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A Window into the HIV epidemic from a South African Emergency Department

Objective(s): To describe the HIV care continuum in Emergency Department (ED) patients in the Eastern Cape region of South Africa. Design: A cross-sectional, identity-unlinked serosurvey was conducted between September and November of 2016 at the Frere Hospital Emergency Department in East London, S... Full description

Journal Title: AIDS research and human retroviruses 2018, Vol.35 (ja), p.139-144
Main Author: Hansoti, Bhakti
Other Authors: Stead, David , Eisenberg, Anna , Mvandaba, Nomzamo , Mwinnyaa, George , Patel, Eshan U , Parrish, Andy , Reynolds, Steven James , Redd, Andrew D , Fernandez, Reinaldo , Rothman, Richard , Laeyendecker, Oliver , Quinn, Thomas C
Format: Electronic Article Electronic Article
Language: English
Subjects:
Age
HIV
Quelle: Alma/SFX Local Collection
Publisher: United States: Mary Ann Liebert, Inc
ID: ISSN: 0889-2229
Link: https://www.ncbi.nlm.nih.gov/pubmed/30215268
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title: A Window into the HIV epidemic from a South African Emergency Department
format: Article
creator:
  • Hansoti, Bhakti
  • Stead, David
  • Eisenberg, Anna
  • Mvandaba, Nomzamo
  • Mwinnyaa, George
  • Patel, Eshan U
  • Parrish, Andy
  • Reynolds, Steven James
  • Redd, Andrew D
  • Fernandez, Reinaldo
  • Rothman, Richard
  • Laeyendecker, Oliver
  • Quinn, Thomas C
subjects:
  • Adolescent
  • Adult
  • Age
  • Age groups
  • AIDS/HIV
  • Anti-Retroviral Agents
  • Antigens
  • Antiretroviral agents
  • Antiretroviral drugs
  • Avidity
  • Child
  • Child, Preschool
  • Confidence intervals
  • Continuity of Patient Care
  • Cross sections
  • Cross-Sectional Studies
  • Drugs
  • Emergency medical services
  • emergency medicine
  • Emergency Service, Hospital - statistics & numerical data
  • Epidemics
  • Epidemics - statistics & numerical data
  • Epidemiology
  • Female
  • Females
  • Hepatitis
  • Hepatitis B
  • Hepatitis C
  • HIV
  • HIV epidemiology
  • HIV incidence
  • HIV Infections - blood
  • HIV Infections - epidemiology
  • HIV-1
  • Human immunodeficiency virus
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Infections
  • Male
  • Males
  • Middle Aged
  • Population studies
  • Seroepidemiologic Studies
  • South Africa
  • South Africa - epidemiology
  • Statistical methods
  • Viral Load
  • Viruses
  • Young Adult
ispartof: AIDS research and human retroviruses, 2018, Vol.35 (ja), p.139-144
description: Objective(s): To describe the HIV care continuum in Emergency Department (ED) patients in the Eastern Cape region of South Africa. Design: A cross-sectional, identity-unlinked serosurvey was conducted between September and November of 2016 at the Frere Hospital Emergency Department in East London, South Africa. Methods: Discarded/excess samples from all patients who had blood drawn during the study period for routine care were tested for HIV, HBV, and HCV infection; HIV viral load; and presence of antiretroviral drugs. Cross-sectional incidence was estimated using the LAg Avidity assay and HIV viral load. Results: The overall HIV prevalence was 26.9% (95%CI: 25.0-28.8; n=2100). The highest prevalence was observed among females in the 30-39 age group (60.3% [95%CI: 53.2-67.1]). HIV prevalence was significantly higher among females compared to males in both the 20-29 year age group and 30-39 year age group (P
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0889-2229
fulltext: fulltext
issn:
  • 0889-2229
  • 1931-8405
url: Link


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titleA Window into the HIV epidemic from a South African Emergency Department
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creatorHansoti, Bhakti ; Stead, David ; Eisenberg, Anna ; Mvandaba, Nomzamo ; Mwinnyaa, George ; Patel, Eshan U ; Parrish, Andy ; Reynolds, Steven James ; Redd, Andrew D ; Fernandez, Reinaldo ; Rothman, Richard ; Laeyendecker, Oliver ; Quinn, Thomas C
