Incorporation of the rapid HIV test in a sexually-transmitted disease clinic in Buenos Aires: Dramatic increase in the frequency of HIV diagnosis

array:24 ["pii" => "S0325754120300237" "issn" => "03257541" "doi" => "10.1016/j.ram.2019.12.004" "estado" => "S300" "fechaPublicacion" => "2020-10-01" "aid" => "384" "copyright" => "Asociación Argentina de Microbiología" "copyrightAnyo" => "2020" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "Rev Argent Microbiol. 2020;52:272-7" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "itemSiguiente" => array:19 [ "pii" => "S0325754119301257" "issn" => "03257541" "doi" => "10.1016/j.ram.2019.11.005" "estado" => "S300" "fechaPublicacion" => "2020-10-01" "aid" => "375" "copyright" => "Asociación Argentina de Microbiología" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "Rev Argent Microbiol. 2020;52:278-82" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 17 "formatos" => array:3 [ "EPUB" => 3 "HTML" => 5 "PDF" => 9 ] ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "Brief report" "titulo" => "Microscopic agglutination test: Variables that affect the time of serological confirmation of human leptospirosis cases" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:3 [ 0 => "en" 1 => "en" 2 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "278" "paginaFinal" => "282" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Test de microaglutinación: variables que afectan el tiempo de confirmación de los casos humanos de leptospirosis" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 2868 "Ancho" => 1508 "Tamanyo" => 235620 ] ] "descripcion" => array:1 [ "en" => "(A) Days elapsed between the onset of clinical manifestations and the collection of the first sample for the serological diagnosis of the disease. (B) Days between the collection of the first clinical sample for serological diagnosis and admission at the specific diagnostic laboratory. (C) Cross-reaction between serogroups used as antigens in MAT, according to the days of the course of disease. (D) Antibody titers for serogroups used as antigens in MAT, according to the days of the course of disease." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Exequiel Scialfa, Mariana Rivero, Sergio Moreno, Marcela Ortiz, Fabricio Bongiorno" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Exequiel" "apellidos" => "Scialfa" ] 1 => array:2 [ "nombre" => "Mariana" "apellidos" => "Rivero" ] 2 => array:2 [ "nombre" => "Sergio" "apellidos" => "Moreno" ] 3 => array:2 [ "nombre" => "Marcela" "apellidos" => "Ortiz" ] 4 => array:2 [ "nombre" => "Fabricio" "apellidos" => "Bongiorno" ] ] ] ] "resumen" => array:1 [ 0 => array:3 [ "titulo" => "Highlights" "clase" => "author-highlights" "resumen" => "<ul class="elsevierStyleList" id="lis0020"><li class="elsevierStyleListItem" id="lsti0005">•64% of cases are confirmed by MAT with the first clinical sample.</li><li class="elsevierStyleListItem" id="lsti0010">•Human cases of leptospirosis are confirmed 21 days after the onset of clinical signs.</li><li class="elsevierStyleListItem" id="lsti0015">•Ballum and Canicola were the most reactive serogroups.</li><li class="elsevierStyleListItem" id="lsti0020">•The confirmation time depends on the distance of the health region from the reference laboratory.</li><li class="elsevierStyleListItem" id="lsti0025">•The number of serogroups that cross-reacted decreased as the disease progressed.</li></ul>" ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0325754119301257?idApp=UINPBA00004N" "url" => "/03257541/0000005200000004/v1_202012180643/S0325754119301257/v1_202012180643/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S0325754120300055" "issn" => "03257541" "doi" => "10.1016/j.ram.2020.01.002" "estado" => "S300" "fechaPublicacion" => "2020-10-01" "aid" => "382" "copyright" => "Asociación Argentina de Microbiología" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "Rev Argent Microbiol. 2020;52:266-71" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "Original article" "titulo" => "Syphilis seroprevalence among HIV-infected males in Istanbul, Turkey" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:3 [ 0 => "en" 1 => "en" 2 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "266" "paginaFinal" => "271" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Seroprevalencia de la sífilis entre hombres infectados con el HIV en Estambul, Turquía" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Muammer Osman Köksal, Hayati Beka, Oğuz Evlice, Sevgi Çiftçi, Fahriye Keskin, Seniha Başaran, Baki Akgül, Haluk Eraksoy, Ali Ağaçfidan" "autores" => array:9 [ 0 => array:2 [ "nombre" => "Muammer Osman" "apellidos" => "Köksal" ] 1 => array:2 [ "nombre" => "Hayati" "apellidos" => "Beka" ] 2 => array:2 [ "nombre" => "Oğuz" "apellidos" => "Evlice" ] 3 => array:2 [ "nombre" => "Sevgi" "apellidos" => "Çiftçi" ] 4 => array:2 [ "nombre" => "Fahriye" "apellidos" => "Keskin" ] 5 => array:2 [ "nombre" => "Seniha" "apellidos" => "Başaran" ] 6 => array:2 [ "nombre" => "Baki" "apellidos" => "Akgül" ] 7 => array:2 [ "nombre" => "Haluk" "apellidos" => "Eraksoy" ] 8 => array:2 [ "nombre" => "Ali" "apellidos" => "Ağaçfidan" ] ] ] ] "resumen" => array:1 [ 0 => array:3 [ "titulo" => "Highlights" "clase" => "author-highlights" "resumen" => "<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005">•The prevalence of syphilis is high in HIV-infected men in Istanbul, Turkey.</li><li class="elsevierStyleListItem" id="lsti0010">•The rate of syphilis was found to be significantly higher in MSM HIV infected patients than heterosexual HIV infected patients in Turkey.</li><li class="elsevierStyleListItem" id="lsti0015">•Findings of the study highlight the fact that patients infected with HIV must be screened for syphilis at least annually and must be informed about STDs.</li></ul>" ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0325754120300055?idApp=UINPBA00004N" "url" => "/03257541/0000005200000004/v1_202012180643/S0325754120300055/v1_202012180643/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "Original article" "titulo" => "Incorporation of the rapid HIV test in a sexually-transmitted disease clinic in Buenos Aires: Dramatic increase in the frequency of HIV diagnosis" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "272" "paginaFinal" => "277" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Nicolas Morando, María Lucía Gallo Vaulet, Asunta Melgar, Marcelo Rodríguez Fermepin, Ricardo Casco, María de los Ángeles Pando" "autores" => array:6 [ 0 => array:3 [ "nombre" => "Nicolas" "apellidos" => "Morando" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "María Lucía Gallo" "apellidos" => "Vaulet" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Asunta" "apellidos" => "Melgar" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] ] ] 3 => array:3 [ "nombre" => "Marcelo Rodríguez" "apellidos" => "Fermepin" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 4 => array:3 [ "nombre" => "Ricardo" "apellidos" => "Casco" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] ] ] 5 => array:4 [ "nombre" => "María de los Ángeles" "apellidos" => "Pando" "email" => array:1 [ 0 => "mpando@fmed.uba.ar" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "CONICET-Universidad de Buenos Aires, Instituto de Investigaciones Biomédicas en Retrovirus y Sida (INBIRS), Paraguay 2155, CABA, Argentina" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Departamento de Bioquímica Clínica, Cátedra de Microbiología Clínica, Inmunología y Virología Clínica, Junín 954, CABA, Argentina" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Universidad de Buenos Aires, Hospital de Clínicas “José de San Martín”, Programa de Enfermedades de Transmisión Sexual, Av. Córdoba 2351, CABA, Argentina" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Incorporación del test rápido del HIV en una clínica de enfermedades de transmisión sexual en Buenos Aires: aumento dramático en la frecuencia de diagnóstico del HIV" ] ] "textoCompleto" => "IntroductionGiven the worldwide commitment to end the epidemic by 2030, UNAIDS has set a series of objectives for the year 2020: that 90% of all people living with HIV become aware of their infection, that 90% of those aware of their infection gain access to treatment and that 90% of those on treatment suppress their viral load one year after the infection<a class="elsevierStyleCrossRef" href="#bib0175">17</a>. This highlights the importance of improved access to diagnosis as the first step in the control of the HIV/AIDS epidemic. However, there still remains much to be done in this area, considering the high frequency of late diagnoses worldwide<a class="elsevierStyleCrossRefs" href="#bib0130">8,13</a>. In this context, rapid HIV tests (RHT) are essential tools to achieve the 90–90–90 target due to their proved efficacy in facilitating access to diagnosis<a class="elsevierStyleCrossRef" href="#bib0140">10</a>.In Argentina, HIV prevalence has been estimated to be 0.4% among young people and adults. The epidemic is mostly concentrated in men who have sex with men (MSM) and transgender women, with HIV prevalence rates of 12–15% and 34%, respectively. Moreover, it has been reported that approximately 37.5% of men and 30% of women receive a late HIV diagnosis<a class="elsevierStyleCrossRef" href="#bib0100">2</a>. Even when international studies clearly associated RHT introduction with increased HIV testing in several settings, only one research study on the implementation of the RHT has been performed in Argentina<a class="elsevierStyleCrossRef" href="#bib0115">5</a>. Given the need for local data on the implications of the incorporation of the RHT into the diagnostic algorithms, our goal was to test the effectiveness of a structural intervention: the incorporation of the RHT followed by immediate counseling, diagnosis confirmation and entry to care in a walk-in sexually-transmitted disease (STD) clinic located in a University Hospital (Programa de Enfermedades de Transmisión Sexual (PETS), Hospital de Clínicas “José de San Martin” Universidad de Buenos Aires).Materials and methodsEnrollment of participantsA diagnostic algorithm was designed in line with those recommended by the national health ministry<a class="elsevierStyleCrossRef" href="#bib0095">1</a>, in particular the one-rapid-test screening algorithm. Between March and December 2015 the RHT was offered to all patients attending the STD clinic who met eligibility criteria. Eligible patients were men and women 18 years old or older who attended the clinic regardless of the reason for consultation. During the process of registration each patient was told that the test would be carried out from a finger prick blood sample and that the result would be informed to them directly by the physician during the consultation. Those who manifested interest were given an informed consent for them to read and sign, as well as a survey to complete in order to collect socio-demographical data and information related to sexual behavior, linkage to the healthcare system and previous HIV testing. Upon reading, completing and signing this documentation, they were enrolled in the study and individually led to a room which was especially conditioned for carrying out the test.Rapid HIV test and delivery of resultsThe RHT was performed by collecting a blood sample through a finger prick, using the commercial kit Determine™ HIV-1/2 (Alere), an immunochromatographic test for the qualitative detection of antibodies against HIV-1/2 antigens. The test was carried out according to the manufacturer's instructions and the results were available within 15minutes These were interpreted by the technician and/or researcher in charge and delivered to the physician for him to read and to show to the patient. In the event of a non-reactive RHT, the physician gave the patient the necessary recommendations based on reported risk factors. In case of reactive RHT, on the other hand, the patient was informed about the need for further confirmatory studies and referred to the INBIRS diagnostic laboratory, which is located in the nearby School of Medicine (Facultad de Medicina, Universidad de Buenos Aires), approximately 100 meters away from the University Hospital.HIV confirmatory studies and delivery of resultsA 15ml peripheral blood sample was taken from those individuals with reactive RHT who attended the INBIRS laboratory for confirmatory studies, which included ELISA (Genscreen Ultra HIV Ag-AbBio-rad), plasma viral load (Abbott Real Time HIV-1 RNA Version 3.0) and CD4+T cell count (flow citometry). The results were sent to the clinic and handed over to the patient by the same physician during a second visit. Patients with confirmed HIV diagnosis were referred to the Infectious Diseases Unit of the University Hospital (Departamento de Infectología, Hospital de Clínicas “José de San Martín”, Universidad de Buenos Aires) in order to be assisted. Patient follow-up was performed by regular reviewing of clinical records for a period of one year following the study period.Statistical analysisFisher's exact test and Mann–Whitney U test were used to compare differences in categorical and numerical variables, respectively. All statistical analyses, including calculation of interquartile ranges (IQR) and 95% confidence intervals (95% CI) were carried out using IBM SPSS Statistics Base 22.0 (IBM Corp. Released 2013. IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp.).Ethical aspectAll the