Can a clinical prediction tool guide HIV-testing decisions? Experience at a national hospital in Guatemala.

Abstract:

:The USA and international recommendations no longer emphasize using risk factors to target groups for HIV-testing. Using a Guatemalan database of HIV tests, we developed a clinical prediction rule to guide decisions on HIV-testing. Prior to HIV-testing, data were collected on demographics, risk factors and prior testing. Based on a theoretical construct incorporating demographics, known HIV risk factors and symptoms, we developed a logistic regression model to predict HIV seropositivity. Between 2000 and 2005, 16,471 tests were performed, of which 19.8% were positive. The algorithm successfully predicted 1883 of 2489 HIV-positive tests (sensitivity 76%, likelihood ratio [LR]-positive 2.45) and 6282 of 9086 HIV-negative tests (specificity 69%, LR-negative 0.35). Although the model indices are robust, applying the model in a clinical setting would have little impact on improving selective testing practices. Our findings support current recommendations for universal HIV-testing, not selective testing based on risk factors. Before these recommendations can be adopted widely in Guatemala, treatment access needs to be assured and protections put in place for people diagnosed with HIV infection.

journal_name

Int J STD AIDS

authors

Anderson MR,Samayoa B,O'Sullivan LF,Fletcher J,Arathoon E

doi

10.1258/ijsa.2008.008223

subject

Has Abstract

pub_date

2009-01-01 00:00:00

pages

30-4

issue

1

eissn

0956-4624

issn

1758-1052

pii

20/1/30

journal_volume

20

pub_type

杂志文章
  • Causal links between binge drinking patterns, unsafe sex and HIV in South Africa: its time to intervene.

    abstract::South Africa has a massive burden of HIV and alcohol disease, and these pandemics are inextricably linked. Much evidence indicates that alcohol independently influences decisions around sex, and undermines skills for condom negotiation and correct use. Thus, not surprisingly, people with problem drinking in Africa hav...

    journal_title:International journal of STD & AIDS

    pub_type: 杂志文章,评审

    doi:10.1258/ijsa.2000.009432

    authors: Chersich MF,Rees HV

    更新日期:2010-01-01 00:00:00

  • Pseudomonas orchitis in puberty.

    abstract::Acute epididymo-orchitis is a common cause of 'acute scrotum' in adolescence and young adults, and the common causative pathogens are Chlamydia trachomatis and Neisseria gonorrhoeae. This is a rare case of acute epididymo-orchitis due to Pseudomonas aeruginosa in a pubertal boy with a history of 'ano-receptive' interc...

    journal_title:International journal of STD & AIDS

    pub_type: 杂志文章

    doi:10.1177/095646240401501014

    authors: Rajagopal AS

    更新日期:2004-10-01 00:00:00

  • STD surveillance in the Russian Federation.

    abstract::The Russian Federation has had a well developed state system for the surveillance and control of sexually transmitted diseases (STDs) since World War II. The system is centered around clinical dermatovenereology (DV) services controlled by the Ministry of Health, and in the regions by the Divisions of Health Care. D...

    journal_title:International journal of STD & AIDS

    pub_type: 杂志文章

    doi:

    authors: Borisenko K

    更新日期:1998-01-01 00:00:00

  • Association of Trichomonas vaginalis with sociodemographic factors and other STDs among female inmates in Lisbon.

    abstract::A study on STDs was conducted among 211 female inmates in a prison in Lisbon, Portugal, in order to establish possible associations between Trichomonas vaginalis infection, sociodemographic factors and other STDs. T. vaginalis was found in 31.2% of the women, from whom only 65.1% presented symptoms. It was more freque...

    journal_title:International journal of STD & AIDS

    pub_type: 杂志文章

    doi:10.1258/0956462041724235

    authors: Garcia A,Exposto F,Prieto E,Lopes M,Duarte A,Correia da Silva R

    更新日期:2004-09-01 00:00:00

  • Cytomegalovirus pp65 antigenaemia as an indicator of end-organ disease in AIDS.

    abstract::We aim to assess the usefulness of the cytomegalovirus (CMV) pp65 antigenaemia test, also called the CMV direct antigen test (DAT), in the management of patients with advanced human immunodeficiency virus (HIV) infection; we studied all patients who had pp65 assays between 8 September 1995 and 30 August 1996. Twenty-t...

