ArticleJournal of the International AIDS Society2019
Using a HIV registry to develop accurate estimates for the HIV care cascade - the Singapore experience.
Article in Journal of the International AIDS Society, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A systematic review of models used to estimate undiagnosed HIV prevalence in high-income low-prevalence countries and territories.AIDS (London, England) · 2026Pooled it
- Improving Identification of Patients Experiencing Homelessness in the Electronic Health Record: A Curated Registry Approach.Journal of general internal medicine · 2024Article
- Bridging Real-World Data Gaps: Connecting Dots Across 10 Asian Countries.JMIR medical informatics · 2024Article
- Suppression of HIV in the first 12 months of antiretroviral therapy: a comparative analysis of dolutegravir- and efavirenz-based regimens.Einstein (Sao Paulo, Brazil) · 2023Article
- Perceptions of an HIV self-testing intervention and its potential role in addressing the barriers to HIV testing among at-risk heterosexual men: a qualitative analysis.Sexually transmitted infections · 2021Article
- Epidemiological factors associated with recent HIV infection among newly-diagnosed cases in Singapore, 2013-2017.BMC public health · 2021Article
- A new patient registry for Chagas disease.PLoS neglected tropical diseases · 2020Article
- Article
- Using a HIV registry to develop accurate estimates for the HIV care cascade - the Singapore experience.Journal of the International AIDS Society · 2019Article
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7 authors.
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Abstract
introductionAchieving UNAIDS 90-90-90 targets is a crucial step towards ending the AIDS epidemic. Many countries have published estimates of care cascades, although often with methodological limitations. We describe an approach that used the national HIV registry as a starting-point to determine the HIV care cascade and resulting UNAIDS 90-90-90 estimates for Singapore in 2014.
methodsHIV is a legally notifiable disease in Singapore. The anonymized HIV registry data provided for a back-calculation model from the European Centre for Disease Prevention and Control to obtain 2014 estimates for the total number of persons living with HIV (PLHIV), and the count in the registry for proportions diagnosed with HIV and linked to care. Using additional data collected for a simple random sample from the registry, outcomes in 2015 and 2016 were ascertained retrospectively to derive proportions for those retained in care, on antiretroviral therapy, and achieved viral suppression. Findings were extrapolated to derive national estimates and UN90-90-90 estimates. Bootstrapped samples from the model and sample were used to derive 95% confidence intervals.
resultsAn estimated 6900 (95% CI 6650, 7050) persons were living with HIV and AIDS in 2014. Of these, 4948 were diagnosed with HIV, and 4820 had been linked to care. The random sample of 500 persons was further analysed, and of these, 87.2% were retained in care, 84.6% on antiretroviral therapy, and 79.6% had suppressed viral loads. The proportions of HIV-infected individuals on antiretroviral therapy and achieving viral suppression were 60.7% (95% CI 58.4, 63.6) and 57.1% (95% CI 55.0, 60.5) respectively. The corresponding UNAIDS 90-90-90 estimates were 71.7% (95% CI 70.0, 74.2) of all persons diagnosed; 84.6% (95% CI 81.6, 87.4) of diagnosed persons being on antiretroviral therapy, and 94.1% (95% CI 91.6, 96.2) of persons on therapy having achieved viral suppression.
conclusionsA national HIV registry, alongside back-calculation and additional data from a sample, can be used to estimate attainment of UNAIDS 90-90-90 targets and identify system gaps. The registry had advantages of providing a well-established, comprehensive capture of diagnosed persons and easily accessible data. The same approach can be used elsewhere if similar data are available.
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