TY - JOUR
T1 - Missed Opportunities for HIV Prevention
T2 - Individuals Who HIV Seroconverted Despite Accessing Healthcare
AU - Cossarini, Francesca
AU - Hanna, David B.
AU - Ginsberg, Mindy S.
AU - Blackstock, Oni J.
AU - Anastos, Kathryn
AU - Felsen, Uriel R.
N1 - Funding Information:
Funding The Einstein-Rockefeller-CUNY Center for AIDS Research (P30-AI124414) is supported by the following NIH co-funding and participating Institutes and Centers: NIAID, NCI, NICHD, NHLBI,
Publisher Copyright:
© 2018, Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2018/11/1
Y1 - 2018/11/1
N2 - Individuals with a negative HIV test before a positive one (seroconverters) may represent missed opportunities for prevention. To inform HIV prevention strategies, we aimed to characterize patients who seroconverted despite accessing care. We identified patients at a large, urban healthcare system who seroconverted between 2009 and 2014. Demographics, visits, and HIV-related variables were extracted from the medical records. We performed descriptive statistics, assessed for trends, and tested for associations according to sex. 220 seroconverters were identified: 45% were female, 87% were non-Hispanic Black or Hispanic, and median number of negative tests prior to diagnosis was 2 (IQR 1–3). Overall, 49% reported heterosexual contact as their risk factor and the proportion with heterosexual risk increased over time (24% in 2009 vs. 56% in 2014, p = 0.03). Compared to men, women were older at the time of diagnosis (35 vs. 26 years old, p < 0.01), had more visits between their latest negative and positive HIV test (4 vs. 2, p < 0.01), and were more likely to be diagnosed in the context of screening (64% vs. 56%, p = 0.05). We identified a population that became HIV-infected despite multiple healthcare encounters and undergoing HIV testing multiple times. Patients were mostly heterosexual and almost half were female. To avoid missed opportunities for those already accessing care, HIV prevention efforts should include strategies tailored to individuals with less frequently recognized risk profiles.
AB - Individuals with a negative HIV test before a positive one (seroconverters) may represent missed opportunities for prevention. To inform HIV prevention strategies, we aimed to characterize patients who seroconverted despite accessing care. We identified patients at a large, urban healthcare system who seroconverted between 2009 and 2014. Demographics, visits, and HIV-related variables were extracted from the medical records. We performed descriptive statistics, assessed for trends, and tested for associations according to sex. 220 seroconverters were identified: 45% were female, 87% were non-Hispanic Black or Hispanic, and median number of negative tests prior to diagnosis was 2 (IQR 1–3). Overall, 49% reported heterosexual contact as their risk factor and the proportion with heterosexual risk increased over time (24% in 2009 vs. 56% in 2014, p = 0.03). Compared to men, women were older at the time of diagnosis (35 vs. 26 years old, p < 0.01), had more visits between their latest negative and positive HIV test (4 vs. 2, p < 0.01), and were more likely to be diagnosed in the context of screening (64% vs. 56%, p = 0.05). We identified a population that became HIV-infected despite multiple healthcare encounters and undergoing HIV testing multiple times. Patients were mostly heterosexual and almost half were female. To avoid missed opportunities for those already accessing care, HIV prevention efforts should include strategies tailored to individuals with less frequently recognized risk profiles.
KW - Epidemiology
KW - HIV prevention
KW - Missed opportunities
KW - Seroconverters
UR - http://www.scopus.com/inward/record.url?scp=85047312678&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85047312678&partnerID=8YFLogxK
U2 - 10.1007/s10461-018-2162-x
DO - 10.1007/s10461-018-2162-x
M3 - Article
C2 - 29797162
AN - SCOPUS:85047312678
SN - 1090-7165
VL - 22
SP - 3519
EP - 3524
JO - AIDS and Behavior
JF - AIDS and Behavior
IS - 11
ER -
