Recent HIV Infection Among Men Who Have Sex with Men, Transgender Women, and Genderqueer Individuals with Newly Diagnosed HIV Infection in Zimbabwe: Results from a Respondent-Driven Sampling Survey

Abstract

In Africa, rapid testing for recent HIV infection (RTRI) is being scaled up; however, use of the recent infection testing algorithm (RITA), which uses viral load (VL) to confirm RTRI-recent infections, is not a widespread practice. We present results of recently acquired HIV infections among men who have sex with men (MSM), transgender women, and genderqueer (TGW/GQ) individuals with newly diagnosed HIV infection in Zimbabwe as per the national approach (RTRI) and applying a RITA. In 2019, 1,538 MSM and TGW/GQ in Harare and Bulawayo, Zimbabwe were recruited to participate in a biobehavioral survey using respondent-driven sampling. Consenting participants received HIV testing and all HIV-positive specimens were tested with the RTRI Asanté HIV-1 Rapid Recency Assay, and for VL and CD4 count. RTRI-recent participants with unsuppressed VL (≥1,000 copies/mL) were classified as RITA-recent. Descriptive statistics were used to summarize results among RTRI-recent and RITA-recent participants. Among those tested for HIV (1,511/1,538), 22.5% (340/1,511) tested positive and of those, 55.0% (187/340) self-reported an HIV-negative or unknown status. Among these, 8.6% (16/187) were classified as RTRI-recent and 91.4% (171/187) were classified as RTRI-long term. After accounting for VL, RITA-recency was 1.1% (2/187). Two of 16 (12.5%) RTRI-recent infections were RITA-recent. VL among RITA-recent cases were 9,052 copies/mL and 40,694 copies/mL and both had CD4 counts <500. Data highlight misclassification of recent infections among MSM and TGW/GQ with newly diagnosed HIV infection using RTRI. With the incorporation of VL, >85% of RTRI-recent cases were reclassified as RITA-long term. True characterization of recent infections may not be possible without VL testing, which remains challenging in resource-limited settings.

Recent HIV infections among newly diagnosed individuals living with HIV in rural Lesotho: Secondary data from the VIBRA cluster-randomized trial

“…These figures provide important insights into ongoing transmission patterns in the region. However, they should be viewed critically since there is still a lack of proper field validation of these rapid recency assays [ 28 ] and especially misleading when not combined with VL testing [ 29 ]. More research is needed to validate such assays in the field.…”

“…Lastly, we did not measure the presence of antiretrovirals to exclude participants on ART from the recency sample. However, all samples were tested for VL, that improves the false positive recent rate [ 29 ], and the VIBRA trial team verified every new diagnosis they found in the field with the surrounding health facilities, thus minimizing the risk of including persons who were already taking ART or knew their status.…”

Correlates of feeding difficulties among children of Chinese transgender parents

“…Briefly, we consulted experienced maternal and child health professionals and researchers, experts with research experience related to transgender population, and volunteers from transgender communities, to develop the survey materials. Participants were recruited using a sampling strategy that combined convenience, respondent-driven, and snowball sampling, all of which have been shown to be effective in recruiting gender and sexual minorities (Chen et al., 2019 ; Parmley et al., 2022 ; Westafer et al., 2022 ). First, we used social media platforms to deliver an online survey to transgender communities and recruited the first wave of participants.…”

Rates of breastfeeding or chestfeeding and influencing factors among transgender and gender-diverse parents: a cross sectional study

“…All participants were recruited via a sampling strategy that combined convenience, respondent-driven, and snowball sampling, which have proven effective in recruiting gender and sexual minorities. 24 , 25 , 26 First, we distributed an online survey of the TGD community on the social media platform. We also invited the initial participants to distribute the questionnaire to their TGD and gender-diverse friends and acquaintances (TGD parents who from same family was avoided to invite via a notice showed in invitation letter).…”