creatorcontribHansoti, Bhakti ; Stead, David ; Eisenberg, Anna ; Mvandaba, Nomzamo ; Mwinnyaa, George ; Patel, Eshan U ; Parrish, Andy ; Reynolds, Steven James ; Redd, Andrew D ; Fernandez, Reinaldo ; Rothman, Richard ; Laeyendecker, Oliver ; Quinn, Thomas C
descriptionObjective(s): To describe the HIV care continuum in Emergency Department (ED) patients in the Eastern Cape region of South Africa. Design: A cross-sectional, identity-unlinked serosurvey was conducted between September and November of 2016 at the Frere Hospital Emergency Department in East London, South Africa. Methods: Discarded/excess samples from all patients who had blood drawn during the study period for routine care were tested for HIV, HBV, and HCV infection; HIV viral load; and presence of antiretroviral drugs. Cross-sectional incidence was estimated using the LAg Avidity assay and HIV viral load. Results: The overall HIV prevalence was 26.9% (95%CI: 25.0-28.8; n=2100). The highest prevalence was observed among females in the 30-39 age group (60.3% [95%CI: 53.2-67.1]). HIV prevalence was significantly higher among females compared to males in both the 20-29 year age group and 30-39 year age group (P<0.05), but nearly identical at older age groups. Antiretroviral drugs were detected in 53.5% (95%CI: 48.1-58.9) of HIV-infected subjects. The frequency of HIV viral suppression (<1000 copies/mL) was 48.5% (95%CI: 44.3-52.7), and was not statistically different between males and females (age-adjusted PR=1.15, 95%CI: 0.95-1.39). The HIV incidence rate was estimated to be 2.6% (95%CI: 1.2-3.9). Conclusions: The Frere Hospital ED has an extremely high burden of HIV infection. The detection of antiretroviral drugs and prevalence of viral suppression falls short of the WHO 90-90-90 goals in this population. The ED is an underutilized venue for testing and linkage to care of a high needs population that is likely missed by current screening.
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subjectAdolescent ; Adult ; Age ; Age groups ; AIDS/HIV ; Anti-Retroviral Agents ; Antigens ; Antiretroviral agents ; Antiretroviral drugs ; Avidity ; Child ; Child, Preschool ; Confidence intervals ; Continuity of Patient Care ; Cross sections ; Cross-Sectional Studies ; Drugs ; Emergency medical services ; emergency medicine ; Emergency Service, Hospital - statistics & numerical data ; Epidemics ; Epidemics - statistics & numerical data ; Epidemiology ; Female ; Females ; Hepatitis ; Hepatitis B ; Hepatitis C ; HIV ; HIV epidemiology ; HIV incidence ; HIV Infections - blood ; HIV Infections - epidemiology ; HIV-1 ; Human immunodeficiency virus ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infections ; Male ; Males ; Middle Aged ; Population studies ; Seroepidemiologic Studies ; South Africa ; South Africa - epidemiology ; Statistical methods ; Viral Load ; Viruses ; Young Adult
ispartofAIDS research and human retroviruses, 2018, Vol.35 (ja), p.139-144
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1Stead, David
2Eisenberg, Anna
3Mvandaba, Nomzamo
4Mwinnyaa, George
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6Parrish, Andy
7Reynolds, Steven James
8Redd, Andrew D
9Fernandez, Reinaldo
10Rothman, Richard
11Laeyendecker, Oliver
12Quinn, Thomas C
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descriptionObjective(s): To describe the HIV care continuum in Emergency Department (ED) patients in the Eastern Cape region of South Africa. Design: A cross-sectional, identity-unlinked serosurvey was conducted between September and November of 2016 at the Frere Hospital Emergency Department in East London, South Africa. Methods: Discarded/excess samples from all patients who had blood drawn during the study period for routine care were tested for HIV, HBV, and HCV infection; HIV viral load; and presence of antiretroviral drugs. Cross-sectional