Out-of-Hospital screening for HIV, HBV, HCV and Syphilis in a vulnerable population, a public health challenge.
We explored rates of Hepatitis B virus (HBV), Human Immunodeficiency Virus, Hepatitis C virus and Syphilis in a vulnerable population (mostly intravenous drug users, sex workers and homeless people) and focused on factors associated with failure to return for results (FTR) and with having a false perception (FP) of Immunization against HBV. We performed a prospective multicenter observational study in nine mobile (Out-of-Hospital) areas of screening located in Paris from 1 January 2014 through 31 December 2014. A total of 341 patients were recruited. The proportion of FTR for results was 38.75%. In multivariate analysis, unemployment was significantly associated with FTR (OR = 4.29; IC = [1.12; 16.39]), as well as having been screened in the past (OR = 4.32, IC = [1.70; 10.97]); 18.03% of patients had a FP of an Immunization against HBV. In multivariate analysis, having one's own place of residence protected against FP (OR = 0.33, [0.12; 0.95]), while being screened in the past enhanced the risk of FP (OR = 3.28, IC = [1.06; 10.11]). The rate of FTR is a problem and use of currently available technologies, such as phone texting, might be a partial solution in conjunction with rapid tests for diagnosis. In addition, more information and comprehension of the results should be provided together with specific anti-HBV vaccination campaigns targeting these specific populations.
a Public Health Department AP-HP , Saint-Louis - Lariboisiere Fernand-Widal Hospital Group , Paris , France.|b Center for Free and Anonymous Screening of HIV, Hepatitis and Sexually Transmitted Diseases , Saint-Louis - Lariboisiere Fernand-Widal Hospital Group , Paris , France.
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C
Legoupil
c Aremedia, Association for Prevention and Harm Reduction (Drug Use and Sexual Activity) , Paris , France.
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A
Peltier
c Aremedia, Association for Prevention and Harm Reduction (Drug Use and Sexual Activity) , Paris , France.
V
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Henry Kagan
a Public Health Department AP-HP , Saint-Louis - Lariboisiere Fernand-Widal Hospital Group , Paris , France.|b Center for Free and Anonymous Screening of HIV, Hepatitis and Sexually Transmitted Diseases , Saint-Louis - Lariboisiere Fernand-Widal Hospital Group , Paris , France.
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C
Segouin
d Clinical Epidemiology Department, AP-HP , Robert Debre Hospital , Paris , France.|e INSERM, U 1123 and CIC-EC 1426, ECEVE , Paris , France.|f Epidémiologie clinique-évaluation économique appliqué aux populations vulnérables, University Paris Diderot , Paris , France.
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C
Alberti
c Aremedia, Association for Prevention and Harm Reduction (Drug Use and Sexual Activity) , Paris , France.
Luc
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de Massé
b Center for Free and Anonymous Screening of HIV, Hepatitis and Sexually Transmitted Diseases , Saint-Louis - Lariboisiere Fernand-Widal Hospital Group , Paris , France.|c Aremedia, Association for Prevention and Harm Reduction (Drug Use and Sexual Activity) , Paris , France.
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M
Shelly
a Public Health Department AP-HP , Saint-Louis - Lariboisiere Fernand-Widal Hospital Group , Paris , France.|b Center for Free and Anonymous Screening of HIV, Hepatitis and Sexually Transmitted Diseases , Saint-Louis - Lariboisiere Fernand-Widal Hospital Group , Paris , France.
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E
Krastinova
D000328:Adult; D000553:Ambulatory Care; D001294:Attitude to Health; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000523:psychology; D006509:Hepatitis B / Q000453:epidemiology* / Q000517:prevention & control / Q000523:psychology; D017325:Hepatitis B Vaccines / Q000008:administration & dosage*; D006526:Hepatitis C / Q000453:epidemiology* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009098:Multiphasic Screening / Q000458:organization & administration* / Q000523:psychology; D010297:Paris; D010352:Patient Dropouts / Q000523:psychology* / Q000706:statistics & numerical data*; D015995:Prevalence; D011446:Prospective Studies; D011634:Public Health / Q000706:statistics & numerical data*; D013587:Syphilis / Q000453:epidemiology* / Q000523:psychology; D035862:Vulnerable Populations / Q000706:statistics & numerical data*
D017325:Hepatitis B Vaccines
AIDS; STD; hepatitis; public health; screening