    journal_title:International journal of STD & AIDS

    pub_type: 临床试验,杂志文章

    doi:10.1258/0956462981922809

    authors: Fox EF,Smith NA,Rice P,Dunn H,Peters BS

    更新日期:1998-09-01 00:00:00

  • HIV infection among patients with sexually transmitted diseases in rural South Africa.

    abstract::A cross-sectional study of 360 patients presenting with sexually transmitted diseases (STDs) to a primary care clinic in KwaZulu/Natal, South Africa was done. Prevalence of HIV infection was 42.5%. HIV-infected patients were of similar age to uninfected patients (mean age 25.1 vs 26.1 years), but were less likely to b...

    journal_title:International journal of STD & AIDS

    pub_type: 杂志文章

    doi:10.1258/0956462981921486

    authors: Wilkinson D,Wilkinson N

    更新日期:1998-12-01 00:00:00

  • The dysfunctional foreskin.

    abstract::Although important, the foreskin is not absolutely essential to penile function. Dysfunction is common and a cause of considerable morbidity, and is sometimes associated with mortality from squamous cell carcinoma (SCC). Penile dermatoses herald, complicate or cause preputial dysfunction. Their effective diagnosis and...

    journal_title:International journal of STD & AIDS

    pub_type: 杂志文章,评审

    doi:10.1258/0956462011922922

    authors: Porter WM,Bunker CB

    更新日期:2001-04-01 00:00:00

  • A review of cervical cytology in genitourinary medicine clinics in England between 1997 and 2008.

    abstract::The current cervical screening guidelines lay the duty of care of women under 25 years of age on genitourinary (GU) medicine clinics. To date there has not been an extensive review of cervical cytology results sourced from GU medicine departments. We reviewed the annual reports of the cervical screening programme, wit...

    journal_title:International journal of STD & AIDS

    pub_type: 杂志文章,评审

    doi:10.1258/ijsa.2009.009122

    authors: Markos AR

    更新日期:2009-10-01 00:00:00

  • An economic exploration of oral and intravenous ganciclovir in the induction and maintenance treatment of AIDS-related cytomegalovirus retinitis.

    abstract::The objective of the study was to compare the impact of oral and i.v. ganciclovir on resource use and direct health care costs, from the perspective of the UK National Health Service (NHS). The analytical framework used was cost analysis. The sources of data were an open, randomized clinical trial, and additional rese...

    journal_title:International journal of STD & AIDS

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1258/0956462961918383

    authors: Davies L,Maynard A

    更新日期:1996-10-01 00:00:00

  • Which sexually active female students get themselves tested for Chlamydia trachomatis? A cohort study.

    abstract::Using data from the Prevention of Pelvic Infection (POPI) chlamydia screening trial, we compared the characteristics of female students who did or did not get tested for chlamydia outside the trial during 12 months' follow-up. Of the 2529 women in the trial, we excluded 68 chlamydia positives in the intervention group...

    journal_title:International journal of STD & AIDS

    pub_type: 杂志文章

    doi:10.1177/0956462415587636

    authors: Kerry SR,Nightingale CM,Hay P,Oakeshott P

    更新日期:2016-06-01 00:00:00

  • Can data from HIV voluntary counselling and testing be used to assess the impact of public health interventions? A literature review.

    abstract::Routinely collected data from clinical sites offering voluntary counselling and testing (VCT) for HIV diagnosis have been used to evaluate the impact of public health interventions; however, there has been considerable diversity in strategies. To gain an understanding of the outcome of these evaluations and provide th...

    journal_title:International journal of STD & AIDS

    pub_type: 杂志文章,评审

    doi:10.1258/ijsa.2009.009005

    authors: Guy RJ,Prybylski D,Fairley CK,Hellard ME,Kaldor JM

    更新日期:2009-06-01 00:00:00

  • PCR detection of Epstein-Barr virus, herpes simplex virus and human papillomavirus from the anal mucosa in HIV-seropositive and HIV-seronegative homosexual men.

