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REVIEW • Rev. Bras. Enferm. 76 (3) • 2023 • https://doi.org/10.1590/0034-7167-2022-0565 copy

Early diagnosis of HIV/aids infection: concept analysis

Diagnóstico precoz de la infección por VIH/SIDA: análisis de concepto

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objectives:

to analyze the concept of “early diagnosis of HIV/Aids infection” in light of Walker and Avant’s conceptual analysis model.

Methods:

concept analysis study based on the framework proposed by Walker and Avant, instrumented by a scoping review conducted in April 2022, following the recommendations of the Joanna Briggs Institute and checklist Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. The search was made in eight data sources, obtaining sixteen articles.

Results:

the study found homosexual intercourses, early examination, anti-HIV antibodies, CD4 count, and sexually transmitted infection as the main attributes of the concept. As antecedents: information, risky behavior, unprotected sexual relations, prevention, and access to the service. As main consequences: antiretroviral treatment, seroconversion, transmission, and consultations.

Final Considerations:

the study approached the circumstantial situations of the theme, its attributes, antecedents, and consequences, qualifying the work process based on knowledge of nursing practice.

Descriptors:
Acquired Immunodeficiency Syndrome; HIV Infections; Early Diagnosis; AIDS Serodiagnosis; Hospital Units.

Data sources	Search syntaxes
BDENF	(HIV OR “Síndrome da imunodeficiência adquirida” OR “Vírus da Imunodeficiência Humana”) AND (“Diagnóstico precoce”) AND (“Unidades hospitalares” OR “serviços de saúde”)
Gale Academic Onefile	HIV OR Acquired Immunodeficiency Syndrome OR Human immunodeficiency virus AND Keyword: Early DiagnosisANDKeyword: Hospital Units OR Health Services
Google Scholar	(HIV OR “Acquired Immunodeficiency Syndrom” OR “Human immunodeficiency virus”) AND (“Early Diagnosis”) AND (“Hospital Units” OR “Health Services”)
LILACS	HIV OR “Síndrome da imunodeficiência adquirida” OR “Vírus da Imunodeficiência Humana” [words] and “Diagnóstico precoce” [words] and “Unidades hospitalares” OR “serviços de saúde” [words]
MEDLINE / PubMed	((HIV OR “Acquired Immunodeficiency Syndrome” OR “Human immunodeficiency virus”) AND (”Early Diagnosis“)) AND (“Hospital Units” OR “Health Services”)
SciELO	(^(HIV OR “Acquired Immunodeficiency Syndrome” OR “Human immunodeficiency vírus”)) AND ((“Early Diagnosis”)) AND ((“Hospital Units” OR “Health Services”))*
Scopus	TITLE-ABS-KEY (hiv OR “acquired immunodeficiency syndrome” OR “human immunodeficiency vírus”) AND TITLE-ABS-KEY (“early diagnosis”) AND TITLE-ABS-KEY (“hospital units” OR “health services”)
Web of Science	TS=(HIV OR Acquired Immunodeficiency Syndrome OR Human immunodeficiency vírus) AND TS=(Early Diagnosis) AND TS=(Hospital Units OR Health Services)