procedures were in line with the Declaration of Helsinki (Seoul 2008), the National Personal Information Protection Law (Law 25326) and followed the recommendations provided by national regulations for research. The protocol of the study, as well as the documentation used (namely, informed consent and survey) were evaluated and approved by the University Hospital Institutional Review Board (IRB) (Comité de Ética, Hospital de Clínicas “José de San Martín”, Universidad de Buenos Aires). Informed consent was obtained from all study participants.ResultsSocio-demographic characteristics of the study populationBetween March and December 2015, a total of 593 RHT were performed on 547 patients (39 patients were tested twice, six patients three times and one patient four times; there were no duplicate cases among reactive RHT). Unless otherwise noted, all analyses were performed based on the non-duplicate cases. Considering gender at birth, 76.8% (420/547) of participants were men and 23.2% (127/547) were women. Regarding self-identified gender, most individuals identified themselves as male (75.6%, 403/533), others as female (22.5%, 120/533) and a small minority as transgender (1.3%, 7/533). <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> shows all socio-demographic characteristics, stratified by self-identified gender. Briefly, the patients’ median age was 29 years (IQR: 24–38), with self-identified males being significantly older than females (males: 29 years old, IQR: 25–39; females: 27 years old, IQR: 22–33.75; Mann–Whitney test, p=0.001). Transgender individuals showed a higher median age (32 years old, IQR: 23–35). However, no statistically significant difference could be inferred either with males (p=0.84) or females (p=0.42). Most patients lived in Buenos Aires, the capital city (72.6%, 323/445), or in the Buenos Aires Province (26.3%, 117/445). Most individuals (74.5%, 404/542) reported having completed high school education level. Regarding work status, 38.6% (201/521) had a steady job, i.e. with a contract, 29.9% (156/521) had an unsteady job, i.e. without a contract, while the remaining individuals who reported not having a job were unemployed, retired or students.<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>Previous linkage to care and HIV testingRegarding linkage to the healthcare system, 73.6% (393/534) of patients reported receiving some kind of medical service during the previous year. Most patients (67.5%, 363/538) had been tested for HIV previously, and 94.5% (294/311) of them reported receiving their results. Probability of having been tested for HIV in the past was higher in patients who reported receiving any kind of medical service during the previous year as opposed to none (71.0% (277/390) vs. 58.6.% (82/140), p=0.008) and men with reported male partners as opposed to female partners (86.0% (141/164) vs. 60.7% (125/206), p<0.001). Inconsistent condom use was more frequent in patients with no previous HIV test when compared to those previously tested (82.9% (136/164) vs. 71.8% (249/347), p=0.006).Sexual practices and condom useRegarding sexual practices, 51.3% (210/409) of men reported having sexual relationships only with women in the six months prior to the study, while 40.3% (165/409) reported having had male sexual partners. The remaining men had either both male and female (3.9%, 16/409), female and trans (0.7%, 3/409), only trans (0.5%, 2/409) or no sexual partners (3.2%, 13/409). In the case of women, the vast majority (95.2%, 120/126) reported having had only male sexual partners, while only 2.4% (3/126) claimed to have had no sexual partners during the previous six months. Only a handful of women reported both male and female (1.6%, 2/126) or only female (0.8%, 1/126) sexual partners.Concerning condom use, only 25.2% (130/516) of participants reported consistent condom use during sexual relationships, while 9.7% (50/516) claimed never to use a condom and the rest reported inconsistent condom use (65.1%, 336/516). Consistent condom use was more frequent among men than women (29.3% (116/396) vs. 11.7% (14/120), p=0.0001). Patients without a previous HIV test also showed a higher frequency of inconsistent condom use (82.9% (136/164) vs. 71.8% (249/347), p=0.006) when compared with those previously tested.HIV prevalence and associated risk factorsAccording to RHT, HIV prevalence was 6.3% (34/538, 95% CI: 4.2–8.5), with a significant higher prevalence in men than in women (7.5% (31/412) vs. 2.4% (3/126), p=0.04). Patients who had not been tested for HIV showed a tendency toward a higher HIV prevalence than those who had been tested once (9.1% (16/175) vs. 5.1% (18/354), p=0.09). When accounting for sexual partner type, a significant higher HIV prevalence was found among men who had exclusively male partners as opposed to exclusively female partners (15.0% (24/160) vs. 1.9% (4/207), p<0.001). No significant differences in HIV prevalence were observed between participants who reported consistent or inconsistent condom use (8.5% (11/129) vs. 5.8% (22/378), p=0.30).Patient referral and first steps in the cascade of careAll patients with a reactive RHT (n=34) were referred to the laboratory for confirmatory studies; 94.1% (32/34) went to the laboratory, and 87.5% (28/32) came back in order to receive their results. The infection was confirmed in 93.8% (30/32) of patients, yielding two false reactive RHT results. Among HIV positive patients (n=30), the median CD4+T cell count was 441cells/μl (p25–p75, 288–608) and the median HIV viral load was 28764 RNA copies/ml (p25–p75, 4446–59177). The two cases classified as false positives were confirmed as HIV negative according to plasma viral load, fourth-generation ELISA and immunological parameters. Of the 30 confirmed HIV-positive individuals, we were able to do follow-up 13 of them, i.e. 43.3%. Among these, 69.2% (9/13) repeated the laboratory tests, namely CD4+T cell count and plasma HIV viral load, and 76.9% (10/13) initiated treatment. Among those who repeated the tests, 55.6% (5/9) managed to suppress their viral load during the course of the follow-up period. Regardless of the presence or absence of viral suppression, all patients, except for one patient, had a lower viral load by the time of the final examination, which took place 4–14 months after the base-line test.Influence of rapid testing on frequency of HIV diagnosisTo evaluate the impact of the incorporation of the RHT on the frequency of patients who agreed to be tested for HIV, we compared the frequency of the previous year performed by the conventional methodology (referral to laboratory, peripheral blood collection, laboratory analyses (ELISA, Western Blot) and delivery of results within 15 days) with the frequency of patients tested by RHT in our study. In the year prior to the study, 6.9% (210/3060) of the patients who attended the clinic agreed to be tested, while this frequency rose to 31.4% (593/1887) during the study period (p<0.001)(this includes duplicate cases). We also observed a slight increment in the reception of confirmatory results from 76.2% (160/210) to 87.5% (28/32) (p=0.6746).DiscussionThis study reveals for the first time in Argentina how the incorporation of the RHT in the diagnostic algorithm can cause a dramatic increase in the frequency of HIV diagnosis (almost fivefold) as observed in the comparison between the results of the present study and the period prior to the study, i.e. with and without the use of the RHT. This is consistent with previous studies performed in other countries comparing the uptake of HIV/AIDS services using RHT and conventional testing, where the implementation of RHT was associated with a threefold increase in the frequency of diagnosis<a class="elsevierStyleCrossRefs" href="#bib0160">14,18</a>. Even when the use of RHT significantly increases the rate of HIV diagnosis, the frequency (≅30%) is still lower than that reported previously in other studies where acceptability of rapid tests ranged from 45% to 95%. However, uptake of RHT depended on the venue where testing was offered as well as the risk group to which clients belonged, for example, acceptability has been reported to be higher in pregnant women and lower among clients of sex workers (45%), black university students tested on campus (50%) and African and Caribbean clients in family practice (45%)<a class="elsevierStyleCrossRefs" href="#bib0105">3,12,15</a>. Low RHT acceptability among some populations may be related to the fact that they did not expect to be offered a test or do not perceive themselves to be at risk for HIV. Due to the fact that at the time of the study it was not very common to find RHT offer in medical services; the poor acceptability can be related to the issues mentioned.This rapid HIV testing approach not only effectively increased the number of individuals tested but also reached individuals at risk for HIV, as can be seen by the high HIV prevalence detected. This was found to be almost 6%, which is considerably higher than that of the general population (below 1%)<a class="elsevierStyleCrossRef" href="#bib0100">2</a>. The reason for this might lie in the fact that the individuals included in this study are already seeking medical attention for STD-related – real or suspected – problems, thus one could expect to find a higher-than-average prevalence of STDs in general, including HIV. We also found that HIV positive individuals reached in this study have a median CD4+T cell count below 500cells/μl, which suggests late HIV diagnosis. This result is of great importance considering the evidence that indicate that immediate antiretroviral therapy, with CD4+T cells count over 500cells/ml, can reduce disease progression, improving the likelihood of immunologic recovery while also increasing the percentage of individuals who achieve viral suppression<a class="elsevierStyleCrossRefs" href="#bib0125">7,16</a>.Our findings underscore the importance of increasing the rate of HIV diagnosis by improving patient linkage to the healthcare system. One in four patients had had no contact with any health service for over a year and HIV testing was significantly less frequent among them, which is consistent with previous studies<a class="elsevierStyleCrossRefs" href="#bib0110">4,6,11</a>. This association between linkage to healthcare system and HIV testing highlights the importance of interventions to bring individuals to clinics/hospitals and identify opportunities for rapid HIV testing in these environments. The model tested in this study could be applied in other clinics with similar characteristics, as long as it does not involve additional time for the patient or moving to another place to be tested. From this finding, it would be pertinent to recommend including the RHT in STDs clinics. To achieve this, it would be imperative to have minimal requirements like funding, room, and trained personnel.It has been previously reported that rapid testing reduces waiting times for the patient, favoring linkage and retention in care<a class="elsevierStyleCrossRef" href="#bib0135">9</a>. Accordingly, our approach to the first steps of the cascade of care with RHT shows encouraging outcomes, with high retention rates (around 90%). However, our study has certain limitations that need to be addressed. Our experimental design only allowed us to closely follow the first few steps of the care cascade – further inquiry is necessary to determine if the beneficial effect observed applies to the entire chain, from testing to treatment and viral suppression. Finally, a higher sample size might have enabled us to examine socio-demographics and conduct differences between other, less frequent populations, such as trans, which here were only found in very low numbers. New studies aimed at applying the implementation of HIV diagnosis via rapid testing would strongly benefit from these additions.ConclusionsIn conclusion, results obtained in this study confirm those of previous interventions performed in other countries and highlight the importance of facilitating patient access to diagnosis and retention within the healthcare system. The incorporation of the RHT resulted in a high retention of patients and an increase in both the frequency of diagnosis and results withdrawal when compared to the conventional methodology. Other notable achievements of the study in this respect include the successful incorporation of RHT in a walk-in clinic, with high acceptance and efficacy. Last but not least, the testing methodology employed, based on the open offer of the RHT without disrupting the normal circuit of the clinic, is potentially applicable to various other clinical settings with similar features.Conflict of interestThe authors declare that they have no conflicts of interest." "textoCompletoSecciones" => array:1 [ "secciones" => array:13 [ 0 => array:3 [ "identificador" => "xres1437162" "titulo" => "Highlights" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0005" ] ] ] 1 => array:3 [ "identificador" => "xres1437161" "titulo" => "Abstract" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0010" ] ] ] 2 => array:2 [ "identificador" => "xpalclavsec1311721" "titulo" => "Keywords" ] 3 => array:3 [ "identificador" => "xres1437163" "titulo" => "Resumen" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0015" ] ] ] 4 => array:2 [ "identificador" => "xpalclavsec1311720" "titulo" => "Palabras clave" ] 5 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 