    abstract::This study aimed to examine the prevalence of the Epstein-Barr virus (EBV), herpes simplex virus (HSV) and human papillomavirus (HPV) in the anal and oral mucosa of homosexual men with and without HIV infection and to correlate these findings to CD4+ count and anal cytology. Anal and oral cell samples from 20 HIV-infe...

    journal_title:International journal of STD & AIDS

    pub_type: 杂志文章

    doi:10.1258/0956462991914762

    authors: Löwhagen GB,Bergbrant IM,Bergström T,Ryd W,Voog E

    更新日期:1999-09-01 00:00:00

  • Effectiveness of peer education in HIV/STD prevention at different types of senior high schools in Shanghai, People's Republic of China.

    abstract::The epidemic of HIV/AIDS greatly threatens Chinese youth. Our study was intended to examine the effectiveness of the peer education method in HIV/AIDS prevention in different types of senior high schools in Shanghai. A peer education intervention was conducted in 10 different types of senior high schools, including th...

    journal_title:International journal of STD & AIDS

    pub_type: 杂志文章

    doi:10.1258/ijsa.2008.008053

    authors: Shen LX,Hong H,Cai Y,Jin XM,Shi R

    更新日期:2008-11-01 00:00:00

  • Evaluating the implementation of nurse-initiated HIV rapid testing in three Veterans Health Administration substance use disorder clinics.

    abstract::Individuals with substance use disorders (SUDs) are at higher risk of HIV infection, yet recent studies show rates of HIV testing are low among this population. We implemented and evaluated a nurse-initiated HIV oral rapid testing (NRT) strategy at three Veterans Health Administration SUD clinics. Implementation of NR...

    journal_title:International journal of STD & AIDS

    pub_type: 杂志文章

    doi:10.1258/ijsa.2012.012050

    authors: Conners EE,Hagedorn HJ,Butler JN,Felmet K,Hoang T,Wilson P,Klima G,Sudzina E,Anaya HD

    更新日期:2012-11-01 00:00:00

  • Healthcare contacts among patients lost to follow-up in HIV care: review of a large regional cohort utilizing electronic health records.

    abstract::In the United States 40% of HIV patients are lost to follow-up (LTFU) following linkage to HIV care and an estimated 30-61% of new HIV transmissions are attributed to this group. To characterize those LTFU and healthcare contacts they make, we retrospectively analyzed a large regional HIV cohort in Calgary, Canada, ut...

    journal_title:International journal of STD & AIDS

    pub_type: 杂志文章

    doi:10.1177/0956462417699464

    authors: Connors WJ,Krentz HB,Gill MJ

    更新日期:2017-11-01 00:00:00

  • Human papillomavirus type-distribution in condylomata acuminata of mainland China: a meta-analysis.

    abstract::The aim of this work was to study the human papillomavirus (HPV) type-distribution in condylomata acuminata (CA) of mainland China and to estimate the potential role of HPV prophylactic vaccines for CA in mainland China. Forty-three studies using polymerase chain reaction to detect HPV were included in this meta-analy...

    journal_title:International journal of STD & AIDS

    pub_type: 杂志文章,meta分析

    doi:10.1258/ijsa.2008.008040

    authors: Wang H,Qiao YL

    更新日期:2008-10-01 00:00:00

  • Development of a heminested polymerase chain reaction assay for the detection of Haemophilus ducreyi in clinical specimens.

    abstract::Detection of Haemophilus ducreyi in genital ulcer specimens by culture lacks sensitivity. To enhance detection, a heminested polymerase chain reaction (PCR) assay was developed targeting the nucleotide sequence of a gene, designated p27, which encodes for a 27 kDa H. ducreyi-specific protein. The p27 PCR assay detecte...

    journal_title:International journal of STD & AIDS

    pub_type: 杂志文章

    doi:10.1258/0956462011924425

    authors: Tekle-Michael T,Van Dyck E,Abdellati S,Laga M

    更新日期:2001-12-01 00:00:00

  • Education attainment as a predictor of HIV risk in rural Uganda: results from a population-based study.

    abstract::We examined the association between education and prevalent HIV-1 infection in the Rakai district, rural Uganda based on a cross-sectional analysis of a population-based cohort. In 1990, 1397 men and 1705 women aged 13 years and older, were enrolled in 31 randomly selected communities. Strata were comprised of main ro...

