Differences among diagnostic testing algorithms in the time from HIV diagnosis to care

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Diagnostic Testing

Background:

• The time from HIV diagnosis to care is a critical factor in patient outcomes.
• Previous analyses of this association lacked control for patient and facility characteristics.
• Evaluating diagnostic algorithm impact on timely care linkage is essential.

Purpose of the Study:

• To evaluate the association between HIV diagnostic testing algorithm type and time from diagnosis to care.
• To extend previous analyses by controlling for patient and diagnosing facility factors.
• To determine if specific HIV testing strategies improve linkage to care.

Main Methods:

• Descriptive analysis of HIV diagnoses reported to the National HIV Surveillance System (2016).
• Categorization of algorithms: traditional, recommended, and rapid HIV testing.
• Multivariate analyses controlling for patient and diagnosing facility characteristics.

Main Results:

• The rapid HIV testing algorithm was associated with a significantly higher likelihood of linkage to care within 30 days (p < 0.01).
• Median time to care linkage was 9.0 days for the rapid algorithm, 17.0 days for the recommended, and 23.0 days for the traditional.
• Significant differences in time to care were observed across all algorithm types.

Conclusions:

• HIV diagnostic testing algorithm type significantly influences the time from diagnosis to care.
• The rapid HIV testing algorithm demonstrated the shortest median time to care.
• Optimizing diagnostic algorithms for faster results reporting is crucial for timely HIV care initiation.