Public health benefit of peer-referral strategies for detecting undiagnosed HIV infection among high-risk heterosexuals in New York City

Marya Gwadz, Charles M. Cleland, David C. Perlman, Holly Hagan, Samuel M. Jenness, Noelle Leonard, Amanda S. Ritchie, Alexandra Kutnick

Research output: Contribution to journalArticle

Abstract

Identifying undiagnosed HIV infection is necessary for the elimination of HIV transmission in the United States. The present study evaluated the efficacy of 3 community-based approaches for uncovering undiagnosed HIV among heterosexuals at high-risk (HHR), who are mainly African American/Black and Hispanic. Heterosexuals comprise 24% of newly reported HIV infections in the United States, but experience complex multilevel barriers to HIV testing. We recruited African American/Black and Hispanic HHR in a discrete urban area with both elevated HIV prevalence and poverty rates. Approaches tested were (1) respondent-driven sampling (RDS) and confidential HIV testing in 2 sessions (n = 3116); (2) RDS and anonymous HIV testing in one session (n = 498); and (3) venuebased sampling (VBS) and HIV testing in a single session (n = 403). The main outcome was newly diagnosed HIV infection. RDS with anonymous testing and one session reached HHR with less HIV testing experience and more risk factors than the other approaches. Furthermore, RDS with anonymous (4.0%) and confidential (1.0%) testing yielded significantly higher rates of newly diagnosed HIV than VBS (0.3%). Thus peer-referral approaches were more efficacious than VBS for uncovering HHR with undiagnosed HIV, particularly a single-session/anonymous strategy, and have a vital role to play in efforts to eliminate HIV transmission.

Original languageEnglish (US)
Pages (from-to)499-507
Number of pages9
JournalJournal of Acquired Immune Deficiency Syndromes
Volume74
Issue number5
DOIs
StatePublished - Apr 15 2017

Fingerprint

Heterosexuality
Insurance Benefits
HIV Infections
Referral and Consultation
Public Health
HIV
Anonymous Testing
Hispanic Americans
African Americans
Poverty

Keywords

  • High-risk heterosexuals
  • HIV care cascade
  • HIV testing
  • Respondent-driven sampling
  • Undiagnosed HIV
  • Venuebased sampling

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Infectious Diseases

Cite this

Public health benefit of peer-referral strategies for detecting undiagnosed HIV infection among high-risk heterosexuals in New York City. / Gwadz, Marya; Cleland, Charles M.; Perlman, David C.; Hagan, Holly; Jenness, Samuel M.; Leonard, Noelle; Ritchie, Amanda S.; Kutnick, Alexandra.

In: Journal of Acquired Immune Deficiency Syndromes, Vol. 74, No. 5, 15.04.2017, p. 499-507.

Research output: Contribution to journalArticle

Gwadz, Marya ; Cleland, Charles M. ; Perlman, David C. ; Hagan, Holly ; Jenness, Samuel M. ; Leonard, Noelle ; Ritchie, Amanda S. ; Kutnick, Alexandra. / Public health benefit of peer-referral strategies for detecting undiagnosed HIV infection among high-risk heterosexuals in New York City. In: Journal of Acquired Immune Deficiency Syndromes. 2017 ; Vol. 74, No. 5. pp. 499-507.
@article{28e7fe2ded3146ebbacd86802eb8dbdc,
title = "Public health benefit of peer-referral strategies for detecting undiagnosed HIV infection among high-risk heterosexuals in New York City",
abstract = "Identifying undiagnosed HIV infection is necessary for the elimination of HIV transmission in the United States. The present study evaluated the efficacy of 3 community-based approaches for uncovering undiagnosed HIV among heterosexuals at high-risk (HHR), who are mainly African American/Black and Hispanic. Heterosexuals comprise 24{\%} of newly reported HIV infections in the United States, but experience complex multilevel barriers to HIV testing. We recruited African American/Black and Hispanic HHR in a discrete urban area with both elevated HIV prevalence and poverty rates. Approaches tested were (1) respondent-driven sampling (RDS) and confidential HIV testing in 2 sessions (n = 3116); (2) RDS and anonymous HIV testing in one session (n = 498); and (3) venuebased sampling (VBS) and HIV testing in a single session (n = 403). The main outcome was newly diagnosed HIV infection. RDS with anonymous testing and one session reached HHR with less HIV testing experience and more risk factors than the other approaches. Furthermore, RDS with anonymous (4.0{\%}) and confidential (1.0{\%}) testing yielded significantly higher rates of newly diagnosed HIV than VBS (0.3{\%}). Thus peer-referral approaches were more efficacious than VBS for uncovering HHR with undiagnosed HIV, particularly a single-session/anonymous strategy, and have a vital role to play in efforts to eliminate HIV transmission.",
keywords = "High-risk heterosexuals, HIV care cascade, HIV testing, Respondent-driven sampling, Undiagnosed HIV, Venuebased sampling",
author = "Marya Gwadz and Cleland, {Charles M.} and Perlman, {David C.} and Holly Hagan and Jenness, {Samuel M.} and Noelle Leonard and Ritchie, {Amanda S.} and Alexandra Kutnick",
year = "2017",
month = "4",
day = "15",
doi = "10.1097/QAI.0000000000001257",
language = "English (US)",
volume = "74",
pages = "499--507",
journal = "Journal of Acquired Immune Deficiency Syndromes",
issn = "1525-4135",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - Public health benefit of peer-referral strategies for detecting undiagnosed HIV infection among high-risk heterosexuals in New York City