    journal_title:International journal of STD & AIDS

    pub_type: 杂志文章

    doi:10.1258/0956462991914456

    authors: Smith J,Nalagoda F,Wawer MJ,Serwadda D,Sewankambo N,Konde-Lule J,Lutalo T,Li C,Gray RH

    更新日期:1999-07-01 00:00:00

  • Binge drinking, sexual behaviour and sexually transmitted infection in the UK.

    abstract::Associations between sexual risk and alcohol consumption may be self-evident but have eluded detailed examination in the UK. A cohort of 520 genitourinary (GU) medicine clinic attenders in the south of England were given a detailed questionnaire and compared with a matched cohort from the General Household Survey (GHS...

    journal_title:International journal of STD & AIDS

    pub_type: 杂志文章

    doi:10.1258/095646207782717027

    authors: Standerwick K,Davies C,Tucker L,Sheron N

    更新日期:2007-12-01 00:00:00

  • Gonorrhoea and urogenital chlamydial infection in female prostitutes in Tegucigalpa, Honduras.

    abstract::The prevalence of gonorrhoea and urogenital chlamydial infection was investigated in female prostitutes in Tegucigalpa, Honduras. Epidemiological data were recorded according to a standardized questionnaire. The median age of the prostitutes was 27 years and the median period of prostitution was 2-4 years. Most of the...

    journal_title:International journal of STD & AIDS

    pub_type: 杂志文章

    doi:10.1177/095646249100200309

    authors: Venegas VS,Villafranca P,Madrid JP,Cosenza H,Bygdeman S

    更新日期:1991-05-01 00:00:00

  • Genital elephantiasis and sexually transmitted infections - revisited.

    abstract::Genital elephantiasis is an important medical problem in the tropics. It usually affects young and productive age group, and is associated with physical disability and extreme mental anguish. The majority of cases are due to filariasis; however, a small but significant proportion of patients develop genital elephantia...

    journal_title:International journal of STD & AIDS

    pub_type: 杂志文章,评审

    doi:10.1258/095646206775809150

    authors: Gupta S,Ajith C,Kanwar AJ,Sehgal VN,Kumar B,Mete U

    更新日期:2006-03-01 00:00:00

  • Genital lymphoedema due to ano-genital granulomatosis.

    abstract::A 21-year-old man presented to genitourinary (GU) medicine physicians with (initially) painful penile and scrotal swelling. A diagnosis of ano-genital granulomatosis was confirmed on histological analysis of penile skin. Enquiring about systemic symptoms resulted in the additional diagnosis of gastrointestinal Crohn's...

    journal_title:International journal of STD & AIDS

    pub_type: 杂志文章

    doi:10.1258/ijsa.2012.012183

    authors: Gordon KD,Brice G,Walker Y,Pollok R,Mortimer P,Slater C

    更新日期:2013-02-01 00:00:00

  • Treatment of human immunodeficiency virus-related peripheral neuropathy with Scrambler Therapy: a case report.

    abstract::Peripheral neuropathy is one of the most common neurological complications of HIV infection with a 30-60% lifetime prevalence. Newer HIV drugs cause less peripheral neuropathy, but patients are now living long enough to develop concomitant diabetes-related, vascular-related, and chemotherapy-related neuropathy so it c...

    journal_title:International journal of STD & AIDS

    pub_type: 杂志文章

    doi:10.1177/0956462416656688

    authors: Smith TJ,Auwaerter P,Knowlton A,Saylor D,McArthur J

    更新日期:2017-02-01 00:00:00

  • Racial and ethnic differences in knowledge and willingness to participate in HIV vaccine trials in an urban population in the Southeastern US.

    abstract::Racial/ethnic minorities in the Southeastern USA are disproportionately affected by HIV, and would benefit from a preventive vaccine. We conducted a cross-sectional survey of 220 community college students in Atlanta to evaluate racial/ethnic differences in knowledge and willingness to participate in HIV vaccine trial...

