PLoS ONE (Jan 2022)

Evaluation of accuracy and performance of self-reported HIV and antiretroviral therapy status in the Nigeria AIDS Indicator and Impact Survey (2018).

  • Ibrahim Jahun,
  • Akipu Ehoche,
  • Moyosola Bamidele,
  • Aminu Yakubu,
  • Megan Bronson,
  • Ibrahim Dalhatu,
  • Stacie Greby,
  • Chinedu Agbakwuru,
  • Ibrahim Baffa,
  • Emem Iwara,
  • Matthias Alagi,
  • Olugbenga Asaolu,
  • Ahmed Mukhtar,
  • Akudo Ikpeazu,
  • Charles Nzelu,
  • Jelpe Tapdiyel,
  • Orji Bassey,
  • Alash'le Abimiku,
  • Hetal Patel,
  • Bharat Parekh,
  • Sani Aliyu,
  • Gambo Aliyu,
  • Manhattan Charurat,
  • Mahesh Swaminathan

DOI
https://doi.org/10.1371/journal.pone.0273748
Journal volume & issue
Vol. 17, no. 8
p. e0273748

Abstract

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BackgroundData on awareness of HIV status among people living with HIV (PLHIV) are critical to estimating progress toward epidemic control. To ascertain the accuracy of self-reported HIV status and antiretroviral drug (ARV) use in the Nigeria HIV/AIDS Indicator and Impact Survey (NAIIS), we compared self-reported HIV status with HIV rapid diagnostic test (RDT) results and self-reported ARV use with detectable blood ARV levels.MethodsOn the basis of responses and test results, participants were categorized by HIV status and ARV use. Self-reported HIV status and ARV use performance characteristics were determined by estimating sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Proportions and other analyses were weighted to account for complex survey design.ResultsDuring NAIIS, 186,405 participants consented for interview out of which 58,646 reported knowing their HIV status. Of the 959 (weighted, 1.5%) who self-reported being HIV-positive, 849 (92.1%) tested HIV positive and 64 (7.9%) tested HIV negative via RDT and polymerase chain reaction test for discordant positive results. Of the 849 who tested HIV positive, 743 (89.8%) reported using ARV and 72 (10.2%) reported not using ARV. Of 57,687 who self-reported being HIV negative, 686 (1.2%) tested HIV positive via RDT, with ARV biomarkers detected among 195 (25.1%). ARV was detected among 94.5% of those who self-reported using ARV and among 42.0% of those who self-reported not using ARV. Overall, self-reported HIV status had sensitivity of 52.7% (95% confidence interval [CI]: 49.4%-56.0%) with specificity of 99.9% (95% CI: 99.8%-99.9%). Self-reported ARV use had sensitivity of 95.2% (95% CI: 93.6%-96.7%) and specificity of 54.5% (95% CI: 48.8%-70.7%).ConclusionsSelf-reported HIV status and ARV use screening tests were found to be low-validity measures during NAIIS. Laboratory tests to confirm self-reported information may be necessary to determine accurate HIV and clinical status for HIV studies in Nigeria.