Epidemiological factors associated with the absence of previous HIV testing among HIV-positive persons in Singapore, 2012–2017

Objective To assess the temporal trend and identify risk factors associated with the absence of previous HIV testing prior to their diagnosis among HIV-positive persons in Singapore.Study design Cross-sectional.Setting and participants We analysed data of HIV-positive persons infected via sexual tra...

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Main Authors: Chen Seong Wong, Angela Chow, Li Wei Ang, Yee Sin Leo, Matthias Paul Han Sim Toh, Sophia Archuleta, Vernon Lee, Irving Charles Boudville
Format: Article
Language:English
Published: BMJ Publishing Group 2021-08-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/11/8/e050133.full
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author Chen Seong Wong
Angela Chow
Li Wei Ang
Yee Sin Leo
Matthias Paul Han Sim Toh
Sophia Archuleta
Vernon Lee
Irving Charles Boudville
author_facet Chen Seong Wong
Angela Chow
Li Wei Ang
Yee Sin Leo
Matthias Paul Han Sim Toh
Sophia Archuleta
Vernon Lee
Irving Charles Boudville
author_sort Chen Seong Wong
collection DOAJ
description Objective To assess the temporal trend and identify risk factors associated with the absence of previous HIV testing prior to their diagnosis among HIV-positive persons in Singapore.Study design Cross-sectional.Setting and participants We analysed data of HIV-positive persons infected via sexual transmission, who were notified to the National HIV Registry in 2012–2017.Outcomes Epidemiological factors associated with the absence of HIV testing prior to diagnosis were determined separately for two groups of HIV-positive persons: early and late stages of HIV infection at diagnosis.Results 2188 HIV-positive persons with information on HIV testing history and CD4 cell count were included in the study. The median age at HIV diagnosis was 40 years (IQR 30–51). Nearly half (45.1%) had never been tested for HIV prior to their diagnosis. The most common reason cited for no previous HIV testing was ‘not necessary to test’ (73.7%). The proportion diagnosed at late-stage HIV infection was significantly higher among HIV-positive persons who had never been tested for HIV (63.9%) compared with those who had undergone previous HIV tests (29.0%). Common risk factors associated with no previous HIV testing in multivariable logistic regression analysis stratified by stage of HIV infection were: older age at HIV diagnosis, lower educational level, detection via medical care and HIV infection via heterosexual transmission. In the stratified analysis for persons diagnosed at early-stage of HIV infection, in addition to the four risk factors, women and those of Malay ethnicity were also less likely to have previous HIV testing prior to their diagnosis.Conclusion Targeted prevention efforts and strategies are needed to raise the level of awareness of HIV/AIDS and to encourage early and regular screening among the at-risk groups by making HIV testing more accessible.
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spelling doaj-art-46a3cd256a8d4281a8ed8d86dadc92bb2025-08-20T02:20:57ZengBMJ Publishing GroupBMJ Open2044-60552021-08-0111810.1136/bmjopen-2021-050133Epidemiological factors associated with the absence of previous HIV testing among HIV-positive persons in Singapore, 2012–2017Chen Seong Wong0Angela Chow1Li Wei Ang2Yee Sin Leo3Matthias Paul Han Sim Toh4Sophia Archuleta5Vernon Lee6Irving Charles Boudville7Department of Infectious Diseases, Tan Tock Seng Hospital, SingaporeNanyang Technological University, SingaporeNational Centre for Infectious Diseases, SingaporeTan Tock Seng Hospital, SingaporeNational Centre for Infectious Diseases, SingaporeDivision of Infectious Diseases, Department of Medicine, National University Hospital, National University Health System, SingaporeNational University of Singapore, SingaporeNational Centre for Infectious Diseases, SingaporeObjective To assess the temporal trend and identify risk factors associated with the absence of previous HIV testing prior to their diagnosis among HIV-positive persons in Singapore.Study design Cross-sectional.Setting and participants We analysed data of HIV-positive persons infected via sexual transmission, who were notified to the National HIV Registry in 2012–2017.Outcomes Epidemiological factors associated with the absence of HIV testing prior to diagnosis were determined separately for two groups of HIV-positive persons: early and late stages of HIV infection at diagnosis.Results 2188 HIV-positive persons with information on HIV testing history and CD4 cell count were included in the study. The median age at HIV diagnosis was 40 years (IQR 30–51). Nearly half (45.1%) had never been tested for HIV prior to their diagnosis. The most common reason cited for no previous HIV testing was ‘not necessary to test’ (73.7%). The proportion diagnosed at late-stage HIV infection was significantly higher among HIV-positive persons who had never been tested for HIV (63.9%) compared with those who had undergone previous HIV tests (29.0%). Common risk factors associated with no previous HIV testing in multivariable logistic regression analysis stratified by stage of HIV infection were: older age at HIV diagnosis, lower educational level, detection via medical care and HIV infection via heterosexual transmission. In the stratified analysis for persons diagnosed at early-stage of HIV infection, in addition to the four risk factors, women and those of Malay ethnicity were also less likely to have previous HIV testing prior to their diagnosis.Conclusion Targeted prevention efforts and strategies are needed to raise the level of awareness of HIV/AIDS and to encourage early and regular screening among the at-risk groups by making HIV testing more accessible.https://bmjopen.bmj.com/content/11/8/e050133.full
spellingShingle Chen Seong Wong
Angela Chow
Li Wei Ang
Yee Sin Leo
Matthias Paul Han Sim Toh
Sophia Archuleta
Vernon Lee
Irving Charles Boudville
Epidemiological factors associated with the absence of previous HIV testing among HIV-positive persons in Singapore, 2012–2017
BMJ Open
title Epidemiological factors associated with the absence of previous HIV testing among HIV-positive persons in Singapore, 2012–2017
title_full Epidemiological factors associated with the absence of previous HIV testing among HIV-positive persons in Singapore, 2012–2017
title_fullStr Epidemiological factors associated with the absence of previous HIV testing among HIV-positive persons in Singapore, 2012–2017
title_full_unstemmed Epidemiological factors associated with the absence of previous HIV testing among HIV-positive persons in Singapore, 2012–2017
title_short Epidemiological factors associated with the absence of previous HIV testing among HIV-positive persons in Singapore, 2012–2017
title_sort epidemiological factors associated with the absence of previous hiv testing among hiv positive persons in singapore 2012 2017
url https://bmjopen.bmj.com/content/11/8/e050133.full
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