6 => array:3 [ "identificador" => "sec0010" "titulo" => "Materials and methods" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Enrollment of participants" ] 1 => array:3 [ "identificador" => "sec0020" "titulo" => "Rapid HIV test and delivery of results" "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0025" "titulo" => "HIV confirmatory studies and delivery of results" ] ] ] 2 => array:2 [ "identificador" => "sec0030" "titulo" => "Statistical analysis" ] 3 => array:2 [ "identificador" => "sec0035" "titulo" => "Ethical aspect" ] ] ] 7 => array:3 [ "identificador" => "sec0040" "titulo" => "Results" "secciones" => array:6 [ 0 => array:2 [ "identificador" => "sec0045" "titulo" => "Socio-demographic characteristics of the study population" ] 1 => array:2 [ "identificador" => "sec0050" "titulo" => "Previous linkage to care and HIV testing" ] 2 => array:2 [ "identificador" => "sec0055" "titulo" => "Sexual practices and condom use" ] 3 => array:2 [ "identificador" => "sec0060" "titulo" => "HIV prevalence and associated risk factors" ] 4 => array:2 [ "identificador" => "sec0065" "titulo" => "Patient referral and first steps in the cascade of care" ] 5 => array:2 [ "identificador" => "sec0070" "titulo" => "Influence of rapid testing on frequency of HIV diagnosis" ] ] ] 8 => array:2 [ "identificador" => "sec0075" "titulo" => "Discussion" ] 9 => array:2 [ "identificador" => "sec0080" "titulo" => "Conclusions" ] 10 => array:2 [ "identificador" => "sec0085" "titulo" => "Conflict of interest" ] 11 => array:2 [ "identificador" => "xack501426" "titulo" => "Acknowledgements" ] 12 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2019-09-16" "fechaAceptado" => "2019-12-10" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1311721" "palabras" => array:5 [ 0 => "Human immunodeficiency virus" 1 => "Rapid test" 2 => "Linkage to care" 3 => "Diagnosis" 4 => "90–90–90" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1311720" "palabras" => array:5 [ 0 => "Human immunodeficiency virus" 1 => "Test rápido" 2 => "Vinculación al sistema de salud" 3 => "Diagnóstico" 4 => "90–90–90" ] ] ] ] "tieneResumen" => true "highlights" => array:2 [ "titulo" => "Highlights" "resumen" => "<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005">•The use of the RHT significantly increased the frequency of HIV diagnosis.</li><li class="elsevierStyleListItem" id="lsti0010">•Approximately one of three individuals had never tested for HIV previously.</li><li class="elsevierStyleListItem" id="lsti0015">•No access to medical care and irregular condom use associated with no HIV testing.</li><li class="elsevierStyleListItem" id="lsti0020">•Tendency toward a higher HIV prevalence in patients with no prior HIV testing.</li><li class="elsevierStyleListItem" id="lsti0025">•Use of RHT slightly incremented the receipt of confirmatory results.</li></ul>" ] "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "Improving access to diagnosis constitutes a key step in the control of the Human immunodeficiency virus (HIV)/AIDS epidemic. Rapid testing is increasingly gaining interest as a powerful diagnostic tool to achieve this goal. The purpose of this study was to implement the rapid HIV test (RHT) in a clinical setting in order to evaluate its effectiveness in increasing HIV diagnosis and patient linkage to the healthcare system.The RHT was offered to all patients attending a sexually-transmitted disease clinic in the City of Buenos Aires between March and December 2015. A total of 593 RHT were performed. The implementation of the RHT yielded an increase in frequency of diagnosis from 6.9% to 31.4% (p<0.001). The first steps of the care cascade showed high retention rates around 90%. RHT yielded an HIV prevalence of 6.3% (95% CI: 4.2–8.5) in this population. HIV prevalence tended to be higher in individuals with no previous HIV testing (p=0.09). Linkage to the healthcare system was associated with a higher probability of having been tested for HIV (p=0.008). The incorporation of the RHT resulted in a high retention of patients and an increase in both frequency of diagnosis and results reception when compared to the classic methodology." ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "El mejoramiento del acceso al diagnóstico constituye un punto clave en el control de la epidemia del virus de la inmunodeficiencia humana (Human immunodeficiency virus: HIV)/sida. El testeo rápido se ha convertido en una poderosa herramienta diagnóstica de interés para alcanzar este objetivo. El propósito de este estudio fue la implementación del test rápido del HIV (TRH) en un contexto clínico con el fin de evaluar su efectividad para incrementar la tasa de diagnóstico de HIV y la vinculación de los pacientes al sistema de salud. Se ofreció el TRH a todos los pacientes que acudieron a una clínica de enfermedades de transmisión sexual en la Ciudad Autónoma de Buenos Aires entre marzo y diciembre del 2015. Se realizaron un total de 593 TRH. La implementación del TRH resultó en un aumento en la frecuencia de diagnóstico del 6,9 al 31,4% (p<0,001). Los primeros pasos en la cascada de cuidados mostraron altas tasas de retención alrededor del 90%. La prevalencia del HIV según TRH en la población de estudio fue del 6,3% (IC 95%: 4,2-8,5), tendiendo a ser mayor en individuos sin testeo previo de HIV (p=0,09). La vinculación al sistema de salud se asoció a una mayor probabilidad de haber sido testeado previamente para HIV (p=0,008). La incorporación del TRH resultó en una mayor retención de los pacientes, así como en un aumento tanto en la frecuencia de diagnóstico como en la de retiro de resultados, en comparación con la metodología clásica." ] ] "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Total \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Male \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Female \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Trans \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Median age (IQR)**,<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29 (24–38) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29 (25–39) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">27 (22–33.75) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">32 (23–35) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Residence</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">City of Buenos Aires \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">72.6% (323/445) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">72.6% (239/329) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">70.3% (71/101) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100% (4/4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Other \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">27.4% (122/445) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">27.4% (90/329) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29.7% (30/101) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Education level</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Complete high school \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">74.5% (404/542) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">75.5% (302/400) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">75.0% (90/120) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">42.9% (3/7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Incomplete high school \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25.5% (138/542) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">24.5% (98/400) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25.0% (30/120) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">57.1% (4/7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Employment status</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Steady job with contract \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">38.6% (201/521) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">39.3% (153/389) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">35.7% (41/115) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20.0% (1/5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Unsteady job without contract \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29.9% (156/521) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30.8% (120/389) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25.2% (29/115) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">60.0% (3/5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Other \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">31.5% (164/521) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29.8% (116/389) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">39.1% (45/115) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20.0% (1/5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Student</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13.6% (71/521) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13.9% (54/388) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12.9% (15/116) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20.0% (1/5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">86.4% (450/521) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">86.1% (334/388) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">87.1% (101/116) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">80.0% (4/5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Last visit to a doctor</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><1 year \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">73.6% (393/534) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">74.1% (295/398) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">73.7% (87/118) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">71.4% (5/7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">>1 year \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21.7% (116/534) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21.4% (85/398) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22.0% (26/118) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14.3% (1/7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Does not know/remember \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.7% (25/534) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.5% (18/398) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.2% (5/118) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14.3% (1/7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Previous HIV test*</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">67.5% (363/538) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">70.2% (280/399) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">57.1% (68/119) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">85.7% (6/7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">32.5% (175/538) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29.8% (119/399) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">42.9% (51/119) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14.3% (1/7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sex partners in the last six months</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Male*** \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">56.5% (293/519) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">46.9% (179/382) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">90.8% (108/119) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">85.7% (6/7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Female*** \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">43.7% (227/519) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">57.1% (218/382) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.6% (9/119) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Trans \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.0% (5/519) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.0% (4/382) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14.3% (1/7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">None \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.1% (16/519) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.4% (13/382) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.5% (3/119) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Condom use**</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Regular \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25.2% (130/516) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">28.7% (110/383) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14.5% (17/117) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">50.0% (3/6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Irregular \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">74.8% (386/516) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">71.3% (273/383) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">85.5% (100/117) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">50.0% (3/6) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2472136.