AU - Gwadz, Marya

AU - Cleland, Charles M.

AU - Perlman, David C.

AU - Hagan, Holly

AU - Jenness, Samuel M.

AU - Leonard, Noelle

AU - Ritchie, Amanda S.

AU - Kutnick, Alexandra

PY - 2017/4/15

Y1 - 2017/4/15

N2 - Identifying undiagnosed HIV infection is necessary for the elimination of HIV transmission in the United States. The present study evaluated the efficacy of 3 community-based approaches for uncovering undiagnosed HIV among heterosexuals at high-risk (HHR), who are mainly African American/Black and Hispanic. Heterosexuals comprise 24% of newly reported HIV infections in the United States, but experience complex multilevel barriers to HIV testing. We recruited African American/Black and Hispanic HHR in a discrete urban area with both elevated HIV prevalence and poverty rates. Approaches tested were (1) respondent-driven sampling (RDS) and confidential HIV testing in 2 sessions (n = 3116); (2) RDS and anonymous HIV testing in one session (n = 498); and (3) venuebased sampling (VBS) and HIV testing in a single session (n = 403). The main outcome was newly diagnosed HIV infection. RDS with anonymous testing and one session reached HHR with less HIV testing experience and more risk factors than the other approaches. Furthermore, RDS with anonymous (4.0%) and confidential (1.0%) testing yielded significantly higher rates of newly diagnosed HIV than VBS (0.3%). Thus peer-referral approaches were more efficacious than VBS for uncovering HHR with undiagnosed HIV, particularly a single-session/anonymous strategy, and have a vital role to play in efforts to eliminate HIV transmission.

AB - Identifying undiagnosed HIV infection is necessary for the elimination of HIV transmission in the United States. The present study evaluated the efficacy of 3 community-based approaches for uncovering undiagnosed HIV among heterosexuals at high-risk (HHR), who are mainly African American/Black and Hispanic. Heterosexuals comprise 24% of newly reported HIV infections in the United States, but experience complex multilevel barriers to HIV testing. We recruited African American/Black and Hispanic HHR in a discrete urban area with both elevated HIV prevalence and poverty rates. Approaches tested were (1) respondent-driven sampling (RDS) and confidential HIV testing in 2 sessions (n = 3116); (2) RDS and anonymous HIV testing in one session (n = 498); and (3) venuebased sampling (VBS) and HIV testing in a single session (n = 403). The main outcome was newly diagnosed HIV infection. RDS with anonymous testing and one session reached HHR with less HIV testing experience and more risk factors than the other approaches. Furthermore, RDS with anonymous (4.0%) and confidential (1.0%) testing yielded significantly higher rates of newly diagnosed HIV than VBS (0.3%). Thus peer-referral approaches were more efficacious than VBS for uncovering HHR with undiagnosed HIV, particularly a single-session/anonymous strategy, and have a vital role to play in efforts to eliminate HIV transmission.

KW - High-risk heterosexuals

KW - HIV care cascade

KW - HIV testing

KW - Respondent-driven sampling

KW - Undiagnosed HIV

KW - Venuebased sampling

UR - http://www.scopus.com/inward/record.url?scp=85016313836&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85016313836&partnerID=8YFLogxK

U2 - 10.1097/QAI.0000000000001257

DO - 10.1097/QAI.0000000000001257

M3 - Article

C2 - 28267698

AN - SCOPUS:85016313836

VL - 74

SP - 499

EP - 507

JO - Journal of Acquired Immune Deficiency Syndromes

JF - Journal of Acquired Immune Deficiency Syndromes

SN - 1525-4135

IS - 5

ER -