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Title: Epidemiological factors associated with recent HIV infection among newly-diagnosed cases in Singapore, 2013-2017
Authors: Ang, Li Wei
Low, Carmen 
Wong, Chen Seong 
Boudville, Irving Charles
Toh, Matthias Paul Han Sim 
Archuleta, Sophia 
Lee, Vernon Jian Ming 
Leo, Yee Sin 
Chow, Angela 
Lin, Raymond Tzer-Pin 
Keywords: Science & Technology
Life Sciences & Biomedicine
Public, Environmental & Occupational Health
Recent HIV infection
Newly diagnosed
Risk factors
HIV testing
Modifiable behaviors
Issue Date: 2-Mar-2021
Publisher: BMC
Citation: Ang, Li Wei, Low, Carmen, Wong, Chen Seong, Boudville, Irving Charles, Toh, Matthias Paul Han Sim, Archuleta, Sophia, Lee, Vernon Jian Ming, Leo, Yee Sin, Chow, Angela, Lin, Raymond Tzer-Pin (2021-03-02). Epidemiological factors associated with recent HIV infection among newly-diagnosed cases in Singapore, 2013-2017. BMC PUBLIC HEALTH 21 (1). ScholarBank@NUS Repository.
Abstract: Background: Early diagnosis is crucial in securing optimal outcomes in the HIV care cascade. Recent HIV infection (RHI) serves as an indicator of early detection in the course of HIV infection. Surveillance of RHI is important in uncovering at-risk groups in which HIV transmission is ongoing. The study objectives are to estimate the proportion of RHI among persons newly-diagnosed in 2013–2017, and to elucidate epidemiological factors associated with RHI in Singapore. Methods: As part of the National HIV Molecular Surveillance Programme, residual plasma samples of treatment-naïve HIV-1 positive individuals were tested using the biotinylated peptide-capture enzyme immunoassay with a cutoff of normalized optical density ≤ 0.8 for evidence of RHI. A recent infection testing algorithm was applied for the classification of RHI. We identified risk factors associated with RHI using logistic regression analyses. Results: A total of 701 newly-diagnosed HIV-infected persons were included in the study. The median age at HIV diagnosis was 38 years (interquartile range, 28–51). The majority were men (94.2%), and sexual route was the predominant mode of HIV transmission (98.3%). Overall, 133/701 (19.0, 95% confidence interval [CI] 16.2–22.0%) were classified as RHI. The proportions of RHI in 2015 (31.1%) and 2017 (31.0%) were significantly higher than in 2014 (11.2%). A significantly higher proportion of men having sex with men (23.4, 95% CI 19.6–27.6%) had RHI compared with heterosexual men (11.1, 95% CI 7.6–15.9%). Independent factors associated with RHI were: age 15–24 years (adjusted odds ratio [aOR] 4.18, 95% CI 1.69–10.31) compared with ≥55 years; HIV diagnosis in 2015 (aOR 2.36, 95% CI 1.25–4.46) and 2017 (aOR 2.52, 95% CI 1.32–4.80) compared with 2013–2014; detection via voluntary testing (aOR 1.91, 95% CI 1.07–3.43) compared with medical care; and self-reported history of HIV test(s) prior to diagnosis (aOR 1.72, 95% CI 1.06–2.81). Conclusion: Although there appears to be an increasing trend towards early diagnosis, persons with RHI remain a minority in Singapore. The strong associations observed between modifiable behaviors (voluntary testing and HIV testing history) and RHI highlight the importance of increasing the accessibility to HIV testing for at-risk groups.
ISSN: 14712458
DOI: 10.1186/s12889-021-10478-5
Appears in Collections:Staff Publications

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