title: Screening for acute HIV infections and estimating HIV incidence among female sex workers from low-grade venues in Guangxi, China.
abstract: BACKGROUND
  Guangxi has become one of the provinces with the most severe HIV-1 epidemic in China, where heterosexual contact is the dominant transmission route. However, data of acute HIV infections and HIV incidence among female sex workers (FSWs) from low-grade venues are scant.
  
  
  METHODS
  A cross-sectional survey was performed among FSWs from low-grade venues in Guangxi. HIV antibody screening was performed by rapid testing (RT). HIV antibody-negative specimens were screened by pooled nucleic acid amplification testing (NAAT) for acute HIV infections. HIV antibody-positive specimens were further analyzed by Western blot (WB), followed by an HIV-1 BED capture enzyme immunoassay (BED-CEIA) to identify the recent infections. HIV-1 incidence was estimated by the data of pooled NAAT and BED-CEIA, respectively.
  
  
  RESULTS
  A total of 7936 FSWs were recruited and answered the questionnaires. We successfully collected the blood samples from 6469 (81.5%) participants, of which 139 (2.1%) were HIV antibody-positive and 6330 (97.9%) were HIV antibody-negative by RT. With pooled NAAT, 7 cases were found to be HIV RNA positive, representing an additional 5.0% of HIV-infected persons and an estimated HIV incidence of 1.45 (95% CI: 1.17-1.76) per 100 person years. There were 137 positive and 2 indeterminate by WB, of which 124 (90.5%) positive specimens were subjected to BED-CEIA testing identifying 28 recent infections. The HIV incidence determined by BED-CEIA testing was 1.04 (95% CI: 0.65-1.43) per 100 person years. The overall prevalence of HIV among FSWs from low-grade venues in Guangxi was 2.2% (95% CI: 1.9-2.6).
  
  
  CONCLUSIONS
  We found that the addition of HIV RNA screening to routine HIV antibody testing significantly improved the detection of HIV infection among FSWs from low-grade venues in Guangxi. Our findings also provided the useful baseline data of HIV incidence among this population for targeting local HIV prevention, intervention, monitoring and treatment.
authors.affiliation: Guangxi Central Laboratory of HIV/AIDS Confirmation, Institute of HIV/AIDS Prevention and Control, Guangxi Center for Disease Control and Prevention, Nanning, China.
authors.forename: Jianjun
authors.initials: J
authors.lastname: Li
authors.affiliation: Guangxi Central Laboratory of HIV/AIDS Confirmation, Institute of HIV/AIDS Prevention and Control, Guangxi Center for Disease Control and Prevention, Nanning, China.
authors.forename: Hongman
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Institute of HIV/AIDS Prevention and Control, Guangxi Center for Disease Control and Prevention, Nanning, China.
authors.forename: Zhiyong
authors.initials: Z
authors.lastname: Shen
authors.affiliation: Institute of HIV/AIDS Prevention and Control, Guangxi Center for Disease Control and Prevention, Nanning, China.
authors.forename: Yuejiao
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: Guangxi Central Laboratory of HIV/AIDS Confirmation, Institute of HIV/AIDS Prevention and Control, Guangxi Center for Disease Control and Prevention, Nanning, China.
authors.forename: Ningye
authors.initials: N
authors.lastname: Fang
authors.affiliation: Guangxi Central Laboratory of HIV/AIDS Confirmation, Institute of HIV/AIDS Prevention and Control, Guangxi Center for Disease Control and Prevention, Nanning, China.
authors.forename: Lu
authors.initials: L
authors.lastname: Wang
authors.affiliation: Guangxi Central Laboratory of HIV/AIDS Confirmation, Institute of HIV/AIDS Prevention and Control, Guangxi Center for Disease Control and Prevention, Nanning, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Wang
authors.affiliation: Guangxi Central Laboratory of HIV/AIDS Confirmation, Institute of HIV/AIDS Prevention and Control, Guangxi Center for Disease Control and Prevention, Nanning, China.
authors.forename: Jiangwei
authors.initials: J
authors.lastname: Wang
authors.affiliation: Guangxi Center for Disease Control and Prevention, Nanning, China.
authors.forename: Zhenzhu
authors.initials: Z
authors.lastname: Tang
mesh_terms: D000328:Adult; D002681:China; D003430:Cross-Sectional Studies; D005260:Female; D015483:HIV Antibodies / Q000097:blood; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D021141:Nucleic Acid Amplification Techniques; D012367:RNA, Viral / Q000032:analysis; D060386:Sex Workers; D055815:Young Adult
chemical_list: D015483:HIV Antibodies; D012367:RNA, Viral