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  1. Article ; Online: Point of Care CD4 Testing in National Household Surveys - Results and Quality Indicators from Eleven Population-Based HIV Impact Assessment (PHIA) Surveys.

    Birhanu, Sehin / Winterhalter, Frieda S / Stupp, Paul / Cates, Melissa / Rottinghaus, Erin / Yavo, Daniel / Wray-Gordon, Floris / Lupoli, Kathryn / Ndongmo, Clement B / Longwe, Herbert / Reid, Giles A / Metz, Melissa / Saito, Suzue / McCracken, Stephen / Brown, Kristin / Voetsch, Andrew C / Duong, Yen T / Parekh, Bharat S / Patel, Hetal K

    Microbiology spectrum

    2023  Volume 11, Issue 3, Page(s) e0314822

    Abstract: Population-based HIV Impact Assessments (PHIAs) are national household (HH) surveys that provide HIV diagnosis and CD4 testing with an immediate return of results. Accurate CD4 results improve HIV-positive participants' clinical care and inform the ... ...

    Abstract Population-based HIV Impact Assessments (PHIAs) are national household (HH) surveys that provide HIV diagnosis and CD4 testing with an immediate return of results. Accurate CD4 results improve HIV-positive participants' clinical care and inform the effectiveness of HIV programs. Here, we present CD4 results from the PHIA surveys that were conducted in 11 countries in sub-Saharan Africa between 2015 and 2018. All of the HIV-positive participants and 2 to 5% of the HIV-negative participants were offered Pima CD4 (Abbott, IL, USA) point-of-care (POC) tests. The quality of the CD4 test was ensured by conducting instrument verification, comprehensive training, quality control, a review of testing errors and an analysis of unweighted CD4 data by HIV status, age, gender, and antiretroviral (ARV) treatment status. Overall, CD4 testing was completed for 23,085 (99.5%) of the 23,209 HIV-positive and 7,329 (2.7%) of the 270,741 negative participants in 11 surveys. The instrument error rate was 11.3% (range, 4.4% to 15.7%). The median CD4 values among HIV-positive and HIV-negative participants (aged 15+) were 468 cells/mm
    MeSH term(s) Humans ; Anti-Retroviral Agents/therapeutic use ; CD4 Lymphocyte Count ; HIV ; HIV Infections/diagnosis ; HIV Infections/drug therapy ; HIV Infections/epidemiology ; Point-of-Care Systems ; Point-of-Care Testing ; Quality Indicators, Health Care
    Chemical Substances Anti-Retroviral Agents
    Language English
    Publishing date 2023-04-18
    Publishing country United States
    Document type Journal Article ; Research Support, U.S. Gov't, P.H.S.
    ZDB-ID 2807133-5
    ISSN 2165-0497 ; 2165-0497
    ISSN (online) 2165-0497
    ISSN 2165-0497
    DOI 10.1128/spectrum.03148-22
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Progress towards the UNAIDS 95-95-95 targets in the Fifth Botswana AIDS Impact Survey (BAIS V 2021): a nationally representative survey.

    Mine, Madisa / Stafford, Kristen A / Laws, Rebecca L / Marima, Reson / Lekone, Phenyo / Ramaabya, Dinah / Makhaola, Kgomotso / Patel, Hetal K / Mapondera, Prichard / Wray-Gordon, Floris / Agbakwuru, Chinedu / Okui, Lillian / Matroos, Susan / Onyadile, Eden / Ngidi, Julia / Abimiku, Alash'le / Bagapi, Khuteletso / Nkomo, Bornapate / Bodika, Stephane M /
    Kim, Kaylee J / Moloney, Mirna / Mitchell, Andrew / Ehoche, Akipu / Ussery, Faith L / Hong, Steven Y / Keipeile, Stella / Matlhaga, Matshelo / Mathumo, Rapetse / Selato, Robert / Charurat, Manhattan E / Voetsch, Andrew C

    The lancet. HIV

    2024  Volume 11, Issue 4, Page(s) e245–e254

    Abstract: Background: In 2014, UNAIDS set a goal to end the AIDS epidemic by achieving targets for the percentage of people living with HIV who were aware of their status, on antiretroviral therapy (ART), and virally suppressed. In 2020, these targets were ... ...

