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Time since last negative HIV test among men who have sex with men and people who use injection drugs in British Columbia, 2006–2011

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Abstract

OBJECTIVES: Canadian surveys of men who have sex with men (MSM) and people using injection drugs (IDU) demonstrate that most have tested for HIV at least once, but that half or fewer have done so in the previous year. To better inform targeted HIV testing guidelines for these populations, we derived estimates of inter-test interval (ITI) for persons newly diagnosed with HIV in British Columbia (BC) between 2006 and 2011, and assessed variables associated with longer ITI among MSM and IDU.

METHODS: Provincial HIV case report and testing data were linked by deterministic and probabilistic matching (based on unique personal health number, name, and date of birth). ITI was defined as time from last recorded negative to first positive HIV result; those with ITI <30 days were excluded.

RESULTS: Of 2,004 eligible individuals, 1,116 (55.7%) had a recorded negative HIV test result in the previous ten years. Overall median ITI was 20 months with a skewed distribution (inter-quartile range 8–46); median ITI was 15 months for MSM and 21 months for IDU with 41.2% and 33.1 % testing in the past year, respectively. Longer ITI was associated with older age for both groups, and among MSM with residence outside Vancouver and not known to have an HIV-positive partner.

CONCLUSIONS: These findings highlight potential missed opportunities for earlier detection of HIV and prevention of secondary transmission among newly diagnosed MSM and IDU, and provide evidence to inform recommendations for HIV test frequency and testing strategies for these populations in BC.

Résumé

OBJECTIFS: Les enquêtes canadiennes auprès des hommes ayant des relations sexuelles avec des hommes (HARSAH) et des utilisateurs et utilisatrices de drogue par injection (UDI) montrent que la plupart de ces personnes ont subi un test de dépistage du VIH au moins une fois, mais que moins de la moitié l’ont fait au cours de l’année précédente. Pour mieux éclairer les lignes directrices de dépistage du VIH ciblant ces populations, nous avons calculé des estimations de l’intervalle interdépistage (NT) pour les personnes ayant nouvellement reçu un diagnostic de VIH en Colombie-Britannique entre 2006 et 2011, et évalué les variables associées à un NT plus long chez les HARSAH et les UDI.

MÉTHODE: Les exposés de cas de VIH et les données de dépistage de la province ont été maillés par appariement déterministe et probabiliste (d’après le numéro d’assurance-maladie, le nom et la date de naissance). Nous avons défini l’MT comme étant le temps écoulé entre le dernier résultat négatif et le premier résultat positif enregistrés pour le VIH; les personnes dont l’MT était ≤30 jours ont été exclues.

RÉSULTATS: Sur les 2 004 personnes admissibles, 1116 (55,7 %) avaient eu un résultat négatif enregistré au test de dépistage du VIH au cours des 10 années précédentes. Globalement, l’MT médian était de 20 mois, avec une distribution asymétrique (écart interquartile de 8–46); l’MT médian était de 15 mois pour les HARSAH et de 21 mois pour les UDI; 41,2 % et 33,1 % des sujets avaient été dépistés au cours de l’année précédente, respectivement. Un NT plus long était associé à un âge plus avancé dans les deux groupes, et parmi les HARSAH, au fait de résider à l’extérieur de Vancouver et de ne pas avoir de partenaire séropositif pour le VIH connu.

CONCLUSIONS: Ces constatations soulignent qu’il pourrait y avoir des occasions manquées de détecter le VIH plus tôt et d’en prévenir la transmission secondaire parmi les HARSAH et les UDI nouvellement diagnostiqués; les données probantes de l’étude peuvent éclairer les recommandations sur la fréquence et les stratégies de dépistage du VIH dans ces populations en Colombie-Britannique.

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Authors and Affiliations

  1. Clinical Prevention Services, BC Centre for Disease Control, 655 West 12th Avenue, Vancouver, BC, V5Z 4R4, Canada

    Mark Gilbert MD, Travis S. Hottes MSc, Richard Lester MD, Mel Krajden MD & Gina Ogilvie MD

  2. University of British Columbia, Vancouver, BC, Canada

    Mark Gilbert MD, Richard Lester MD, Réka Gustafson MD, Mel Krajden MD & Gina Ogilvie MD

  3. Vancouver Coastal Health Authority, Vancouver, BC, Canada

    Réka Gustafson MD

  4. BC Public Health Microbiology & Reference Laboratory, Vancouver, BC, Canada

    Mel Krajden MD

Authors
  1. Mark Gilbert MD
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  2. Travis S. Hottes MSc
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  3. Richard Lester MD
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  4. Réka Gustafson MD
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  5. Mel Krajden MD
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  6. Gina Ogilvie MD
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Corresponding author

Correspondence to Mark Gilbert MD.

Additional information

Acknowledgements: The authors acknowledge the members of the HIV Testing Strategies Subcommittee of the STOP HIV/AIDS Initiative, with whom these findings were reviewed and testing frequency guidelines developed.

Conflict of Interest and Source of Funding: This analysis was conducted as part of the mandate of the BC Centre for Disease Control and no additional funding was required. Dr. Mel Krajden has received research funding from Siemens; no other authors have any conflicts of interest to declare.

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Gilbert, M., Hottes, T.S., Lester, R. et al. Time since last negative HIV test among men who have sex with men and people who use injection drugs in British Columbia, 2006–2011. Can J Public Health 105, e63–e68 (2014). https://doi.org/10.17269/cjph.105.4262

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  • DOI: https://doi.org/10.17269/cjph.105.4262

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