Assessing secular trends in HIV rapid diagnostic test uptake and positivity in Northeast Iran, a country in MENA region; ingredients for target-specific prevention policies

• Published in: BMC infectious diseases 2023-05, Vol.23 (1), p.323-323, Article 323
• Main Authors: Yousefli, Zahra, Maharlouei, Najmeh, Dadgar Moghaddam, Maliheh, Hosseinpour, Ali Mohammad, Ghiami, Roohollah
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; Adult; Africa, Northern; Age; AIDS; Analysis; Behavior; Bivariate analysis; Clients; Cross-Sectional Studies; Demographics; Demography; Diagnostic systems; Diagnostic tests; Disease transmission; Education; Educational attainment; Female; Females; Gender; Health aspects; HIV; HIV (Viruses); HIV infection; HIV Infections - diagnosis; HIV Infections - epidemiology; HIV Infections - prevention & control; HIV rapid diagnostic test; HIV screening; HIV testing; Human immunodeficiency Virus; Humans; Infection; Infectious Disease Transmission, Vertical; Infectious diseases; Iran - epidemiology; Male; Marital status; Medical informatics; Medical tests; Men; Middle East - epidemiology; Multivariate analysis; Population; Pregnancy; Prevention; Public health; Rapid Diagnostic Tests; Regression analysis; Risk; Risk factors; Risk taking; Tattoos; Test facilities; Women
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-023-08309-6

Iran is amongst the first three countries in Middle East and North Africa (MENA) region where two-thirds of region's new HIV infections are reported. HIV testing at the population level is key to interrupting the HIV transmission chain. The current study aimed to evaluate the history of HIV rapid diagnostic testing (HIV-RDT) and its correlates in northeast Iran. In this cross-sectional study, de-identified records of HIV-RDTs were extracted by the census method from the electronic health information system of 122 testing facilities between 2017 and 2021. Descriptive, bivariate, and multiple logistic regression analyses were performed to identify the factors associated with HIV-RDT uptake and risks and drivers of HIV-RDT positivity, separately among men and women. Conducting 66,548 HIV-RDTs among clients with a mean age of 30.31 years, 63% female, 75.2% married, and 78.5% with high school education or below, yielded 312 (0.47%) positive results. Test uptake was comparatively low among men and the unmarried sub-population. Prenatal care and high-risk heterosexual intercourse were the most frequent reasons for taking HIV-RDT among women and men, respectively (76% and 61.2%). High-risk heterosexual contact, tattooing, mother-to-child transmission (MTCT), having a partner at risk of HIV infection, and injecting drugs were test seekers' most reported transmission routes. One-third of the newly-infected female clients were identified through prenatal testing. Multivariate analysis revealed older age at the time of testing (Adjusted Odd Ratio (AOR) = 1.03), divorce (AOR = 2.10), widowhood (AOR = 4.33), education level of secondary school (AOR = 4.67), and unemployment (AOR = 3.20) as significant demographic predictors of positive HIV-RDT (P-value