High percentage of undiagnosed HIV cases within a hyperendemic South African community: a population-based study
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 surveilla...
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| Main Authors: | , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
2018
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| In: |
Journal of epidemiology and community health
Year: 2017, Volume: 72, Issue: 2, Pages: 168-172 |
| ISSN: | 1470-2738 |
| DOI: | 10.1136/jech-2017-209713 |
| Online Access: | Verlag, Volltext: http://dx.doi.org/10.1136/jech-2017-209713 Verlag, Volltext: https://jech.bmj.com/content/72/2/168 
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| Author Notes: | Alain Vandormael, Tulio de Oliveira, Frank Tanser, Till Bärnighausen, Joshua T. Herbeck |
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| 520 | |a 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. | ||
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