title: Informing efforts to reach UNAIDS' 90-90-90 targets: a comparison of characteristics of people diagnosed with HIV in health facilities to the general population of people living with HIV in Mozambique.
abstract: Global targets aim to increase the number of people living with HIV (PLWH) who know their status. Using data from Mozambican facility-based HIV testing and counseling (HTC) and a population-based survey, we compared characteristics of PLWH diagnosed in HTC to the general population of PLWH to identify subgroups that are missing from the health system and may be undiagnosed. Male and female PLWH aged 50+ (PPR = 0.47, p = .0001) and with higher HIV knowledge (PPR = 0.52, p = .004) were underrepresented in HTC. A higher proportion of patients diagnosed in health facilities were aged 25-39 (PPR = 1.23, p = .02). Female PLWH with lower economic (PPR = 0.70, p = .04) and educational status (PPR = 0.86, p = .02) and male PLWH aged 18-24 (PPR = 0.47, p = .03) were underrepresented in HTC. Comparing HTC data to population-based data can inform efforts to increase HIV diagnoses and to ensure that all PLWH know their status.
authors.affiliation: a Department of Epidemiology , Columbia University Mailman School of Public Health , New York , NY , USA.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Kujawski
authors.affiliation: a Department of Epidemiology , Columbia University Mailman School of Public Health , New York , NY , USA.|b ICAP-Columbia University Mailman School of Public Health , New York , NY , USA.
authors.forename: Maria
authors.initials: M
authors.lastname: Lahuerta
authors.affiliation: a Department of Epidemiology , Columbia University Mailman School of Public Health , New York , NY , USA.|b ICAP-Columbia University Mailman School of Public Health , New York , NY , USA.
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Lamb
authors.affiliation: c ICAP-Columbia University Mailman School of Public Health , Maputo , Mozambique.
authors.forename: Laurence
authors.initials: L
authors.lastname: Ahoua
authors.affiliation: d Centro de Colaboração em Saude , Maputo , Mozambique.
authors.forename: Fatima
authors.initials: F
authors.lastname: Abacassamo
authors.affiliation: a Department of Epidemiology , Columbia University Mailman School of Public Health , New York , NY , USA.
authors.forename: Batya
authors.initials: B
authors.lastname: Elul
mesh_terms: D000293:Adolescent; D003376:Counseling / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D006268:Health Facilities; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009073:Mozambique / Q000453:epidemiology; D011159:Population Surveillance; D055815:Young Adult
keywords: HIV testing; implementation science; population-based surveys; undiagnosed HIV