519. Knowledge of HIV Status and Seropositivity after a Recently Negative Test in Malawi 
Session: Poster Abstract Session: HIV Testing and Diagnosis
Thursday, October 27, 2016
Room: Poster Hall
Posters
  • ID Week Poster- IP.pdf (554.9 kB)
  • Background:

    Awareness of HIV status among all people with HIV is critical for epidemic control. We aimed to assess accurate knowledge of HIV status, defined as concordance with serosurvey test results from the 2010 Malawi Demographic Health Survey (MDHS), and to identify risk factors for seropositivity among adults (aged 15-49) reporting a most recently negative test within twelve months.

     Methods: 

    Data were analyzed from the 2010 MDHS. A logistic regression model was constructed to determine factors independently associated with HIV seropositivity after a recently negative test. All analyses controlled for the survey’s complex design.

    Results: 

    11,649 adults tested for HIV during this MDHS reported ever being sexually active. Among these, HIV seroprevalence was 12.0%, but only 61.7% had accurate knowledge of their status. Forty percent (40.3%; 95% confidence interval [CI]: 36.8-43.8) of seropositive respondents reported a most recently negative test. Of those reporting that this negative test was within 12 months (n=3,630), seroprevalence was 7.2% for women (95% CI: 5.7-9.2), 5.2% for men (95% CI: 3.9-6.9), higher in the South, and in rural areas for men. Women with higher education and men in the richest quintile were at higher risk. More than one lifetime union was significantly associated with recent HIV infection, whereas never being married was significantly protective.

    Conclusion: 

    Self-reported HIV status based on prior test results underestimated seroprevalence. These results highlight the need for post-test risk assessment and support for people who test negative for HIV, and repeat testing in people at high risk for HIV infection.

    Ishani Pathmanathan, MD/MPH1, Philip Lederer, MD2, Ray Shiraishi, PhD1, Nellie Wadonda-Kabondo, PhD, MSc3, Anand Date, MD1, Blackson Matatiyo, MSC4 and E. Kainne Dokubo, MD/MPH5, (1)Division of Global HIV and TB, U.S. Centers for Disease Control and Prevention, Atlanta, GA, (2)Massachusetts General Hospital, Boston, MA, (3)Division of Global HIV and TB, U.S. Centers for Disease Control and Prevention- Malawi, Lilongwe, Malawi, (4)National AIDS Commission- Malawi, Lilongwe 3, Malawi, (5)U.S. Centers for Disease Control and Prevention- Liberia, Monrovia, Liberia

    Disclosures:

    I. Pathmanathan, None

    P. Lederer, None

    R. Shiraishi, None

    N. Wadonda-Kabondo, None

    A. Date, None

    B. Matatiyo, None

    E. K. Dokubo, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.