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "All significant differences were found only between “male” and “female” categories. Asterisks indicate statistical significance (*p<0.05, **p<0.01, ***p<0.001). Denominators vary due to the fact that not all participants answered all demographic and risk factor questions. IQR: interquartile range." ] ] ] "descripcion" => array:1 [ "en" => "Socio-demographic characteristics of the 547 participants included in the study between March and December 2015 in the STD clinic in Buenos Aires, Argentina" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:18 [ 0 => array:3 [ "identificador" => "bib0095" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Algoritmos de diagnósticos para VIH [online]" "autores" => array:1 [ 0 => array:2 [ "colaboracion" => "Dirección de Sida y ETS, Ministerio de Salud de la Nación" "etal" => false ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:2 [ "fecha" => "2018" "editorial" => "Buenos Aires, Argentina" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0100" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Boletín sobre el VIH-SIDA en la Argentina (2017) Año XX. Número 34 [online]" "autores" => array:1 [ 0 => array:2 [ "colaboracion" => "Dirección de Sida y ETS, Ministerio de Salud de la Nación" "etal" => false ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:2 [ "fecha" => "2017" "editorial" => "Buenos Aires, Argentina" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0105" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A cross-sectional survey of attitudes to HIV risk and rapid HIV testing among clients of sex workers in Switzerland" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "K.E. Darling" 1 => "E.A. Diserens" 2 => "C. N’garambe" 3 => "A. Ansermet-Pagot" 4 => "E. Masserey" 5 => "M. Cavassini" 6 => "P. Bodenmann" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/sextrans-2012-050489" "Revista" => array:6 [ "tituloSerie" => "Sex Transm Infect" "fecha" => "2012" "volumen" => "88" "paginaInicial" => "462" "paginaFinal" => "464" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22628660" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0110" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Health care and HIV testing experiences among Black men in the south: implications for “seek, test treat, and retain” HIV prevention strategies" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "R.K. Doshi" 1 => "D. Malebranche" 2 => "L. Bowleg" 3 => "T. Sangaramoorthy" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1089/apc.2012.0269" "Revista" => array:6 [ "tituloSerie" => "AIDS Patient Care STDS" "fecha" => "2013" "volumen" => "27" "paginaInicial" => "123" "paginaFinal" => "133" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23268586" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0115" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Implementation of rapid test for HIV in Buenos Aires City: a strategy to facilitate access to timely diagnosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:19 [ 0 => "A. Duran" 1 => "A. Arévalo" 2 => "L. Betti" 3 => "F. Vulcano" 4 => "M. Nan" 5 => "L. Marachlian" 6 => "M.L. Carones" 7 => "P. Orge" 8 => "D. Serantes" 9 => "E. Carrizo" 10 => "G. Georgetti" 11 => "S. Vulcano" 12 => "A. Rojo" 13 => "F. Portnoy" 14 => "M.A. Pando" 15 => "H. Salomón" 16 => "I. Zapiola" 17 => "L. Tadey" 18 => "M.B. Bouzas" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Argent Salud Pública" "fecha" => "2019" "volumen" => "10" "paginaInicial" => "38" "paginaFinal" => "42" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0120" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Health care use and HIV testing of males aged 15–39 years in physicians’ offices – United States, 2009–2012" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "D.C. Ham" 1 => "Y.L. Huang" 2 => "R. Gvetadze" 3 => "P.J. Peters" 4 => "K.W. Hoover" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.15585/mmwr.mm6524a3" "Revista" => array:6 [ "tituloSerie" => "MMWR Morb Mortal Wkly Rep" "fecha" => "2016" "volumen" => "65" "paginaInicial" => "619" "paginaFinal" => "622" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27337096" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0125" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "HIV-CAUSAL Collaboration. Comparative effectiveness of immediate antiretroviral therapy versus CD4-based initiation in HIV-positive individuals in high-income countries: observational cohort study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:29 [ 0 => "S. Lodi" 1 => "A. Phillips" 2 => "R. Logan" 3 => "A. Olson" 4 => "D. Costagliola" 5 => "S. Abgrall" 6 => "A. van Sighem" 7 => "P. Reiss" 8 => "J.M. Miró" 9 => "E. Ferrer" 10 => "A. Justice" 11 => "N. Gandhi" 12 => "H.C. Bucher" 13 => "H. Furrer" 14 => "S. Moreno" 15 => "S. Monge" 16 => "G. Touloumi" 17 => "N. Pantazis" 18 => "J. Sterne" 19 => "J.G. Young" 20 => "L. Meyer" 21 => "R. Seng" 22 => "F. Dabis" 23 => "M.A. Vandehende" 24 => "S. Pérez-Hoyos" 25 => "I. Jarrín" 26 => "S. Jose" 27 => "C. Sabin" 28 => "M.A. Hernán" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S2352-3018(15)00108-3" "Revista" => array:6 [ "tituloSerie" => "Lancet HIV" "fecha" => "2015" "volumen" => "2" "paginaInicial" => "e335" "paginaFinal" => "e343" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26423376" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0130" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Impact of late diagnosis and treatment on life expectancy in people with HIV-1-UK Collaborative HIV Cohort" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:21 [ 0 => "M. May" 1 => "M. Gompels" 2 => "V. Delpech" 3 => "K. Porter" 4 => "F. Post" 5 => "M. Johnson" 6 => "D. Dunn" 7 => "A. Palfreeman" 8 => "R. Gilson" 9 => "B. Gazzard" 10 => "T. Hill" 11 => "J. Walsh" 12 => "M. Fisher" 13 => "C. Orkin" 14 => "J. Ainsworth" 15 => "L. Bansi" 16 => "A. Phillips" 17 => "C. Leen" 18 => "M. Nelson" 19 => "J. Anderson" 20 => "C. Sabin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/bmj.d6016" "Revista" => array:5 [ "tituloSerie" => "BMJ" "fecha" => "2011" "volumen" => "343" "paginaInicial" => "d6016" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21990260" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0135" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Does rapid HIV testing result in an early diagnosis and reduce the waiting time for patients to receive medical care?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M.C.V. Melo" 1 => "R.A.A. Ximenes" 2 => "I.V. Falcão" 3 => "D.B. Miranda-Filho" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1080/09540121.2017.1360996" "Revista" => array:6 [ "tituloSerie" => "AIDS Care" "fecha" => "2018" "volumen" => "30" "paginaInicial" => "40" "paginaFinal" => "46" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28764562" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0140" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Rapid HIV self-testing: long in coming but opportunities beckon" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J.E. Myers" 1 => "W.M. El-Sadr" 2 => "A. Zerbe" 3 => "B.M. Branson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/QAD.0b013e32835fd7a0" "Revista" => array:6 [ "tituloSerie" => "AIDS" "fecha" => "2013" "volumen" => "27" "paginaInicial" => "1687" "paginaFinal" => "1695" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23807269" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0145" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Social, behavioral, and health care factors associated with recent HIV testing among sexually active non-Hispanic Black Women in the United States" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J. Nearns" 1 => "J.A. Baldwin" 2 => "H. Clayton" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Womens Health Issues" "fecha" => "2009" "volumen" => "19" "paginaInicial" => "52" "paginaFinal" => "60" ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0150" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Rapid point-of-care HIV testing in pregnant women: a systematic review and meta-analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "N.P. Pai" 1 => "J.P. Tulsky" 2 => "D. Cohan" 3 => "J.M. Colford Jr." 4 => "A.L. Reingold" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1365-3156.2006.01812.x" "Revista" => array:7 [ "tituloSerie" => "Trop Med Int Health" "fecha" => "2007" "volumen" => "12" "paginaInicial" => "162" "paginaFinal" => "173" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17300622" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S014067361161177X" "estado" => "S300" "issn" => "01406736" ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0155" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The HIV care continuum in Latin America: challenges and opportunities" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "A. Piñeirúa" 1 => "J. Sierra-Madero" 2 => "P. Cahn" 3 => "R.N. Guevara Palmero" 4 => "E. Martínez Buitrago" 5 => "B. Young" 6 => "C. Del Rio" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S1473-3099(15)00108-5" "Revista" => array:6 [ "tituloSerie" => "Lancet Infect Dis" "fecha" => "2015" "volumen" => "15" "paginaInicial" => "833" "paginaFinal" => "839" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26122456" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0160" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effect of rapid HIV testing on HIV incidence and services in populations at high risk for HIV exposure: an equity-focused systematic review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "K. Pottie" 1 => "O. Medu" 2 => "V. Welch" 3 => "G.P. Dahal" 4 => "M. Tyndall" 5 => "T. Rader" 6 => "G. Wells" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/bmjopen-2014-006859" "Revista" => array:5 [ "tituloSerie" => "BMJ Open" "fecha" => "2014" "volumen" => "4" "paginaInicial" => "e006859" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25510889" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0165" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Feasibility and acceptability of offering rapid HIV tests to patients registering with primary care in London (UK): a pilot study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A. Prost" 1 => "C.J. Griffiths" 2 => "J. Anderson" 3 => "D. Wight" 4 => "G.J. Hart" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/sti.2008.033233" "Revista" => array:6 [ "tituloSerie" => "Sex Transm Infect" "fecha" => "2009" "volumen" => "85" "paginaInicial" => "326" "paginaFinal" => "329" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19487214" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0170" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "From CD4-based initiation to treating all HIV-infected adults immediately: an evidence-based meta-analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:14 [ 0 => "A. Song" 1 => "X. Liu" 2 => "X. Huang" 3 => "K. Meyers" 4 => "D.Y. Oh" 5 => "J. Hou" 6 => "W. Xia" 7 => "B. Su" 8 => "N. Wang" 9 => "X. Lu" 10 => "H. Xia" 11 => "X. Yang" 12 => "H. Chen" 13 => "H. Wu" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3389/fimmu.2018.00212" "Revista" => array:5 [ "tituloSerie" => "Front Immunol" "fecha" => "2018" "volumen" => "9" "paginaInicial" => "212" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29487595" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0175" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "UNAIDS. 90-90-90 an ambitious treatment target to help end the AIDS epidemic [online]. <a target="_blank" href="http://www.unaids.org/sites/default/files/media_asset/90-90-90_en_0.pdf">http://www.unaids.org/sites/default/files/media_asset/90-90-90_en_0.pdf</a> [accessed 10.10.17]." ] ] ] 17 => array:3 [ "identificador" => "bib0180" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Testing and linkage to HIV care in China: a cluster-randomised trial" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:29 [ 0 => "Z. Wu" 1 => "Z. Tang" 2 => "Y. Mao" 3 => "P. Van Veldhuisen" 4 => "W. Ling" 5 => "D. Liu" 6 => "Z. Shen" 7 => "R. Detels" 8 => "G. Lan" 9 => "L. Erinoff" 10 => "R. Lindblad" 11 => "D. Gu" 12 => "H. Tang" 13 => "L. Hu" 14 => "Q. Zhu" 15 => "L. Lu" 16 => "N. Oden" 17 => "A.L. Hasson" 18 => "Y. Zhao" 19 => "J.M. McGoogan" 20 => "X. Ge" 21 => "N. Zhang" 22 => "K. Rou" 23 => "J. Zhu" 24 => "H. Wei" 25 => "C.X. Shi" 26 => "X. Jin" 27 => "J. Li" 28 => "J.S.G. Montaner" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S2352-3018(17)30131-5" "Revista" => array:6 [ "tituloSerie" => "Lancet HIV" "fecha" => "2017" "volumen" => "4" "paginaInicial" => "e555" "paginaFinal" => "e565" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28867267" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack501426" "titulo" => "Acknowledgements" "texto" => "The authors would like to thank all the patients who agreed to participate in this study, as well as the staff of the clinic and the INBIRS laboratory.This study was funded with a research project grant from the University of Buenos Aires: UBACYT 2014/2017 (project code: 20720130200010BA; principal investigator: Dr. María A. Pando). The University of Buenos Aires had no involvement in the study design, the collection, analysis and interpretation of data, the writing of the report or the decision to submit the article for publication." "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/03257541/0000005200000004/v1_202012180643/S0325754120300237/v1_202012180643/en/main.assets" "Apartado" => array:4 [ "identificador" => "37861" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Microbiología clínica y enfermedades infecciosas" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/03257541/0000005200000004/v1_202012180643/S0325754120300237/v1_202012180643/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0325754120300237?idApp=UINPBA00004N"]

