Achieving human immunodeficiency virus (HIV) epidemic control by 2030 requires identifying recent HIV infections to enhance surveillance and enable prompt, targeted interventions. Understanding the pattern of recent versus long-term infections provides critical insight into the dynamics of HIV transmission in specific populations and geographic areas. This study aimed to characterize health indices among newly diagnosed HIV-positive patients at the Lagos University Teaching Hospital HIV Clinic based on their recency test classification as either “recent” or “long-term” infections, and to examine the relationship between socio-demographic factors and infection patterns. A descriptive cross-sectional study was conducted among 456 newly diagnosed people living with HIV (PLHIV) attending the APIN Clinic at Lagos University Teaching Hospital (LUTH) over three months in 2024. Participants were selected using a systematic sampling technique. HIV testing followed a parallel testing algorithm, and all reactive samples were subsequently tested with the Unigold HIV test for confirmation and the Asante HIV-1 Rapid Recency Assay for infection recency classification. The Asante assay displays three distinct bands - control, verification, and long-term infection lines - allowing for differentiation between recent and long-term HIV infections. These recency results were used to support clinical decision-making, epidemiological surveillance, and targeted prevention interventions. The study population comprised male and female clients aged 15 years and above who were newly diagnosed as HIV-positive and met the inclusion criteria. Inclusion criteria were: a reactive Determine test result, no prior HIV diagnosis or antiretroviral therapy (ART) use, and no opt-out from recency testing, in line with the National HIV testing guidelines. Exclusion criteria included newly diagnosed clients presenting with WHO Clinical Stage 3 or 4 disease or those who reported prior or current ARV use at the time of HIV testing. Data were collected using pre-tested, interviewer-administered structured questionnaires and were analyzed using Microsoft Excel 2009 and IBM SPSS Statistics version 26. Statistical significance was set at p ≤ 0.05. Ethical approval for the study was obtained from the Health Research Ethics Committee of Lagos University Teaching Hospital (LUTH). A total of 456 respondents participated in the study (100% response rate), with a mean age of 44.9 ± 11.8 years and a female predominance (63.2%). Overall, 23.5% were classified as having a recent HIV infection. Recent infections were significantly associated with younger age ( p < 0.001), being single ( p = 0.001), and lower educational attainment ( p = 0.009). Recent infection was more common among participants with same-gender or bisexual sexual preferences ( p = 0.006), those with multiple sexual partners ( p = 0.001), alcohol users ( p = 0.002), and people who inject drugs ( p = 0.034). Clinical factors showed strong associations: WHO stage 1 ( p < 0.001) and CD4 ≥ 200 cells/mm³ ( p < 0.001) were strongly predictive of recent HIV infection. Multivariate analysis showed that older age groups, post-secondary education, and WHO stage 2 significantly reduced the odds of recent infection, while CD4 ≥ 200 cells/mm³ increased it. Other sociodemographic and behavioral variables were not significantly associated. Recent HIV infections in this population were driven largely by younger age, lower educational attainment, high-risk sexual behaviors, substance use, and early clinical disease stages. These findings highlight the need for intensified, targeted prevention strategies—particularly for adolescents and young adults, individuals with low education, key populations, and people engaging in high-risk behaviors. Integrating recency testing into routine HIV services, expanding youth-friendly and community-based testing, and strengthening harm-reduction interventions are crucial for interrupting ongoing transmission and improving early diagnosis.
Agulanna et al. (Thu,) studied this question.
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