incidence was estimated using the LAg Avidity assay and HIV viral load. Results: The overall HIV prevalence was 26.9% (95%CI: 25.0-28.8; n=2100). The highest prevalence was observed among females in the 30-39 age group (60.3% [95%CI: 53.2-67.1]). HIV prevalence was significantly higher among females compared to males in both the 20-29 year age group and 30-39 year age group (P<0.05), but nearly identical at older age groups. Antiretroviral drugs were detected in 53.5% (95%CI: 48.1-58.9) of HIV-infected subjects. The frequency of HIV viral suppression (<1000 copies/mL) was 48.5% (95%CI: 44.3-52.7), and was not statistically different between males and females (age-adjusted PR=1.15, 95%CI: 0.95-1.39). The HIV incidence rate was estimated to be 2.6% (95%CI: 1.2-3.9). Conclusions: The Frere Hospital ED has an extremely high burden of HIV infection. The detection of antiretroviral drugs and prevalence of viral suppression falls short of the WHO 90-90-90 goals in this population. The ED is an underutilized venue for testing and linkage to care of a high needs population that is likely missed by current screening.
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32HIV Infections - epidemiology
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34Human immunodeficiency virus
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38Infant, Newborn
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41Males
42Middle Aged
43Population studies
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45South Africa
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titleA Window into the HIV epidemic from a South African Emergency Department
authorHansoti, Bhakti ; Stead, David ; Eisenberg, Anna ; Mvandaba, Nomzamo ; Mwinnyaa, George ; Patel, Eshan U ; Parrish, Andy ; Reynolds, Steven James ; Redd, Andrew D ; Fernandez, Reinaldo ; Rothman, Richard ; Laeyendecker, Oliver ; Quinn, Thomas C
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8Redd, Andrew D
9Fernandez, Reinaldo
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pages139-144
issn0889-2229
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abstractObjective(s): To describe the HIV care continuum in Emergency Department (ED) patients in the Eastern Cape region of South Africa. Design: A cross-sectional, identity-unlinked serosurvey was conducted between September and November of 2016 at the Frere Hospital Emergency Department in East London, South Africa. Methods: Discarded/excess samples from all patients who had blood drawn during the study period for routine care were tested for HIV, HBV, and HCV infection; HIV viral load; and presence of antiretroviral drugs. Cross-sectional incidence was estimated using the LAg Avidity assay and HIV viral load. Results: The overall HIV prevalence was 26.9% (95%CI: 25.0-28.8; n=2100). The highest prevalence was observed among females in the 30-39 age group (60.3% [95%CI: 53.2-67.1]). HIV prevalence was significantly higher among females compared to males in both the 20-29 year age group and 30-39 year age group (P<0.05), but nearly identical at older age groups. Antiretroviral drugs were detected in 53.5% (95%CI: 48.1-58.9) of HIV-infected subjects. The frequency of HIV viral suppression (<1000 copies/mL) was 48.5% (95%CI: 44.3-52.7), and was not statistically different between males and females (age-adjusted PR=1.15, 95%CI: 0.95-1.39). The HIV incidence rate was estimated to be 2.6% (95%CI: 1.2-3.9). Conclusions: The Frere Hospital ED has an extremely high burden of HIV infection. The detection of antiretroviral drugs and prevalence of viral suppression falls short of the WHO 90-90-90 goals in this population. The ED is an underutilized venue for testing and linkage to care of a high needs population that is likely missed by current screening.
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pmid30215268
doi10.1089/AID.2018.0127
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