Under-reporting of known HIV-positive status among people living with HIV: a systematic review and meta-analysis
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Monitoring progress towards the UNAIDS ‘first 90’ target requires accurate estimates of levels of diagnosis among people living with HIV (PLHIV), which is often estimated using self-report. We conducted a systematic review and meta-analysis quantifying under-reporting of known HIV-positive status using objective knowledge proxies. Databases were searched for studies providing self-reported and biological/clinical markers of prior knowledge of HIV-positive status among PLHIV. Random-effects models were used to derive pooled estimates of levels of under-reporting. Thirty-two estimates from 26 studies were included (41,465 PLHIV). The pooled proportion under-reporting known HIV-positive status was 20% (95% confidence interval 13–26%, I2 = 99%). In sub-group analysis, under-reporting was higher among men who have sex with men (32%, number of estimates [Ne] = 10) compared to the general population (9%, Ne = 10) and among Black (18%, Ne = 5) than non-Black (3%, Ne = 3) individuals. Supplementing self-reported data with biological/clinical proxies may improve the validity of the ‘first 90’ estimates.
Date Issued
2021-05-28
Date Acceptance
2021-05-11
Citation
AIDS and Behavior, 2021, 25, pp.3858-3870
ISSN
1090-7165
Publisher
Springer
Start Page
3858
End Page
3870
Journal / Book Title
AIDS and Behavior
Volume
25
Copyright Statement
© The Author(s) 2021. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
License URL
Sponsor
National Institutes of Health
Medical Research Council (MRC)
Identifier
https://link.springer.com/article/10.1007%2Fs10461-021-03310-z
Grant Number
UM1AI068617 Sub#0001014222
MR/R015600/1
Subjects
Science & Technology
Social Sciences
Life Sciences & Biomedicine
Public, Environmental & Occupational Health
Social Sciences, Biomedical
Biomedical Social Sciences
HIV status
Under-report
Knowledge
Proxy
Bias
SEX
MEN
PREVALENCE
INFECTION
ACCURACY
STIGMA
BIAS
Bias
HIV status
Knowledge
Proxy
Under-report
1117 Public Health and Health Services
1607 Social Work
Public Health
Publication Status
Published
Date Publish Online
2021-05-28