    Abstract Background: In 2014, UNAIDS set a goal to end the AIDS epidemic by achieving targets for the percentage of people living with HIV who were aware of their status, on antiretroviral therapy (ART), and virally suppressed. In 2020, these targets were revised to 95% for each measure (known as 95-95-95), to be reached among people living with HIV by 2025. We used data from the Fifth Botswana AIDS Impact Survey (BAIS V) to measure progress towards these testing and treatment targets in Botswana.
    Methods: BAIS V used a two-stage cluster design to obtain a nationally representative sample of people aged 15-64 years in Botswana. During March-August, 2021, 14 763 consenting participants were interviewed and tested for HIV in their households by survey teams. HIV-positive specimens were tested for viral load, presence of antiretroviral drugs, and recency of infection using the HIV-1 limiting antigen avidity enzyme immunoassay. Estimates of HIV-positive status and use of ART were based on self-report and the analysis of blood specimens for antiretroviral drugs. Viral load suppression was defined as an HIV RNA concentration of less than 1000 copies per mL. HIV incidence was calculated using the recent infection testing algorithm. Data were weighted to account for the complex survey design.
    Findings: The national HIV prevalence in Botswana among people aged 15-64 years was 20·8% and the annual incidence of HIV infection was 0·2%. 95·1% (men 93·0%, women 96·4%) of people living with HIV aged 15-64 years were aware of their status, 98·0% (men 97·2%, women 98·4%) of those aware were on ART, and 97·9% (men 96·6%, women 98·6%) of those on ART had viral load suppression. Among young people (aged 15-24 years) living with HIV, 84·5% were aware of their status, 98·5% of those aware were on ART, and 91·6% of those on ART had viral load suppression. The prevalance of viral load suppression among all people living with HIV was 91·8%, and varied by district-ranging from 85·3% in Gaborone to 100·0% in Selibe Phikwe.
    Interpretation: BAIS V is the first population-based survey worldwide to report the achievement of the UNAIDS 95-95-95 goals, both overall and among women. Strategies to reach undiagnosed men and young people, including young women, are needed.
    Funding: US President's Emergency Plan for AIDS Relief.
    MeSH term(s) Male ; Humans ; Female ; Adolescent ; Acquired Immunodeficiency Syndrome/drug therapy ; Acquired Immunodeficiency Syndrome/epidemiology ; HIV Infections/drug therapy ; HIV Infections/epidemiology ; Botswana/epidemiology ; Anti-Retroviral Agents/therapeutic use ; Surveys and Questionnaires ; Viral Load ; Prevalence
    Chemical Substances Anti-Retroviral Agents
    Language English
    Publishing date 2024-03-08
    Publishing country Netherlands
    Document type Journal Article
    ISSN 2352-3018
    ISSN (online) 2352-3018
    DOI 10.1016/S2352-3018(24)00003-1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: A Comprehensive Approach to Assuring Quality of Laboratory Testing in HIV Surveys: Lessons Learned From the Population-Based HIV Impact Assessment Project.

    Patel, Hetal K / Duong, Yen T / Birhanu, Sehin / Dobbs, Trudy / Lupoli, Kathryn / Moore, Carole / Detorio, Mervi / Sleeman, Katrina / Manjengwa, Julius / Wray-Gordon, Floris / Yavo, Daniel / Jackson, Keisha / Domaoal, Robert A / Yufenyuy, Ernest L / Vedapuri, Shanmugam / Ndongmo, Clement B / Ogollah, Francis M / Dzinamarira, Tafadzwa / Rubinstein, Paul /
    Sachathep, Karampreet K / Metz, Melissa / Longwe, Herbert / Saito, Suzue / Brown, Kristin / Voetsch, Andrew C / Parekh, Bharat S

    Journal of acquired immune deficiency syndromes (1999)

    2020  Volume 87, Issue Suppl 1, Page(s) S17–S27

    Abstract: Background: Conducting HIV surveys in resource-limited settings is challenging because of logistics, limited availability of trained personnel, and complexity of testing. We described the procedures and systems deemed critical to ensure high-quality ... ...

    Abstract Background: Conducting HIV surveys in resource-limited settings is challenging because of logistics, limited availability of trained personnel, and complexity of testing. We described the procedures and systems deemed critical to ensure high-quality laboratory data in the population-based HIV impact assessments and large-scale household surveys.
    Methods: Laboratory professionals were engaged in every stage of the surveys, including protocol development, site assessments, procurement, training, quality assurance, monitoring, analysis, and reporting writing. A tiered network of household, satellite laboratories, and central laboratories, accompanied with trainings, optimized process for blood specimen collection, storage, transport, and real-time monitoring of specimen quality, and test results at each level proved critical in maintaining specimen integrity and high-quality testing. A plausibility review of aggregate merged data was conducted to confirm associations between key variables as a final quality check for quality of laboratory results.
    Results: Overall, we conducted a hands-on training for 3355 survey staff across 13 surveys, with 160-387 personnel trained per survey on biomarker processes. Extensive training and monitoring demonstrated that overall, 99% of specimens had adequate volume and 99.8% had no hemolysis, indicating high quality. We implemented quality control and proficiency testing for testing, resolved discrepancies, verified >300 Pima CD4 instruments, and monitored user errors. Aggregate data review for plausibility further confirmed the high quality of testing.
    Conclusions: Ongoing engagement of laboratory personnel to oversee processes at all levels of the surveys is critical for successful national surveys. High-quality population-based HIV impact assessments laboratory data ensured reliable results and demonstrated the impact of HIV programs in 13 countries.
    MeSH term(s) Developing Countries ; Epidemiological Monitoring ; HIV Infections/diagnosis ; HIV Infections/epidemiology ; HIV-1 ; Health Surveys ; Humans ; Laboratory Personnel/education ; Laboratory Personnel/standards ; Laboratory Proficiency Testing/standards ; Quality Control
    Language English
    Publishing date 2020-06-12
    Publishing country United States
    Document type Journal Article ; Research Support, U.S. Gov't, P.H.S.
    ZDB-ID 645053-2
    ISSN 1944-7884 ; 1077-9450 ; 0897-5965 ; 0894-9255 ; 1525-4135
    ISSN (online) 1944-7884 ; 1077-9450
    ISSN 0897-5965 ; 0894-9255 ; 1525-4135
    DOI 10.1097/QAI.0000000000002702
    Database MEDical Literature Analysis and Retrieval System OnLINE

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