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Original article

Incorporación del test rápido del HIV en una clínica de enfermedades de transmisión sexual en Buenos Aires: aumento dramático en la frecuencia de diagnóstico del HIV

Nicolas Morandoa, María Lucía Gallo Vauletb, Asunta Melgarc, Marcelo Rodríguez Fermepinb, Ricardo Cascoc, María de los Ángeles Pandoa,

Corresponding author

mpando@fmed.uba.ar

Corresponding author.

a CONICET-Universidad de Buenos Aires, Instituto de Investigaciones Biomédicas en Retrovirus y Sida (INBIRS), Paraguay 2155, CABA, Argentina

b Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Departamento de Bioquímica Clínica, Cátedra de Microbiología Clínica, Inmunología y Virología Clínica, Junín 954, CABA, Argentina

c Universidad de Buenos Aires, Hospital de Clínicas “José de San Martín”, Programa de Enfermedades de Transmisión Sexual, Av. Córdoba 2351, CABA, Argentina

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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Introduction</span><p id="par0030" class="elsevierStylePara elsevierViewall">Given the worldwide commitment to end the epidemic by 2030&#44; UNAIDS has set a series of objectives for the year 2020&#58; that 90&#37; of all people living with HIV become aware of their infection&#44; that 90&#37; of those aware of their infection gain access to treatment and that 90&#37; of those on treatment suppress their viral load one year after the infection<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">17</span></a>&#46; This highlights the importance of improved access to diagnosis as the first step in the control of the HIV&#47;AIDS epidemic&#46; However&#44; there still remains much to be done in this area&#44; considering the high frequency of late diagnoses worldwide<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">8&#44;13</span></a>&#46; In this context&#44; rapid HIV tests &#40;RHT&#41; are essential tools to achieve the 90&#8211;90&#8211;90 target due to their proved efficacy in facilitating access to diagnosis<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">10</span></a>&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">In Argentina&#44; HIV prevalence has been estimated to be 0&#46;4&#37; among young people and adults&#46; The epidemic is mostly concentrated in men who have sex with men &#40;MSM&#41; and transgender women&#44; with HIV prevalence rates of 12&#8211;15&#37; and 34&#37;&#44; respectively&#46; Moreover&#44; it has been reported that approximately 37&#46;5&#37; of men and 30&#37; of women receive a late HIV diagnosis<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">2</span></a>&#46; Even when international studies clearly associated RHT introduction with increased HIV testing in several settings&#44; only one research study on the implementation of the RHT has been performed in Argentina<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">5</span></a>&#46; Given the need for local data on the implications of the incorporation of the RHT into the diagnostic algorithms&#44; our goal was to test the effectiveness of a structural intervention&#58; the incorporation of the RHT followed by immediate counseling&#44; diagnosis confirmation and entry to care in a walk-in sexually-transmitted disease &#40;STD&#41; clinic located in a University Hospital <span class="elsevierStyleItalic">&#40;Programa de Enfermedades de Transmisi&#243;n Sexual &#40;PETS&#41;&#44; Hospital de Cl&#237;nicas &#8220;Jos&#233; de San Martin&#8221; Universidad de Buenos Aires</span>&#41;&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Materials and methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Enrollment of participants</span><p id="par0040" class="elsevierStylePara elsevierViewall">A diagnostic algorithm was designed in line with those recommended by the national health ministry<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">1</span></a>&#44; in particular the one-rapid-test screening algorithm&#46; Between March and December 2015 the RHT was offered to all patients attending the STD clinic who met eligibility criteria&#46; Eligible patients were men and women 18 years old or older who attended the clinic regardless of the reason for consultation&#46; During the process of registration each patient was told that the test would be carried out from a finger prick blood sample and that the result would be informed to them directly by the physician during the consultation&#46; Those who manifested interest were given an informed consent for them to read and sign&#44; as well as a survey to complete in order to collect socio-demographical data and information related to sexual behavior&#44; linkage to the healthcare system and previous HIV testing&#46; Upon reading&#44; completing and signing this documentation&#44; they were enrolled in the study and individually led to a room which was especially conditioned for carrying out the test&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Rapid HIV test and delivery of results</span><p id="par0045" class="elsevierStylePara elsevierViewall">The RHT was performed by collecting a blood sample through a finger prick&#44; using the commercial kit Determine&#8482; HIV-1&#47;2 &#40;Alere&#41;&#44; an immunochromatographic test for the qualitative detection of antibodies against HIV-1&#47;2 antigens&#46; The test was carried out according to the manufacturer&#39;s instructions and the results were available within 15<span class="elsevierStyleHsp" style=""></span>minutes These were interpreted by the technician and&#47;or researcher in charge and delivered to the physician for him to read and to show to the patient&#46; In the event of a non-reactive RHT&#44; the physician gave the patient the necessary recommendations based on reported risk factors&#46; In case of reactive RHT&#44; on the other hand&#44; the patient was informed about the need for further confirmatory studies and referred to the INBIRS diagnostic laboratory&#44; which is located in the nearby School of Medicine &#40;Facultad de Medicina&#44; Universidad de Buenos Aires&#41;&#44; approximately 100 meters away from the University Hospital&#46;</p><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">HIV confirmatory studies and delivery of results</span><p id="par0050" class="elsevierStylePara elsevierViewall">A 15<span class="elsevierStyleHsp" style=""></span>ml peripheral blood sample was taken from those individuals with reactive RHT who attended the INBIRS laboratory for confirmatory studies&#44; which included ELISA &#40;Genscreen Ultra HIV Ag-AbBio-rad&#41;&#44; plasma viral load &#40;Abbott Real Time HIV-1 RNA Version 3&#46;0&#41; and CD4<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>T cell count &#40;flow citometry&#41;&#46; The results were sent to the clinic and handed over to the patient by the same physician during a second visit&#46; Patients with confirmed HIV diagnosis were referred to the Infectious Diseases Unit of the University Hospital &#40;<span class="elsevierStyleItalic">Departamento de Infectolog&#237;a&#44; Hospital de Cl&#237;nicas &#8220;Jos&#233; de San Mart&#237;n&#8221;&#44; Universidad de Buenos Aires</span>&#41; in order to be assisted&#46; Patient follow-up was performed by regular reviewing of clinical records for a period of one year following the study period&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Statistical analysis</span><p id="par0055" class="elsevierStylePara elsevierViewall">Fisher&#39;s exact test and Mann&#8211;Whitney <span class="elsevierStyleItalic">U</span> test were used to compare differences in categorical and numerical variables&#44; respectively&#46; All statistical analyses&#44; including calculation of interquartile ranges &#40;IQR&#41; and 95&#37; confidence intervals &#40;95&#37; CI&#41; were carried out using IBM SPSS Statistics Base 22&#46;0 &#40;IBM Corp&#46; Released 2013&#46; IBM SPSS Statistics for Windows&#44; Version 22&#46;0&#46; Armonk&#44; NY&#58; IBM Corp&#46;&#41;&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Ethical aspect</span><p id="par0060" class="elsevierStylePara elsevierViewall">All the procedures were in line with the Declaration of Helsinki &#40;Seoul 2008&#41;&#44; the National Personal Information Protection Law &#40;Law 25326&#41; and followed the recommendations provided by national regulations for research&#46; The protocol of the study&#44; as well as the documentation used &#40;namely&#44; informed consent and survey&#41; were evaluated and approved by the University Hospital Institutional Review Board &#40;IRB&#41; &#40;Comit&#233; de &#201;tica&#44; Hospital de Cl&#237;nicas &#8220;Jos&#233; de San Mart&#237;n&#8221;&#44; Universidad de Buenos Aires&#41;&#46; Informed consent was obtained from all study participants&#46;</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Results</span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Socio-demographic characteristics of the study population</span><p id="par0065" class="elsevierStylePara elsevierViewall">Between March and December 2015&#44; a total of 593 RHT were performed on 547 patients &#40;39 patients were tested twice&#44; six patients three times and one patient four times&#59; there were no duplicate cases among reactive RHT&#41;&#46; Unless otherwise noted&#44; all analyses were performed based on the non-duplicate cases&#46; Considering gender at birth&#44; 76&#46;8&#37; &#40;420&#47;547&#41; of participants were men and 23&#46;2&#37; &#40;127&#47;547&#41; were women&#46; Regarding self-identified gender&#44; most individuals identified themselves as male &#40;75&#46;6&#37;&#44; 403&#47;533&#41;&#44; others as female &#40;22&#46;5&#37;&#44; 120&#47;533&#41; and a small minority as transgender &#40;1&#46;3&#37;&#44; 7&#47;533&#41;&#46; <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> shows all socio-demographic characteristics&#44; stratified by self-identified gender&#46; Briefly&#44; the patients&#8217; median age was 29 years &#40;IQR&#58; 24&#8211;38&#41;&#44; with self-identified males being significantly older than females &#40;males&#58; 29 years old&#44; IQR&#58; 25&#8211;39&#59; females&#58; 27 years old&#44; IQR&#58; 22&#8211;33&#46;75&#59; Mann&#8211;Whitney test&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46; Transgender individuals showed a higher median age &#40;32 years old&#44; IQR&#58; 23&#8211;35&#41;&#46; However&#44; no statistically significant difference could be inferred either with males &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;84&#41; or females &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;42&#41;&#46; Most patients lived in Buenos Aires&#44; the capital city &#40;72&#46;6&#37;&#44; 323&#47;445&#41;&#44; or in the Buenos Aires Province &#40;26&#46;3&#37;&#44; 117&#47;445&#41;&#46; Most individuals &#40;74&#46;5&#37;&#44; 404&#47;542&#41; reported having completed high school education level&#46; Regarding work status&#44; 38&#46;6&#37; &#40;201&#47;521&#41; had a steady job&#44; i&#46;e&#46; with a contract&#44; 29&#46;9&#37; &#40;156&#47;521&#41; had an unsteady job&#44; i&#46;e&#46; without a contract&#44; while the remaining individuals who reported not having a job were unemployed&#44; retired or students&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Previous linkage to care and HIV testing</span><p id="par0070" class="elsevierStylePara elsevierViewall">Regarding linkage to the healthcare system&#44; 73&#46;6&#37; &#40;393&#47;534&#41; of patients reported receiving some kind of medical service during the previous year&#46; Most patients &#40;67&#46;5&#37;&#44; 363&#47;538&#41; had been tested for HIV previously&#44; and 94&#46;5&#37; &#40;294&#47;311&#41; of them reported receiving their results&#46; Probability of having been tested for HIV in the past was higher in patients who reported receiving any kind of medical service during the previous year as opposed to none &#40;71&#46;0&#37; &#40;277&#47;390&#41; vs&#46; 58&#46;6&#46;&#37; &#40;82&#47;140&#41;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;008&#41; and men with reported male partners as opposed to female partners &#40;86&#46;0&#37; &#40;141&#47;164&#41; vs&#46; 60&#46;7&#37; &#40;125&#47;206&#41;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46; Inconsistent condom use was more frequent in patients with no previous HIV test when compared to those previously tested &#40;82&#46;9&#37; &#40;136&#47;164&#41; vs&#46; 71&#46;8&#37; &#40;249&#47;347&#41;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;006&#41;&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Sexual practices and condom use</span><p id="par0075" class="elsevierStylePara elsevierViewall">Regarding sexual practices&#44; 51&#46;3&#37; &#40;210&#47;409&#41; of men reported having sexual relationships only with women in the six months prior to the study&#44; while 40&#46;3&#37; &#40;165&#47;409&#41; reported having had male sexual partners&#46; The remaining men had either both male and female &#40;3&#46;9&#37;&#44; 16&#47;409&#41;&#44; female and trans &#40;0&#46;7&#37;&#44; 3&#47;409&#41;&#44; only trans &#40;0&#46;5&#37;&#44; 2&#47;409&#41; or no sexual partners &#40;3&#46;2&#37;&#44; 13&#47;409&#41;&#46; In the case of women&#44; the vast majority &#40;95&#46;2&#37;&#44; 120&#47;126&#41; reported having had only male sexual partners&#44; while only 2&#46;4&#37; &#40;3&#47;126&#41; claimed to have had no sexual partners during the previous six months&#46; Only a handful of women reported both male and female &#40;1&#46;6&#37;&#44; 2&#47;126&#41; or only female &#40;0&#46;8&#37;&#44; 1&#47;126&#41; sexual partners&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Concerning condom use&#44; only 25&#46;2&#37; &#40;130&#47;516&#41; of participants reported consistent condom use during sexual relationships&#44; while 9&#46;7&#37; &#40;50&#47;516&#41; claimed never to use a condom and the rest reported inconsistent condom use &#40;65&#46;1&#37;&#44; 336&#47;516&#41;&#46; Consistent condom use was more frequent among men than women &#40;29&#46;3&#37; &#40;116&#47;396&#41; vs&#46; 11&#46;7&#37; &#40;14&#47;120&#41;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;0001&#41;&#46; Patients without a previous HIV test also showed a higher frequency of inconsistent condom use &#40;82&#46;9&#37; &#40;136&#47;164&#41; vs&#46; 71&#46;8&#37; &#40;249&#47;347&#41;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;006&#41; when compared with those previously tested&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">HIV prevalence and associated risk factors</span><p id="par0085" class="elsevierStylePara elsevierViewall">According to RHT&#44; HIV prevalence was 6&#46;3&#37; &#40;34&#47;538&#44; 95&#37; CI&#58; 4&#46;2&#8211;8&#46;5&#41;&#44; with a significant higher prevalence in men than in women &#40;7&#46;5&#37; &#40;31&#47;412&#41; vs&#46; 2&#46;4&#37; &#40;3&#47;126&#41;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;04&#41;&#46; Patients who had not been tested for HIV showed a tendency toward a higher HIV prevalence than those who had been tested once &#40;9&#46;1&#37; &#40;16&#47;175&#41; vs&#46; 5&#46;1&#37; &#40;18&#47;354&#41;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;09&#41;&#46; When accounting for sexual partner type&#44; a significant higher HIV prevalence was found among men who had exclusively male partners as opposed to exclusively female partners &#40;15&#46;0&#37; &#40;24&#47;160&#41; vs&#46; 1&#46;9&#37; &#40;4&#47;207&#41;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46; No significant differences in HIV prevalence were observed between participants who reported consistent or inconsistent condom use &#40;8&#46;5&#37; &#40;11&#47;129&#41; vs&#46; 5&#46;8&#37; &#40;22&#47;378&#41;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;30&#41;&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Patient referral and first steps in the cascade of care</span><p id="par0090" class="elsevierStylePara elsevierViewall">All patients with a reactive RHT &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>34&#41; were referred to the laboratory for confirmatory studies&#59; 94&#46;1&#37; &#40;32&#47;34&#41; went