Maximising the potential of voluntary counselling and testing for HIV: sexually transmitted infections and HIV epidemiology in a population testing for HIV and its implications for practice
- Hsiu Wu1,
- Pei-Ying Wu2,
- Shu-Ying Li1,
- Sui-Yuan Chang3,4,
- Wen-Chun Liu2,
- Cheng-Hsin Wu2,
- Yi-Cheng Lo2,
- Chia-Yin Hsieh2,
- Hsin-Yun Sun2,
- Chien-Ching Hung2
- 1Centers for Disease Control, Taipei, Taiwan
- 2Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- 3Department of Laboratory Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- 4Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine, Taipei, Taiwan
- Correspondence to Dr Chien-Ching Hung, Department of Internal Medicine, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei, Taiwan;
Contributors HW and P-YW collected, analysed and interpreted the data and drafted and revised the manuscript. S-YL and S-YC performed and supervised the laboratory testing, and reviewed and revised the submitted manuscript. W-CL, C-HW, Y-CL and C-YH performed questionnaire interview, collected and analysed the data, and revised the submitted manuscript. H-YS analysed and interpreted the data, and reviewed and revised the submitted manuscript. C-CH conceived, initiated and supervised the project, analysed and interpreted the data, and reviewed and revised the submitted manuscript.
- Accepted 19 May 2012
- Published Online First 20 June 2012
Objectives This study aimed to describe the epidemiology of HIV infection and sexually transmitted infections (STIs) among persons who attended voluntary counselling and testing (VCT) service for HIV and to assess whether the VCT programme reached the right population at risk in Taiwan.
Methods From 2006 to 2010, questionnaire interview, integrated pretesting and post-testing counselling, followed by serological tests for HIV, Treponema pallidum and Entamoeba histolytica were performed for all VCT clients; additional tests for Chlamydia trachomatis and Neisseria gonorrhoeae using PCR assays of urine specimens were provided when the assays became available in two periods.
Results During the study period, 10 198 VCT attendances occurred in 6863 clients, in whom 1685 (24.6%) had re-attendances. Male clients, men who have sex with men and clients with one-night stand and casual sexual partners were more likely to re-attend VCT service in the next 12 months. The overall STI prevalence was 3.5% for HIV infection, 2.2% syphilis, 1.0% amoebiasis, 4.7% chlamydia and 0.7% gonorrhoea. In logistic regression model, men who have sex with men were consistently independently associated with HIV infection, syphilis and amoebiasis. Among the repeaters, the incidence rate of HIV infection and syphilis was 3.4 and 1.6 per 100 person-years of follow-up, respectively. In Cox regression analysis, clients who used illicit non-injection recreational drugs and who practiced unprotected anal sex were at significantly higher risk of acquiring HIV infection and syphilis.
Conclusions With higher rates of re-attendances and STIs, the VCT programme reached the population most at risk for HIV and STIs compared with other screening programmes in Taiwan. The potential of VCT programme can be maximised in the prevention and control of HIV infection and STIs by providing tests for more STIs and counselling to avoid use of recreational drugs and to promote safe sex.
- Sexually transmitted infection
- voluntary counselling and testing
- antibiotic resistance
- Chlamydia trachomatis
- Neisseria gonorrhoea
- molecular epidemiology
- hepatitis B
- HIV clinical care
Preliminary analyses of these data were presented as P2062 at the 21st European Congress of Clinical Microbiology and Infectious Diseases and the 27th International Congress of Chemotherapy, Milan, Italy, 7–10 May 2011.
HW and P-YW contributed equally to this work.
Funding This work was supported by the Taiwan Centers for Disease Control (grant numbers AIDS-97-1002 and EU099059).
Competing interests None.
Ethics approval Ethics approval was provided by the research ethics committee of the National Taiwan University Hospital (approved registered number: 200904084R).
Provenance and peer review Not commissioned; externally peer reviewed.