number of partners throughout the 10-year period (ANOVA, p = 0.28).
See this image and copyright information in PMC

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References

    1. Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, Kumarasamy N, et al. Prevention of HIV-infection with early antiretroviral therapy. N Engl J Med. 2011; 365(6): 493–505. doi: 10.1056/NEJMoa1105243 - DOI - PMC - PubMed
    1. WHO. Guidance on couples HIV testing and counselling including antiretroviral therapy for treatment and prevention in serodiscordant couples: recommendations for a public health approach. Switzerland: World Health Organization; 2012. - PubMed
    1. El-Bassel N, Gilbert L, Witte S, Wu E, Hunt T, Remien RH. Couple-based HIV prevention in the United States: advantages, gaps, and future directions. J Acquir Immune Dec Syndr. 2010; 55(2): s98–101. - PMC - PubMed
    1. Jiwatram-Negrón T, El-Bassel N. Systematic review of couple-based HIV intervention and prevention studies: advantages, gaps, and future directions. AIDS Behav. 2014; 18(10): 1864–1887. doi: 10.1007/s10461-014-0827-7 - DOI - PMC - PubMed
    1. Rosenberg NE, Pettifor AE, Bruyn GDE, Westreich D, Delany-Moretlwe S, Behets F, et al. HIV testing and counseling leads to immediate consistent condom use among South African stable HIV-discordant couples. J Acquir Immune Defic Syndr. 2013; 62(2): 226–233. doi: 10.1097/QAI.0b013e31827971ca - DOI - PMC - PubMed