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Screening Adults for HIV Testing in the Outpatient Department: An Assessment of Tool Performance in Malawi
AIDS and Behavior ( IF 4.852 ) Pub Date : 2021-08-11 , DOI: 10.1007/s10461-021-03404-8
Corrina Moucheraud 1 , Risa M Hoffman 2 , Kelvin Balakasi 3 , Vincent Wong 4 , Maria Sanena 3 , Sundeep Gupta 2 , Kathryn Dovel 2, 3
Affiliation  

Little is known about screening tools for adults in high HIV burden contexts. We use exit survey data collected at outpatient departments in Malawi (n = 1038) to estimate the sensitivity, specificity, negative and positive predictive values of screening tools that include questions about sexual behavior and use of health services. We compare a full tool (seven relevant questions) to a reduced tool (five questions, excluding sexual behavior measures) and to standard of care (one question, never tested for HIV or tested > 12 months ago). Suspect STI and ≥ 3 sexual partners were associated with HIV positivity, but had weak sensitivity and specificity. The full tool (using the optimal cutoff score of ≥ 3) would achieve 55.6% sensitivity and 84.9% specificity for HIV positivity; the reduced tool (optimal cutoff score ≥ 2) would achieve 59.3% sensitivity and 68.5% specificity; and standard of care 77.8% sensitivity and 47.8% specificity. Screening tools for HIV testing in outpatient departments do not offer clear advantages over standard of care.



中文翻译:

在门诊部筛查成人进行 HIV 检测:马拉维工具性能评估

对于艾滋病毒高负担环境中的成人筛查工具知之甚少。我们使用在马拉维门诊部 (n = 1038) 收集的退出调查数据来估计筛查工具的敏感性、特异性、阴性和阳性预测值,其中包括有关性行为和使用卫生服务的问题。我们将完整工具(七个相关问题)与简化工具(五个问题,不包括性行为测量)和护理标准(一个问题,从未检测过 HIV 或检测 > 12 个月前)进行比较。疑似 STI 和 ≥ 3 名性伴侣与 HIV 阳性相关,但敏感性和特异性较弱。完整的工具(使用 ≥ 3 的最佳截止分数)将实现 55.6% 的 HIV 阳性敏感性和 84.9% 的特异性;减少的工具(最佳截止分数 ≥ 2)将达到 59。3% 的敏感性和 68.5% 的特异性;和标准护理 77.8% 的敏感性和 47.8% 的特异性。在门诊部门进行 HIV 检测的筛查工具与护理标准相比没有明显优势。

更新日期:2021-08-11
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