High Prevalence of Self-Reported Undiagnosed HIV despite High Coverage of HIV Testing A Cross-Sectional Population Based Sero-Survey in South Africa 英文参考文献.docVIP

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High Prevalence of Self-Reported Undiagnosed HIV despite High Coverage of HIV Testing A Cross-Sectional Population Based Sero-Survey in South Africa 英文参考文献.doc

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High Prevalence of Self-Reported Undiagnosed HIV despite High Coverage of HIV Testing A Cross-Sectional Population Based Sero-Survey in South Africa 英文参考文献

HighPrevalenceofSelf-ReportedUndiagnosedHIV despiteHighCoverageofHIVTesting:ACross-Sectional PopulationBasedSero-SurveyinSouthAfrica KatharinaKranzer1,2*,NienkevanSchaik2,UniceKarmue3,KerenMiddelkoop2,ElaineSebastian2, StephenD.Lawn1,2,RobinWood2,4,Linda-GailBekker2 1DepartmentofClinicalResearchUnit,LondonSchoolofHygieneandTropicalMedicine,London,UnitedKingdom,2TheDesmondTutuHIVCentre,UniversityofCape Town, Cape Town, South Africa, 3Northeastern University in Boston, Boston, Massachusetts, United States of America, 4South African Centre for Epidemiological ModelingandAnalysis,UniversityofStellenbosch,Stellenbosch,SouthAfrica Abstract Objectives: To measure HIV prevalence and uptake of HIV counseling and testing (HCT) in a peri-urban South African community.ToassesspredictorsforpreviousHIVtestingandtheassociationbetweentheyieldofpreviouslyundiagnosed HIVandtimeoflastnegativeHIVtest Methods:Arandomsampleof10%oftheadultpopulation($15years)wereinvitedtoattendamobileHCTservice.Study proceduresincludedaquestionnaire,HIVtestingandCD4counts.Predictorsforprevioustestingweredeterminedusinga binominalmodel. Results:1,144(88.0%)of1,300randomlyselectedindividualsparticipatedinthestudy.71.0%(68.3–73.6)hadpreviouslyhad anHIVtestand37.5%(34.6–40.5)hadtestedinthepast12months.Men,migrantsandolder(.35years)andyounger(,20 years)individualswerelesslikelytohavehadapreviousHIVtest.OverallHIVprevalencewas22.7(20.3–25.3)withpeak prevalenceof41.8%(35.8–47.8)inwomenaged25.1–35yearsand37.5%(26.7–48.3)inmenaged25.1–45years.Prevalence ofpreviouslyundiagnosedHIVwas10.3%(8.5–12.1)overalland4.5%(2.3–6.6),8.0%(CI3.9–12.0)and20.0%(13.2–26.8)in individualswhohadtheirmostrecentHIVtestwithin1,1–2andmorethan2yearspriortothesurvey. Conclusion:ThehighburdenofundiagnosedHIVinindividualswhohadrecentlytestedunderscorestheimportanceof frequent repeat testing at least annually. The high prevalence of previously undiagnosed HIV in individuals reporting a negativetestinthe12monthsprecedingthesurveyindicatesaver