High percentage of undiagnosed HIV cases within a hyperendemic South African community

• Verfasst von: Vandormael, Alain [VerfasserIn]
• Verfasst von: Bärnighausen, Till [VerfasserIn]
• Titel: High percentage of undiagnosed HIV cases within a hyperendemic South African community
• Titelzusatz: a population-based study
• Verf.angabe: Alain Vandormael, Tulio de Oliveira, Frank Tanser, Till Bärnighausen, Joshua T. Herbeck
• Jahr des Originals: 2017
• Umfang: 5 S.
• Fussnoten: Published online first 24 November 2017 ; Gesehen am 27.09.2018
• Titel Quelle: Enthalten in: Journal of epidemiology and community health
• Jahr Quelle: 2018
• Band/Heft Quelle: 72(2018), 2, S. 168-172
• ISSN Quelle: 1470-2738
• DOI: doi:10.1136/jech-2017-209713
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1581358652

Abstract

Background Undiagnosed HIV infections could undermine efforts to reverse the global AIDS epidemic by 2030. In this study, we estimated the percentage of HIV-positive persons who remain undiagnosed within a hyperendemic South African community. Methods: The data come from a population-based surveillance system located in the Umkhanyakude district of the northern KwaZulu-Natal province, South Africa. We annually tested 38 661 adults for HIV between 2005 and 2016. Using the HIV-positive test results of 12 039 (31%) participants, we then back-calculated the incidence of infection and derived the number of undiagnosed cases from this result. Results: The percentage of undiagnosed HIV cases decreased from 29.3% in 2005 to 15.8% in 2011. During this period, however, approximately 50% of the participants refused to test for HIV, which lengthened the average time from infection to diagnosis. Consequently, the percentage of undiagnosed HIV cases reversed direction and steadily increased from 16.1% to 18.9% over the 2012-2016 period. Conclusions: Results from this hyperendemic South African setting show that the HIV testing rate is low, with long infection times, and an unsatisfactorily high percentage of undiagnosed cases. A high level of repeat HIV testing is needed to minimise the time from infection to diagnosis if the global AIDS epidemic is to be reversed within the next two decades.