Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Risk Screening Tools Could Potentially Miss Out HIV Positive Individuals Who Seek Testing Services: A Secondary Program Data Analysis on the Performance Characteristics of an Adolescent and Adult HIV Risk Screening Tool in Uganda

John Bosco Junior Matovu
* ,
Marvin Lubega
ORCID logo ,
Katherine Guerra
,
Megan Ginivan
,
Yewande Kamuntu
,
George Senyama
,
Andrew Musoke
,
Fiona Gambaga
,
Shaukat Khan
,
Geoffrey Taasi
,
Sylivia Nalubega
Version 1 : Received: 20 December 2023 / Approved: 20 December 2023 / Online: 21 December 2023 (03:53:46 CET)

A peer-reviewed article of this Preprint also exists.

Lubega, M.; Guerra, K.; Ginivan, M.; Kamuntu, Y.; Senyama, G.; Musoke, A.; Gambanga, F.; Khan, S.; Taasi, G.; Nalubega, S.; Matovu, J.B.J. Risk Screening Tools Could Potentially Miss HIV-Positive Individuals Who Seek Testing Services: A Secondary Program Data Analysis on the Performance Characteristics of an Adolescent and Adult HIV Risk Screening Tool in Uganda. Trop. Med. Infect. Dis. 2024, 9, 37. Lubega, M.; Guerra, K.; Ginivan, M.; Kamuntu, Y.; Senyama, G.; Musoke, A.; Gambanga, F.; Khan, S.; Taasi, G.; Nalubega, S.; Matovu, J.B.J. Risk Screening Tools Could Potentially Miss HIV-Positive Individuals Who Seek Testing Services: A Secondary Program Data Analysis on the Performance Characteristics of an Adolescent and Adult HIV Risk Screening Tool in Uganda. Trop. Med. Infect. Dis. 2024, 9, 37.

Abstract

Improving HIV testing efficiency saves financial and material resources for health. We conducted a retrospective secondary data analysis of routinely collected HIV risk screening program data in Uganda, from October to November 2019, to determine the performance characteristics of the adolescent and adult HIV risk screening tool in public health facility settings. A total of 19,854 clients had been screened for HIV testing eligibility and tested for HIV. The overall positivity rate (cluster weighted prevalence of HIV) among those screened was 4.5% (95% CI: 4.1%-4.8%) versus 3.71% (95% CI: 3.06-4.50) among those not screened. The sensitivity and specificity of the risk screening tool were 90.7% (95% CI: 88.4%, 92.7%) and 75.8%, (75.2-76.4) respectively. With screening, the number needed to test to identify one PLHIV was reduced from 27 to 22. Although risk screening would have led to a 24.5% (4,825/19,704) reduction in testing volume, 9.3% (68/732) of PLHIV would have been missed, being misclassified as not eligible for testing. The cost per PLHIV identified fell by 3% from $69 without screening to $66.9 with screening. We recommend the use of scientifically validated HIV risk screening tools, and a need to explore the use of HIV self-testing as a test for tirage.

Keywords

HIV testing services; HIV risk screening; HIV risk screening tools; misclassification; HIV testing cost analysis

Subject

Public Health and Healthcare, Public Health and Health Services

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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