ArticleJournal of acquired immune deficiency syndromes (1999)2016
Incorporating Acute HIV Screening into Routine HIV Testing at Sexually Transmitted Infection Clinics, and HIV Testing and Counseling Centers in Lilongwe, Malawi.
Article in Journal of acquired immune deficiency syndromes (1999), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed, 30 citations in OpenAlex.
- Trial
- A randomized controlled trial evaluating combination detection of HIV in Malawian sexually transmitted infections clinics.Journal of the International AIDS Society · 2021Trial
- Human Immunodeficiency Virus (HIV)-1 Transmission Among Persons With Acute HIV-1 Infection in Malawi: Demographic, Behavioral, and Phylogenetic Relationships.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2019Trial
- High rates of transmitted NNRTI resistance among persons with acute HIV infection in Malawi: implications for first-line dolutegravir scale-up.AIDS research and therapy · 2019Trial
- Sustained Sexual Behavior Change After Acute HIV Diagnosis in Malawi.Sexually transmitted diseases · 2018Trial
- Poor Oral HIV Pre-Exposure Prophylaxis (PrEP) Persistence in an Integrated PrEP/STI Program in Malawi.AIDS and behavior · 2026Article
- Article
- Public health implications of diagnosing and treating acute HIV.Current opinion in HIV and AIDS · 2025Review
- Point-of-care nucleic acid testing - a step forward in controlling the HIV epidemic: A review.HIV medicine · 2025Review
- Geospatial and phylogenetic clustering of acute and recent HIV infections in Lilongwe, Malawi.PLOS global public health · 2025Article
- Depression, Alcohol Use, and Sexual Behaviors by HIV Infection Stage and Diagnosis Timing Among STI Clinic Patients in Lilongwe, Malawi.AIDS and behavior · 2023Article
- Novel Criteria for Diagnosing Acute and Early Human Immunodeficiency Virus Infection in a Multinational Study of Early Antiretroviral Therapy Initiation.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Go Where the Virus Is: An HIV Micro-epidemic Control Approach to Stop HIV Transmission.Global health, science and practice · 2020Article
- Initiation, discontinuation, and restarting HIV pre-exposure prophylaxis: ongoing implementation strategies.The lancet. HIV · 2020Review
- Challenges of HIV diagnosis and management in the context of pre-exposure prophylaxis (PrEP), post-exposure prophylaxis (PEP), test and start and acute HIV infection: a scoping review.Journal of the International AIDS Society · 2019Article
- Point-of-care HIV RNA testing and immediate antiretroviral therapy initiation in young adults seeking out-patient care in Kenya.AIDS (London, England) · 2019Article
- Pilot testing of an online training module about screening for acute HIV infection in adult patients seeking urgent healthcare.International health · 2019Article
- Randomized Controlled Pilot Study of Antiretrovirals and a Behavioral Intervention for Persons With Acute HIV Infection: Opportunity for Interrupting Transmission.Open forum infectious diseases · 2019Article
- Observational
- The effect of oral preexposure prophylaxis on the progression of HIV-1 seroconversion.AIDS (London, England) · 2017Article
Corrections and comments
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Authors and funding
15 authors at 3 institutions in 1 country.
Funding
Abstract
BACKGROUND AND
objectivesIntegrating acute HIV-infection (AHI) testing into clinical settings is critical to prevent transmission, and realize potential treatment-as-prevention benefits. We evaluated acceptability of AHI testing and compared AHI prevalence at sexually transmitted infection (STI) clinics and HIV testing and counseling (HTC) clinics in Lilongwe, Malawi.
methodsWe conducted HIV RNA testing for HIV-seronegative patients visiting STI and HTC clinics. AHI was defined as positive RNA and negative/discordant rapid antibody tests. We evaluated demographic, behavioral, and transmission-risk differences between STI and HTC patients and assessed performance of a risk-score for targeted screening.
resultsNearly two-thirds (62.8%, 9280/14,755) of eligible patients consented to AHI testing. We identified 59 persons with AHI (prevalence = 0.64%)-a 0.9% case-identification increase. Prevalence was higher at STI [1.03% (44/4255)] than at HTC clinics [0.3% (15/5025), P < 0.01], accounting for 2.3% of new diagnoses vs 0.3% at HTC clinic. Median viral load (VL) was 758,050 copies per milliliter; 25% (15/59) had VL ≥ 10,000,000 copies per milliliter. Median VL was higher at STI (1,000,000 copies/mL) compared with HTC (153,125 copies/mL, P = 0.2). Among persons with AHI, those tested at STI clinics were more likely to report genital sores compared with those tested at HTC clinics (54.6% vs 6.7%, P < 0.01). The risk score algorithm performed well in identifying persons with AHI at HTC clinics (sensitivity = 73%, specificity = 89%).
conclusionsThe majority of patients consented to AHI testing. AHI prevalence was substantially higher in STI clinics than HTC clinics. Remarkably high VLs and concomitant genital scores demonstrate the potential for transmission. Universal AHI screening at STI clinics, and targeted screening at HTC centers, should be considered.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.