Profiling the case characteristics of individuals with recent HIV infection among those newly confirmed HIV-positive in Vietnam


BACKGROUND: Vietnam has made substantial progress toward reaching its HIV epidemic control commitments. Approximately 87% of people living with HIV (PLHIV) in Vietnam know their status. With smaller numbers of PLHIV left undiagnosed, programs must use data to target HIV testing and other services. Because recent infection highlights active transmission, we identified factors associated with recent HIV infection among newly diagnosed clients to sharpen the focus of programming in Dong Nai, Tay Ninh, and Tien Giang provinces.
METHODS: From October 2019 to September 2020, staff at public HIV testing sites secured informed client consent and collected blood samples to complete recent HIV infection confirmation concurrent with blood draws for HIV confirmation. Reactive rapid tests for recent HIV infection were confirmed via viral load testing. Using provincial HIV testing systems, we collected case characteristics of PLHIV newly diagnosed in the last year. We used the x2 test to assess dependent relationships between case characteristics and confirmed recent versus all other new HIV confirmations. We constructed a multivariate logistic regression model incorporating characteristics with significant bivariate relationships (p 'ยค 0.05) to calculate odds ratios reflecting associations between these characteristics and the likelihood of having recent HIV infection.
RESULTS: Among 1,637 newly diagnosed HIV clients screened in the three provinces, 5.50% (90/1,637) were confirmed to have recent HIV infection. In the multivariate model, factors that independently increased the likelihood of recent HIV infection were being below the age of 25 years (odds ratio [OR]= 3.2, p-value= 0.001, 95% CL: 1.62 to 6.24) and self-identifying as men who have sex with men (MSM) (OR=2.6, p-value=0.019, 95% CL: 1.17 to 5.74). In different subgroups, the highest proportion of recent HIV infection was found among MSM below 25 years old (9.97%). Recent infection was detected less frequently among men who did not report sex with men, and women ages 35 to 44 years (2.17%).
CONCLUSIONS: Our findings suggest more active HIV transmission among young people (<25 years) and MSM in these provinces. The program is enhancing efforts to interrupt active HIV transmission by differentiating HIV testing, prevention, and treatment services for these groups.