High Risk Individuals Are Testing For HIV More Frequently

MedicalResearch.com Interview with:
Qian An, PhD

Division of HIV/AIDS Prevention

MedicalResearch.com: What is the background for this study?

Response: Since 2006, the Centers for Disease Control and Prevention (CDC) has recommended HIV testing for all persons aged 13-64 years old. Persons at high risk for HIV infection should be tested more frequently. Among sexually active men who have sex with men (MSM), repeat testing is recommended at least annually. An analysis in 2011 suggested that MSM might benefit from more frequent than annual testing.(1)

Among non-MSM, repeat testing is recommended at least annually for persons at high risk, including persons who inject drugs (PWID) and their sex partners, those who have sex in exchange for money or drugs, heterosexuals who have had more than one sex partner since their most recent HIV test, and those whose partners are living with HIV..

Using statistical models based on renewal theory, we estimate the mean HIV inter-test interval (ITI) — meaning the average time period (in months) between two successive HIV tests — to describe temporal trends in HIV testing frequency among MSM, PWID and high-risk heterosexuals (HRH) and differences in testing frequency by age and race/ethnicity. A decrease in ITI means individuals are testing more frequently.

MedicalResearch.com: What are the main findings?

Response: The main findings include:

1) Among people who reported the most recent HIV test date, the estimated HIV ITI generally decreased among MSM, PWID, and HRH over the last decade;

2) Estimated HIV ITI was the shortest among MSM and the longest among high-risk heterosexuals; and

3) Within each high-risk group, estimated HIV ITI was the shortest among individuals aged 18–24 years and African Americans.

MedicalResearch.com: What should readers take away from your report?

Response: Individuals at high risk for HIV infection who ever tested for HIV are testing for HIV more frequently than in the past. In most recent years, adherence to the CDC recommendations of annual HIV testing was much better among MSM and PWID than HRH in this study.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: In 2014, the estimated mean HIV ITI suggests that 18-24 year-old MSM were testing twice a year (mean ITI of 5.8 months). It is not clear that there is a benefit to all MSM to testing more than annually. Future studies should evaluate the potential benefits of more frequent HIV testing (e.g., 3 or 6 months) of sexually active MSM, considering individual risk factors, the local HIV epidemiology, and local testing policies in U.S. jurisdictions.

MedicalResearch.com: Is there anything else you would like to add:

Response: This analysis used data from National HIV Behavioral Surveillance (NHBS), which operates in 20 large urban areas with high HIV prevalence. Most of the 20 NHBS metropolitan statistical areas (MSAs) were part of the initial sites funded for CDC’s Expanded Testing Initiative. In addition, three health departments within NHBS MSAs (Seattle/King County, New York City, and San Francisco) recommend that some MSM be tested more frequently than annually, such as 3-6 months.

HIV testing in NHBS MSAs — especially those where public health officials have officially recommended some MSM be tested for HIV more frequently than annually —may be higher than in other cities. Therefore, reported mean ITI cannot be generalized to all persons at risk for HIV infection in the U.S.

1. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6021a3.htm

Estimated HIV Inter-test Interval Among People at High Risk for HIV Infection in the U.S.
An, Qian et al.
American Journal of Preventive Medicine , Volume 0 , Issue 0 March 20, 2017
DOI: http://dx.doi.org/10.1016/j.amepre.2017.02.009

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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