    journal_title:International journal of STD & AIDS

    pub_type: 杂志文章

    doi:10.1258/095646206775455667

    authors: Priddy FH,Cheng AC,Salazar LF,Frew PM

    更新日期:2006-02-01 00:00:00

  • Regional variations in HIV disclosure in Thailand: implications for future interventions.

    abstract::People living with HIV (PLH) in Thailand face tremendous challenges, including HIV disclosure. With the advent of antiretroviral (ARV) therapy in Thailand, the positive benefits of HIV disclosure are becoming more salient. However, there are regional variations in the levels of HIV disclosure in Thailand. We examined ...

    journal_title:International journal of STD & AIDS

    pub_type: 杂志文章

    doi:10.1258/ijsa.2009.009008

    authors: Lee SJ,Li L,Jiraphongsa C,Iamsirithaworn S,Khumtong S,Rotheram-Borus MJ

    更新日期:2010-03-01 00:00:00

  • Antibiotic susceptibility, serovars and auxotypes of gonococcal isolates in Stockholm. Relation to geographical origin of the infection.

    abstract::The antibiotic susceptibility, serovars and auxotypes were investigated in gonococcal strains isolated from all patients with gonorrhoea during one year in Stockholm, Sweden. The results were correlated to geographical origin of the infection. A total of 394 gonococcal strains were isolated from 392 patients, 135 (34%...

    journal_title:International journal of STD & AIDS

    pub_type: 杂志文章

    doi:10.1177/095646249300400107

    authors: Bygdeman SM,Rudén AK,Jonsson A,Lidbrink P,Olofsson MB,Bäckman M,Gästrin B,Kallings I,Ramberg M,Rylander M

    更新日期:1993-01-01 00:00:00

  • Audit of hepatitis C antibody requests made by a genito-urinary department.

    abstract::Requests for hepatitis C antibodies (HCV Ab) made by the Oxford Department of Genito-urinary (GU) Medicine were audited against national guidelines to determine how the service performed and to develop locally applicable standards. This resulted in more effective screening and cost savings. ...

    journal_title:International journal of STD & AIDS

    pub_type: 杂志文章

    doi:10.1258/095646206777689026

    authors: Williams PM,Edwards A

    更新日期:2006-07-01 00:00:00

  • Behavioural risk factors for HIV/AIDS in a low-HIV prevalence Muslim nation: Bangladesh.

    abstract::A review of published and unpublished data indicates the prevalence of high-risk behaviours for HIV transmission in segments of the Bangladeshi population. These include casual unprotected sex, heterosexual as well as between males, prior to and after marriage. Intravenous drug use (IVDU) exists though illicit drugs a...

    journal_title:International journal of STD & AIDS

    pub_type: 杂志文章

    doi:10.1258/0956462991913862

    authors: Gibney L,Choudhury P,Khawaja Z,Sarker M,Vermund SH

    更新日期:1999-03-01 00:00:00

  • Seroprevalence and incidence of sexually transmitted diseases in a rural Ugandan population.

    abstract::The aim of the study was to determine in a rural population the age- and sex-specific prevalence and incidence rates of serological reactivity of 5 common sexually transmitted diseases (STDs) and their association with HIV-1 antibody status. Of the adult population of two villages (529 adults aged 15 years or more) 29...

    journal_title:International journal of STD & AIDS

    pub_type: 杂志文章

    doi:10.1177/095646249400500509

    authors: Wagner HU,Van Dyck E,Roggen E,Nunn AJ,Kamali A,Schmid DS,Dobbins JG,Mulder DW

    更新日期:1994-09-01 00:00:00

  • Factors associated with mother to child transmission of HIV despite overall low transmission rates in HIV-exposed infants in rural Kenya.

    abstract::Despite the availability of efficacious prevention of mother-to-child transmission (PMTCT) interventions and improved access to preventive services in many developing countries, vertical HIV transmission persists. A matched case-control study of HIV-exposed infants between January and June 2012 was conducted at 20 cli...

    journal_title:International journal of STD & AIDS

    pub_type: 杂志文章

    doi:10.1177/0956462417693735

    authors: Okoko NA,Owuor KO,Kulzer JL,Owino GO,Ogolla IA,Wandera RW,Bukusi EA,Cohen CR,Abuogi LL

    更新日期:2017-10-01 00:00:00