to the laboratory&#44; and 87&#46;5&#37; &#40;28&#47;32&#41; came back in order to receive their results&#46; The infection was confirmed in 93&#46;8&#37; &#40;30&#47;32&#41; of patients&#44; yielding two false reactive RHT results&#46; Among HIV positive patients &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>30&#41;&#44; the median CD4<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>T cell count was 441<span class="elsevierStyleHsp" style=""></span>cells&#47;&#956;l &#40;p25&#8211;p75&#44; 288&#8211;608&#41; and the median HIV viral load was 28<span class="elsevierStyleHsp" style=""></span>764 RNA copies&#47;ml &#40;p25&#8211;p75&#44; 4446&#8211;59<span class="elsevierStyleHsp" style=""></span>177&#41;&#46; The two cases classified as false positives were confirmed as HIV negative according to plasma viral load&#44; fourth-generation ELISA and immunological parameters&#46; Of the 30 confirmed HIV-positive individuals&#44; we were able to do follow-up 13 of them&#44; i&#46;e&#46; 43&#46;3&#37;&#46; Among these&#44; 69&#46;2&#37; &#40;9&#47;13&#41; repeated the laboratory tests&#44; namely CD4<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>T cell count and plasma HIV viral load&#44; and 76&#46;9&#37; &#40;10&#47;13&#41; initiated treatment&#46; Among those who repeated the tests&#44; 55&#46;6&#37; &#40;5&#47;9&#41; managed to suppress their viral load during the course of the follow-up period&#46; Regardless of the presence or absence of viral suppression&#44; all patients&#44; except for one patient&#44; had a lower viral load by the time of the final examination&#44; which took place 4&#8211;14 months after the base-line test&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Influence of rapid testing on frequency of HIV diagnosis</span><p id="par0095" class="elsevierStylePara elsevierViewall">To evaluate the impact of the incorporation of the RHT on the frequency of patients who agreed to be tested for HIV&#44; we compared the frequency of the previous year performed by the conventional methodology &#40;referral to laboratory&#44; peripheral blood collection&#44; laboratory analyses &#40;ELISA&#44; Western Blot&#41; and delivery of results within 15 days&#41; with the frequency of patients tested by RHT in our study&#46; In the year prior to the study&#44; 6&#46;9&#37; &#40;210&#47;3060&#41; of the patients who attended the clinic agreed to be tested&#44; while this frequency rose to 31&#46;4&#37; &#40;593&#47;1887&#41; during the study period &#40;<span class="elsevierStyleItalic">p</span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#40;this includes duplicate cases&#41;&#46; We also observed a slight increment in the reception of confirmatory results from 76&#46;2&#37; &#40;160&#47;210&#41; to 87&#46;5&#37; &#40;28&#47;32&#41; &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;6746&#41;&#46;</p></span></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Discussion</span><p id="par0100" class="elsevierStylePara elsevierViewall">This study reveals for the first time in Argentina how the incorporation of the RHT in the diagnostic algorithm can cause a dramatic increase in the frequency of HIV diagnosis &#40;almost fivefold&#41; as observed in the comparison between the results of the present study and the period prior to the study&#44; i&#46;e&#46; with and without the use of the RHT&#46; This is consistent with previous studies performed in other countries comparing the uptake of HIV&#47;AIDS services using RHT and conventional testing&#44; where the implementation of RHT was associated with a threefold increase in the frequency of diagnosis<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">14&#44;18</span></a>&#46; Even when the use of RHT significantly increases the rate of HIV diagnosis&#44; the frequency &#40;&#8773;30&#37;&#41; is still lower than that reported previously in other studies where acceptability of rapid tests ranged from 45&#37; to 95&#37;&#46; However&#44; uptake of RHT depended on the venue where testing was offered as well as the risk group to which clients belonged&#44; for example&#44; acceptability has been reported to be higher in pregnant women and lower among clients of sex workers &#40;45&#37;&#41;&#44; black university students tested on campus &#40;50&#37;&#41; and African and Caribbean clients in family practice &#40;45&#37;&#41;<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">3&#44;12&#44;15</span></a>&#46; Low RHT acceptability among some populations may be related to the fact that they did not expect to be offered a test or do not perceive themselves to be at risk for HIV&#46; Due to the fact that at the time of the study it was not very common to find RHT offer in medical services&#59; the poor acceptability can be related to the issues mentioned&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">This rapid HIV testing approach not only effectively increased the number of individuals tested but also reached individuals at risk for HIV&#44; as can be seen by the high HIV prevalence detected&#46; This was found to be almost 6&#37;&#44; which is considerably higher than that of the general population &#40;below 1&#37;&#41;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">2</span></a>&#46; The reason for this might lie in the fact that the individuals included in this study are already seeking medical attention for STD-related &#8211; real or suspected &#8211; problems&#44; thus one could expect to find a higher-than-average prevalence of STDs in general&#44; including HIV&#46; We also found that HIV positive individuals reached in this study have a median CD4<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>T cell count below 500<span class="elsevierStyleHsp" style=""></span>cells&#47;&#956;l&#44; which suggests late HIV diagnosis&#46; This result is of great importance considering the evidence that indicate that immediate antiretroviral therapy&#44; with CD4<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>T cells count over 500<span class="elsevierStyleHsp" style=""></span>cells&#47;ml&#44; can reduce disease progression&#44; improving the likelihood of immunologic recovery while also increasing the percentage of individuals who achieve viral suppression<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">7&#44;16</span></a>&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Our findings underscore the importance of increasing the rate of HIV diagnosis by improving patient linkage to the healthcare system&#46; One in four patients had had no contact with any health service for over a year and HIV testing was significantly less frequent among them&#44; which is consistent with previous studies<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">4&#44;6&#44;11</span></a>&#46; This association between linkage to healthcare system and HIV testing highlights the importance of interventions to bring individuals to clinics&#47;hospitals and identify opportunities for rapid HIV testing in these environments&#46; The model tested in this study could be applied in other clinics with similar characteristics&#44; as long as it does not involve additional time for the patient or moving to another place to be tested&#46; From this finding&#44; it would be pertinent to recommend including the RHT in STDs clinics&#46; To achieve this&#44; it would be imperative to have minimal requirements like funding&#44; room&#44; and trained personnel&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">It has been previously reported that rapid testing reduces waiting times for the patient&#44; favoring linkage and retention in care<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">9</span></a>&#46; Accordingly&#44; our approach to the first steps of the cascade of care with RHT shows encouraging outcomes&#44; with high retention rates &#40;around 90&#37;&#41;&#46; However&#44; our study has certain limitations that need to be addressed&#46; Our experimental design only allowed us to closely follow the first few steps of the care cascade &#8211; further inquiry is necessary to determine if the beneficial effect observed applies to the entire chain&#44; from testing to treatment and viral suppression&#46; Finally&#44; a higher sample size might have enabled us to examine socio-demographics and conduct differences between other&#44; less frequent populations&#44; such as trans&#44; which here were only found in very low numbers&#46; New studies aimed at applying the implementation of HIV diagnosis via rapid testing would strongly benefit from these additions&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Conclusions</span><p id="par0120" class="elsevierStylePara elsevierViewall">In conclusion&#44; results obtained in this study confirm those of previous interventions performed in other countries and highlight the importance of facilitating patient access to diagnosis and retention within the healthcare system&#46; The incorporation of the RHT resulted in a high retention of patients and an increase in both the frequency of diagnosis and results withdrawal when compared to the conventional methodology&#46; Other notable achievements of the study in this respect include the successful incorporation of RHT in a walk-in clinic&#44; with high acceptance and efficacy&#46; Last but not least&#44; the testing methodology employed&#44; based on the open offer of the RHT without disrupting the normal circuit of the clinic&#44; is potentially applicable to various other clinical settings with similar features&#46;</p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Conflict of interest</span><p id="par0125" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
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          "titulo" => "Introduction"
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          "titulo" => "Materials and methods"
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            0 => array:2 [
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              "titulo" => "Rapid HIV test and delivery of results"
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          "titulo" => "Results"
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              "titulo" => "Socio-demographic characteristics of the study population"
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            1 => array:2 [
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              "titulo" => "Previous linkage to care and HIV testing"
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            2 => array:2 [
              "identificador" => "sec0055"
              "titulo" => "Sexual practices and condom use"
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            3 => array:2 [
              "identificador" => "sec0060"
              "titulo" => "HIV prevalence and associated risk factors"
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            4 => array:2 [
              "identificador" => "sec0065"
              "titulo" => "Patient referral and first steps in the cascade of care"
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            5 => array:2 [
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              "titulo" => "Influence of rapid testing on frequency of HIV diagnosis"
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        11 => array:2 [
          "identificador" => "xack501426"
          "titulo" => "Acknowledgements"
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        12 => array:1 [
          "titulo" => "References"
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    "fechaRecibido" => "2019-09-16"
    "fechaAceptado" => "2019-12-10"
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        0 => array:4 [
          "clase" => "keyword"
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            0 => "<span class="elsevierStyleItalic">Human immunodeficiency virus</span>"
            1 => "Rapid test"
            2 => "Linkage to care"
            3 => "Diagnosis"
            4 => "90&#8211;90&#8211;90"
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            0 => "<span class="elsevierStyleItalic">Human immunodeficiency virus</span>"
            1 => "Test r&#225;pido"
            2 => "Vinculaci&#243;n al sistema de salud"
            3 => "Diagn&#243;stico"
            4 => "90&#8211;90&#8211;90"
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    "highlights" => array:2 [
      "titulo" => "Highlights"
      "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall"><ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">&#8226;</span><p id="par0005" class="elsevierStylePara elsevierViewall">The use of the RHT significantly increased the frequency of HIV diagnosis&#46;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">&#8226;</span><p id="par0010" class="elsevierStylePara elsevierViewall">Approximately one of three individuals had never tested for HIV previously&#46;</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">&#8226;</span><p id="par0015" class="elsevierStylePara elsevierViewall">No access to medical care and irregular condom use associated with no HIV testing&#46;</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">&#8226;</span><p id="par0020" class="elsevierStylePara elsevierViewall">Tendency toward a higher HIV prevalence in patients with no prior HIV testing&#46;</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">&#8226;</span><p id="par0025" class="elsevierStylePara elsevierViewall">Use of RHT slightly incremented the receipt of confirmatory results&#46;</p></li></ul></p></span>"
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    "resumen" => array:2 [
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Improving access to diagnosis constitutes a key step in the control of the <span class="elsevierStyleItalic">Human immunodeficiency virus</span> &#40;HIV&#41;&#47;AIDS epidemic&#46; Rapid testing is increasingly gaining interest as a powerful diagnostic tool to achieve this goal&#46; The purpose of this study was to implement the rapid HIV test &#40;RHT&#41; in a clinical setting in order to evaluate its effectiveness in increasing HIV diagnosis and patient linkage to the healthcare system&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The RHT was offered to all patients attending a sexually-transmitted disease clinic in the City of Buenos Aires between March and December 2015&#46; A total of 593 RHT were performed&#46; The implementation of the RHT yielded an increase in frequency of diagnosis from 6&#46;9&#37; to 31&#46;4&#37; &#40;<span class="elsevierStyleItalic">p<span class="elsevierStyleHsp" style=""></span></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46; The first steps of the care cascade showed high retention rates around 90&#37;&#46; RHT yielded an HIV prevalence of 6&#46;3&#37; &#40;95&#37; CI&#58; 4&#46;2&#8211;8&#46;5&#41; in this population&#46; HIV prevalence tended to be higher in individuals with no previous HIV testing &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;09&#41;&#46; Linkage to the healthcare system was associated with a higher probability of having been tested for HIV &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;008&#41;&#46; The incorporation of the RHT resulted in a high retention of patients and an increase in both frequency of diagnosis and results reception when compared to the classic methodology&#46;</p></span>"
      ]
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0015" class="elsevierStyleSection elsevierViewall"><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">El mejoramiento del acceso al diagn&#243;stico constituye un punto clave en el control de la epidemia del virus de la inmunodeficiencia humana &#40;<span class="elsevierStyleItalic">Human immunodeficiency virus&#58;</span> HIV&#41;&#47;sida&#46; El testeo r&#225;pido se ha convertido en una poderosa herramienta diagn&#243;stica de inter&#233;s para alcanzar este objetivo&#46; El prop&#243;sito de este estudio fue la implementaci&#243;n del test r&#225;pido del HIV &#40;TRH&#41; en un contexto cl&#237;nico con el fin de evaluar su efectividad para incrementar la tasa de diagn&#243;stico de HIV y la vinculaci&#243;n de los pacientes al sistema de salud&#46; Se ofreci&#243; el TRH a todos los pacientes que acudieron a una cl&#237;nica de enfermedades de transmisi&#243;n sexual en la Ciudad Aut&#243;noma de Buenos Aires entre marzo y diciembre del 2015&#46; Se realizaron un total de 593 TRH&#46; La implementaci&#243;n del TRH result&#243; en un aumento en la frecuencia de diagn&#243;stico del 6&#44;9 al 31&#44;4&#37; &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; Los primeros pasos en la cascada de cuidados mostraron altas tasas de retenci&#243;n alrededor del 90&#37;&#46; La prevalencia del HIV seg&#250;n TRH en la poblaci&#243;n de estudio fue del 6&#44;3&#37; &#40;IC 95&#37;&#58; 4&#44;2-8&#44;5&#41;&#44; tendiendo a ser mayor en individuos sin testeo previo de HIV &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;09&#41;&#46; La vinculaci&#243;n al sistema de salud se asoci&#243; a una mayor probabilidad de haber sido testeado previamente para HIV &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;008&#41;&#46; La incorporaci&#243;n del TRH result&#243; en una mayor retenci&#243;n de los pacientes&#44; as&#237; como en un aumento tanto en la frecuencia de diagn&#243;stico como en la de retiro de resultados&#44; en comparaci&#243;n con la metodolog&#237;a cl&#225;sica&#46;</p></span>"
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                  \t\t\t\t"><span class="elsevierStyleItalic">Median age &#40;IQR&#41;</span>&#42;&#42;<span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39&#46;3&#37; &#40;153&#47;389&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35&#46;7&#37; &#40;41&#47;115&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&#46;0&#37; &#40;1&#47;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Unsteady job without contract&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29&#46;9&#37; &#40;156&#47;521&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&#46;8&#37; &#40;120&#47;389&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&#46;2&#37; &#40;29&#47;115&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">60&#46;0&#37; &#40;3&#47;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Other&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31&#46;5&#37; &#40;164&#47;521&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29&#46;8&#37; &#40;116&#47;389&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39&#46;1&#37; &#40;45&#47;115&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&#46;0&#37; &#40;1&#47;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Student</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#46;6&#37; &#40;71&#47;521&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#46;9&#37; &#40;54&#47;388&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#46;9&#37; &#40;15&#47;116&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&#46;0&#37; &#40;1&#47;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">86&#46;4&#37; &#40;450&#47;521&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">86&#46;1&#37; &#40;334&#47;388&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">87&#46;1&#37; &#40;101&#47;116&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">80&#46;0&#37; &#40;4&#47;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Last visit to a doctor</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#60;1 year&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73&#46;6&#37; &#40;393&#47;534&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">74&#46;1&#37; &#40;295&#47;398&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73&#46;7&#37; &#40;87&#47;118&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">71&#46;4&#37; &#40;5&#47;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#62;1 year&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&#46;7&#37; &#40;116&#47;534&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&#46;4&#37; &#40;85&#47;398&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#46;0&#37; &#40;26&#47;118&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&#46;3&#37; &#40;1&#47;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Does not know&#47;remember&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;7&#37; &#40;25&#47;534&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;5&#37; &#40;18&#47;398&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;2&#37; &#40;5&#47;118&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&#46;3&#37; &#40;1&#47;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Previous HIV test</span>&#42;</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">67&#46;5&#37; &#40;363&#47;538&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">70&#46;2&#37; &#40;280&#47;399&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">57&#46;1&#37; &#40;68&#47;119&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">85&#46;7&#37; &#40;6&#47;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32&#46;5&#37; &#40;175&#47;538&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29&#46;8&#37; &#40;119&#47;399&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42&#46;9&#37; &#40;51&#47;119&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&#46;3&#37; &#40;1&#47;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Sex partners in the last six months</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Male&#42;&#42;&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">56&#46;5&#37; &#40;293&#47;519&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">46&#46;9&#37; &#40;179&#47;382&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">90&#46;8&#37; &#40;108&#47;119&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">85&#46;7&#37; &#40;6&#47;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Female&#42;&#42;&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">43&#46;7&#37; &#40;227&#47;519&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">57&#46;1&#37; &#40;218&#47;382&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#46;6&#37; &#40;9&#47;119&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                      "Revista" => array:6 [
                        "tituloSerie" => "AIDS"
                        "fecha" => "2013"
                        "volumen" => "27"
                        "paginaInicial" => "1687"
                        "paginaFinal" => "1695"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23807269"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
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            10 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "11"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Social&#44; behavioral&#44; and health care factors associated with recent HIV testing among sexually active non-Hispanic Black Women in the United States"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46; Nearns"
                            1 => "J&#46;A&#46; Baldwin"
                            2 => "H&#46; Clayton"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Womens Health Issues"
                        "fecha" => "2009"
                        "volumen" => "19"
                        "paginaInicial" => "52"
                        "paginaFinal" => "60"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Rapid point-of-care HIV testing in pregnant women&#58; a systematic review and meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "N&#46;P&#46; Pai"
                            1 => "J&#46;P&#46; Tulsky"
                            2 => "D&#46; Cohan"
                            3 => "J&#46;M&#46; Colford Jr&#46;"
                            4 => "A&#46;L&#46; Reingold"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1365-3156.2006.01812.x"
                      "Revista" => array:7 [
                        "tituloSerie" => "Trop Med Int Health"
                        "fecha" => "2007"
                        "volumen" => "12"
                        "paginaInicial" => "162"
                        "paginaFinal" => "173"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17300622"
                            "web" => "Medline"
                          ]
                        ]
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                          "pii" => "S014067361161177X"
                          "estado" => "S300"
                          "issn" => "01406736"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The HIV care continuum in Latin America&#58; challenges and opportunities"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:7 [
                            0 => "A&#46; Pi&#241;eir&#250;a"
                            1 => "J&#46; Sierra-Madero"
                            2 => "P&#46; Cahn"
                            3 => "R&#46;N&#46; Guevara Palmero"
                            4 => "E&#46; Mart&#237;nez Buitrago"
                            5 => "B&#46; Young"
                            6 => "C&#46; Del Rio"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S1473-3099(15)00108-5"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet Infect Dis"
                        "fecha" => "2015"
                        "volumen" => "15"
                        "paginaInicial" => "833"
                        "paginaFinal" => "839"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26122456"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0160"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effect of rapid HIV testing on HIV incidence and services in populations at high risk for HIV exposure&#58; an equity-focused systematic review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:7 [
                            0 => "K&#46; Pottie"
                            1 => "O&#46; Medu"
                            2 => "V&#46; Welch"
                            3 => "G&#46;P&#46; Dahal"
                            4 => "M&#46; Tyndall"
                            5 => "T&#46; Rader"
                            6 => "G&#46; Wells"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/bmjopen-2014-006859"
                      "Revista" => array:5 [
                        "tituloSerie" => "BMJ Open"
                        "fecha" => "2014"
                        "volumen" => "4"
                        "paginaInicial" => "e006859"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25510889"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0165"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Feasibility and acceptability of offering rapid HIV tests to patients registering with primary care in London &#40;UK&#41;&#58; a pilot study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46; Prost"
                            1 => "C&#46;J&#46; Griffiths"
                            2 => "J&#46; Anderson"
                            3 => "D&#46; Wight"
                            4 => "G&#46;J&#46; Hart"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/sti.2008.033233"
                      "Revista" => array:6 [
                        "tituloSerie" => "Sex Transm Infect"
                        "fecha" => "2009"
                        "volumen" => "85"
                        "paginaInicial" => "326"
                        "paginaFinal" => "329"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19487214"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0170"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "From CD4-based initiation to treating all HIV-infected adults immediately&#58; an evidence-based meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:14 [
                            0 => "A&#46; Song"
                            1 => "X&#46; Liu"
                            2 => "X&#46; Huang"
                            3 => "K&#46; Meyers"
                            4 => "D&#46;Y&#46; Oh"
                            5 => "J&#46; Hou"
                            6 => "W&#46; Xia"
                            7 => "B&#46; Su"
                            8 => "N&#46; Wang"
                            9 => "X&#46; Lu"
                            10 => "H&#46; Xia"
                            11 => "X&#46; Yang"
                            12 => "H&#46; Chen"
                            13 => "H&#46; Wu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3389/fimmu.2018.00212"
                      "Revista" => array:5 [
                        "tituloSerie" => "Front Immunol"
                        "fecha" => "2018"
                        "volumen" => "9"
                        "paginaInicial" => "212"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29487595"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0175"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "UNAIDS&#46; 90-90-90 an ambitious treatment target to help end the AIDS epidemic &#91;online&#93;&#46; <a target="_blank" href="http://www.unaids.org/sites/default/files/media_asset/90-90-90_en_0.pdf">http&#58;&#47;&#47;www&#46;unaids&#46;org&#47;sites&#47;default&#47;files&#47;media&#95;asset&#47;90-90-90&#95;en&#95;0&#46;pdf</a> &#91;accessed 10&#46;10&#46;17&#93;&#46;"
                ]
              ]
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Testing and linkage to HIV care in China&#58; a cluster-randomised trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:29 [
                            0 => "Z&#46; Wu"
                            1 => "Z&#46; Tang"
                            2 => "Y&#46; Mao"
                            3 => "P&#46; Van Veldhuisen"
                            4 => "W&#46; Ling"
                            5 => "D&#46; Liu"
                            6 => "Z&#46; Shen"
                            7 => "R&#46; Detels"
                            8 => "G&#46; Lan"
                            9 => "L&#46; Erinoff"
                            10 => "R&#46; Lindblad"
                            11 => "D&#46; Gu"
                            12 => "H&#46; Tang"
                            13 => "L&#46; Hu"
                            14 => "Q&#46; Zhu"
                            15 => "L&#46; Lu"
                            16 => "N&#46; Oden"
                            17 => "A&#46;L&#46; Hasson"
                            18 => "Y&#46; Zhao"
                            19 => "J&#46;M&#46; McGoogan"
                            20 => "X&#46; Ge"
                            21 => "N&#46; Zhang"
                            22 => "K&#46; Rou"
                            23 => "J&#46; Zhu"
                            24 => "H&#46; Wei"
                            25 => "C&#46;X&#46; Shi"
                            26 => "X&#46; Jin"
                            27 => "J&#46; Li"
                            28 => "J&#46;S&#46;G&#46; Montaner"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S2352-3018(17)30131-5"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet HIV"
                        "fecha" => "2017"
                        "volumen" => "4"
                        "paginaInicial" => "e555"
                        "paginaFinal" => "e565"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28867267"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
                  ]
                ]
              ]
            ]
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        "texto" => "<p id="par0130" class="elsevierStylePara elsevierViewall">The authors would like to thank all the patients who agreed to participate in this study&#44; as well as the staff of the clinic and the INBIRS laboratory&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">This study was funded with a research project grant from the <span class="elsevierStyleGrantSponsor" id="gs1">University of Buenos Aires</span>&#58; <span class="elsevierStyleGrantNumber" refid="gs1">UBACYT 2014&#47;2017</span> &#40;project code&#58; 20720130200010BA&#59; principal investigator&#58; Dr&#46; Mar&#237;a A&#46; Pando&#41;&#46; The University of Buenos Aires had no involvement in the study design&#44; the collection&#44; analysis and interpretation of data&#44; the writing of the report or the decision to submit the article for publication&#46;</p>"
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Article information

ISSN: 03257541
Original language: English

DOI:10.1016/j.ram.2019.12.004

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Year/Month	Html	Pdf	Total

2024 November	6	2	8
2024 October	33	8	41
2024 September	43	4	47
2024 August	33	4	37
2024 July	21	5	26
2024 June	21	8	29
2024 May	23	6	29
2024 April	30	11	41
2024 March	50	9	59
2024 February	17	4	21
2024 January	33	8	41
2023 December	18	11	29
2023 November	39	12	51
2023 October	40	7	47
2023 September	18	2	20
2023 August	32	11	43
2023 July	20	5	25
2023 June	24	7	31
2023 May	37	8	45
2023 April	21	3	24
2023 March	37	6	43
2023 February	22	10	32
2023 January	29	5	34
2022 December	29	6	35
2022 November	31	12	43
2022 October	26	12	38
2022 September	24	7	31
2022 August	37	12	49
2022 July	25	8	33
2022 June	25	11	36
2022 May	23	12	35
2022 April	23	17	40
2022 March	27	11	38
2022 February	21	12	33
2022 January	25	10	35
2021 December	23	19	42
2021 November	16	12	28
2021 October	57	18	75
2021 September	56	15	71
2021 August	20	5	25
2021 July	12	14	26
2021 June	19	8	27
2021 May	21	12	33
2021 April	39	41	80
2021 March	33	33	66
2021 February	30	23	53
2021 January	25	58	83
2020 December	14	22	36
2020 November	15	23	38
2020 October	12	17	29
2020 September	16	7	23
2020 August	17	10	27
2020 July	9	10	19
2020 June	8	11	19
2020 May	10	14	24
2020 April	12	11	23

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