TITLE

Implications of the HIV testing protocol for refusal bias in seroprevalence surveys

AUTHOR(S)
Reniers, Georges; Araya, Tekebash; Berhane, Yemane; Davey, Gail; Sanders, Eduard J.
PUB. DATE
January 2009
SOURCE
BMC Public Health;2009, Vol. 9 Issue 1, p1
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: HIV serosurveys have become important sources of HIV prevalence estimates, but these estimates may be biased because of refusals and other forms of non-response. We investigate the effect of the post-test counseling study protocol on bias due to the refusal to be tested. Methods: Data come from a nine-month prospective study of hospital admissions in Addis Ababa during which patients were approached for an HIV test. Patients had the choice between three consent levels: testing and post-test counseling (including the return of HIV test results), testing without post-test counseling, and total refusal. For all patients, information was collected on basic sociodemographic background characteristics as well as admission diagnosis. The three consent levels are used to mimic refusal bias in serosurveys with different post-test counseling study protocols. We first investigate the covariates of consent for testing. Second, we quantify refusal bias in HIV prevalence estimates using Heckman regression models that account for sample selection. Results: Refusal to be tested positively correlates with admission diagnosis (and thus HIV status), but the magnitude of refusal bias in HIV prevalence surveys depends on the study protocol. Bias is larger when post-test counseling and the return of HIV test results is a prerequisite of study participation (compared to a protocol where test results are not returned to study participants, or, where there is an explicit provision for respondents to forego post-test counseling). We also find that consent for testing increased following the introduction of antiretroviral therapy in Ethiopia. Other covariates of refusal are age (non-linear effect), gender (higher refusal rates in men), marital status (lowest refusal rates in singles), educational status (refusal rate increases with educational attainment), and counselor. Conclusion: The protocol for post-test counseling and the return of HIV test results to study participants is an important consideration in HIV prevalence surveys that wish to minimize refusal bias. The availability of ART is likely to reduce refusal rates.
ACCESSION #
43227020

 

Related Articles

  • Immunohistochemical Detection of MYC-driven Diffuse Large B-Cell Lymphomas. Kluk, Michael J.; Chapuy, Bjoern; Sinha, Papiya; Roy, Alyssa; Cin, Paola Dal; Neuberg, Donna S.; Monti, Stefano; Pinkus, Geraldine S.; Shipp, Margaret A.; Rodig, Scott J. // PLoS ONE;Apr2012, Vol. 7 Issue 4, p1 

    Diffuse large B cell lymphoma (DLBCL) is a clinically and genetically heterogeneous disease. A small subset of DLBCLs has translocations involving the MYC locus and an additional group has amolecular signature resembling Burkitt lymphoma (mBL). Presently, identification of such cases by...

  • Decline in HIV Prevalence among Young Women in Zambia: National-Level Estimates of Trends Mask Geographical and Socio-Demographic Differences. Kayeyi, Nkomba; Fylkesnes, Knut; Michelo, Charles; Makasa, Mpundu; Sandøy, Ingvild // PLoS ONE;Apr2012, Vol. 7 Issue 4, p1 

    Background: A decline in HIV incidence has been reported in Zambia and a number of other sub-Saharan countries. The trend of HIV prevalence among young people is a good marker of HIV incidence. In this study, different data sources are used to examine geographical and sub-population group...

  • Decline in HIV Prevalence among Young Women in Zambia: National-Level Estimates of Trends Mask Geographical and Socio-Demographic Differences. Kayeyi, Nkomba; Fylkesnes, Knut; Michelo, Charles; Makasa, Mpundu; Sandøy, Ingvild // PLoS ONE;Apr2012, Vol. 7 Issue 4, p1 

    Background: A decline in HIV incidence has been reported in Zambia and a number of other sub-Saharan countries. The trend of HIV prevalence among young people is a good marker of HIV incidence. In this study, different data sources are used to examine geographical and sub-population group...

  • Unprotected Sex with Injecting Drug Users among Iranian Female Sex Workers: Unhide HIV Risk Study. Ahmadi, Khodabakhsh; Rezazade, Majid; Nafarie, Mohammad; Moazen, Babak; Yarmohmmadi Vasel, Mosaieb; Assari, Shervin // AIDS Research & Treatment;2012, p1 

    Purpose. To assess the prevalence and associated factors of unprotected sex with injecting drug users (IDUs) among a sample of female sex workers (FSWs) in Iran. Methods. This cross-sectional study included 144 FSWs who were interviewed as a part of Unhide HIV Risk Study, a national behavioral...

  • Nutritional Knowledge, Attitude, and Practices among Pregnant and Lactating Women Living with HIV in the Manzini Region of Swaziland. Masuku, Sakhile K. S.; Lan, Shu-Jan J. // Journal of Health, Population & Nutrition;Jun2014, Vol. 32 Issue 2, p261 

    The prevalence of HIV infection in Swaziland (26%) is among the highest in the world. We investigated nutritional knowledge, attitude, and practices (KAP) and the influence of sociodemographic factors on KAP among pregnant and lactating women living with HIV in the Manzini region of Swaziland....

  • Prevalência da infecção pelo HIV em pacientes com tuberculose na atenção básica em Fortaleza, Ceará. Silva, Helder Oliveira e.; Gonçalves, Marcelo Luiz Carvalho // Jornal Brasileiro de Pneumologia;mai2012, Vol. 38 Issue 3, p382 

    The objective of this study was to determine the prevalence of HIV infection among individuals = 15 years of age with a confirmed diagnosis of tuberculosis and treated at family health care clinics in the city of Fortaleza, Brazil. We evaluated a random sample of 110 patients with tuberculosis,...

  • Intimate partner violence is associated with HIV infection in women in Kenya: A cross-sectional analysis. Chyun-Fung Shi; Kouyoumdjian, Fiona G.; Dushoff, Jonathan // BMC Public Health;2013, Vol. 13 Issue 1, p1 

    Background: The relationship between intimate partner violence (IPV) and women's risk of HIV infection has attracted much recent attention, with varying results in terms of whether there is an association and what the magnitude of association is. Understanding this relationship is important for...

  • Low prevalences of HIV infection and HSV genital shedding in the general adult female population in Senegal. Diawara, Silman; Bélec, Laurent; Dem, Ahmadou; Mbaye, Seydou; Ndiaye, Halimatou Diop; Matta, Mathieu; Gueye, Sokhna Bousso; Mboup, Souleymane; Kane, Coumba Toure // Journal of Infection in Developing Countries;Nov2015, Vol. 9 Issue 11, p1272 

    Introduction: Herpes simplex virus (HSV) is the main co-factor for heterosexual transmission of the human immunodeficiency virus (HIV) in sub-Saharan Africa, and could be involved in the dynamics of the HIV epidemic in Senegal. Methodology: Genital shedding of HSV was evaluated in adult females...

  • Population-Based HIV Prevalence and Associated Factors in Male-to-Female Transsexuals from Southern Brazil. Costa, Angelo; Fontanari, Anna; Jacinto, Michelle; Silva, Dhiordan; Lorencetti, Emilaine; Rosa Filho, Heitor; Mueller, Andressa; Garcia, Claudia; Nardi, Henrique; Koller, Silvia; Lobato, Maria // Archives of Sexual Behavior;Feb2015, Vol. 44 Issue 2, p521 

    This study assessed HIV prevalence and associated factors in 284 male-to-female transsexuals from southern Brazil. Seroprevalence was 25 %. Seroprevalence was higher and associated with older age, residence in the metropolitan area, history of diagnosis of other STDs, and reported history of sex...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics