Self-Reported HIV-Positive Status but Subsequent HIV-Negative Test Results in Population-Based HIV Impact Assessment (PHIA) Survey Participants – 11 Sub-Saharan African Countries, 2015-2017
- The Population-Based HIV Impact Assessment (PHIA) surveys are nationally representative, household-based surveys funded by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). During 2015–2017, 11 PHIA surveys were conducted in Cameroon, Cote d’Ivoire, Ethiopia, Lesotho, Malawi, Namibia, Eswatini, Tanzania, Uganda, Zambia, and Zimbabwe. Structured household and individual questionnaires were used to collect data on demographic characteristics, and self-reported testing and treatment history. The surveys also included home-based HIV testing and counseling using each country’s national HIV rapid testing algorithm.
- Our study found that a small proportion of survey participants reported being HIV-positive when they were actually HIV-negative; however, extrapolation across the 11 PHIA countries suggests that approximately 73,000 people could have been potentially misclassified as HIV-positive and nearly 29,000 people may have inappropriately started antiretroviral therapy (ART).
- Understanding factors contributing to false HIV positive results are important given the significant medical, emotional and financial costs of inaccurate HIV test results. Preventing and addressing HIV misdiagnoses is key as countries work to scale up HIV testing efforts and start people who are HIV-positive on ART immediately after diagnosis.
“The issue of HIV misdiagnosis became apparent when we identified people who told us they were HIV-positive but then tested HIV-negative during our survey’s household field testing. We decided to investigate the extent of the problem further using combined data from 11 countries. Considering the stigma and discrimination that can accompany an HIV-positive diagnosis and resources needed to care for people who are HIV-positive, our study underscores the importance of quality assurance in testing and clear messaging about HIV test results.”
– Naeemah Logan, MD, EIS Class of 2017
CDC Media Relations
Naeemah Logan, MD,
EIS Class of 2017
CDC Center for Global Health
Division of Global HIV and Tuberculosis
Education: MD: University of California, Los Angeles, 2011
BA: Cornell University, 2002
Resident(IM): Providence Portland Internal Medicine Residency,Portland, Oregon, 2012-2015
Work Experience: Physician, Primary Care, Alliance Medical Center, Windsor, California, 2016-2017
Lead Residential Aide, The Arc of Centre County, State College, Pennsylvania, 2004-2005
Library Assistant/Epidemiology and Public Health Library, Yale School of Public Health, New Haven, CT, 2003-2004
Student Aide/Mentor, Cornell University/Undergraduate Biology Center, Ithaca, New York, 2001-2002
Student Assistant, Cornell University/ College of Arts and Sciences, Ithaca, New York, 1999-2002
Notetaker, Cornell University/ TakeNote- Student Agencies, Inc., Ithaca, NY, 2000-2002