^* * ID - Article identification. ID	Country / Year	Article title	Type of study
E1(⁹9 Arksey H, O’Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005;8(1):19-32. https://doi.org/10.1080/1364557032000119616 https://doi.org/10.1080/1364557032000119... )	Sweden/2000	Diagnosis of primary HIV-1 infection and duration of follow-up after HIV exposure	Prospective study
E2(¹⁰10 Lindbäck S, Thostensson R, Karlsson AC, Sydow MV, Flamholc L, Blaxhult A, et al. Diagnosis of primary HIV-1 infection and duration of follow-up after HIV exposure. AIDS [Internet]. 2000[cited 2022 Jun 10];14(15):2333-9. https://doi.org/10.1097/00002030-200010200-00014 https://doi.org/10.1097/00002030-2000102... )	Spain/2009	Increasing Early Diagnosis of HIV through Rapid Testing in a Street Outreach Program in Spain	Analytical study
E3(¹¹11 Fuente L, Delgado J, Hoyos J, Belza MJ, Álvarez J, Gutiérrez J, et al. Increasing Early Diagnosis of HIV through Rapid Testing in a Street Outreach Program in Spain. AIDS Patient Care STDS. 2009;23(8):625-29. https://doi.org/10.1089/apc.2009.0019 https://doi.org/10.1089/apc.2009.0019... )	United States of America (USA)/2010	Routine Opt-Out Rapid HIV Screening and Detection of HIV Infection in Emergency Department Patients	Prospective study
E4(¹²12 Haukoos JS, Hopkins E, Conroy AA, Silverman M, Byyny RL, Eisert S, et al. Routine Opt-Out Rapid HIV Screening and Detection of HIV Infection in Emergency Department Patients. JAMA Network. 2010;304(3): 284-92. https://doi.org/10.1001/jama.2010.953 https://doi.org/10.1001/jama.2010.953... )	Spain/2011	Assessment of an outreach street-based HIV rapid testing programme as a strategy to promote early diagnosis: a comparison with two surveillance systems in Spain, 2008-2011	Comparative study
E5(¹³13 Belza MJ, Hoyos J, Balbuena SF, Bravo MJ, Fuente L. Assessment of an outreach street-based HIV rapid testing programme as a strategy to promote early diagnosis: a comparison with two surveillance systems in Spain, 2008-2011. Eurosurveillance. 2014;20(14):1-11. https://doi.org/10.2807/1560-7917.es2015.20.14.21089 https://doi.org/10.2807/1560-7917.es2015... )	India/2012	Feasibility and Effectiveness of Provider Initiated HIV Testing and Counseling of TB Suspects in Vizianagaram District, South India	Cross-sectional study
E6(¹⁴14 Achanta S, Kumar AMV, Nagaraja SB, Jaju J, Rao S, Shamrao M, et al. Feasibility and effectiveness of provider initiated HIV testing and counseling of TB suspects in Vizianagaram district, South India. PLoS One. 2012;7(7):e41378. https://doi.org/10.1371/journal.pone.0041378 https://doi.org/10.1371/journal.pone.004... )	USA/2014	Social Support as a Predictor of Early Diagnosis, Linkage, Retention, and Adherence to HIV Care: Results From The Steps Study	Prospective observational study
E7(¹⁵15 Kelly JD, Hartman C, Graham J, Kallen MA, Giordano TP. Social Support as a Predictor of Early Diagnosis, Linkage, Retention, and Adherence to HIV Care: results from the steps study. J Assoc Nurses AIDS Care. 2014;25(5): 405-13. https://doi.org/10.1016/j.jana.2013.12.002 https://doi.org/10.1016/j.jana.2013.12.0... )	Kenya/2015	Stage of HIV presentation at initial clinic visit following a community-based HIV testing campaign in rural Kenya	Comparative study
E8(¹⁶16 Haskew J, Turner K, Ro G, Ho A, Kimanga D, Sharif S. Stage of HIV presentation at initial clinic visit following a community-based HIV testing campaign in rural Kenya. BMC Public Health. 2015;15(16):1-7. https://doi.org/10.1186/s12889-015-1367-4 https://doi.org/10.1186/s12889-015-1367-... )	USA/2017	Clinical and public health implications of acute and early HIV detection and treatment: a scoping review	Scope review
E9(¹⁷17 Rutstein SE, Ananworanich J, Fidler S, Johnson C, Sanders EJ, Sued O, et al. Clinical and public health implications of acute and early HIV detection and treatment: a scoping review. J Int AIDS Soc. 2017;20(1):1-13. https://doi.org/10.7448/IAS.20.1.21579 https://doi.org/10.7448/IAS.20.1.21579... )	Australia/2018	Identifying missed clinical opportunities for the earlier diagnosis of HIV in Australia, a retrospective cohort data linkage study	Retrospective study
E10(¹⁸18 Mallitt KA, Wilson DP, Jansson J, McDonald A, Wand H, Post JJ. Identifying missed clinical opportunities for the earlier diagnosis of HIV in Australia, a retrospective cohort data linkage study. PLoS One. 2018;13(12): e0208323. https://doi.org/10.1371/journal.pone.0208323 https://doi.org/10.1371/journal.pone.020... )	Spain/2018	The contribution of HIV point-of-care tests in early HIV diagnosis: community-based HIV testing monitoring in Catalonia, 1995 to 2018	Descriptive study
E11(¹⁹19 López LF, Urueña JR, Conway A, Saz J, Morales A, Quezadas J, et al. The contribution of HIV point-of-care tests in early HIV diagnosis: community-based HIV testing monitoring in Catalonia, 1995 to 2018. Eurosurveillance. 2018;25(43):1900424. https://doi.org/10.2807/1560-7917.ES.2020.25.43.1900424 https://doi.org/10.2807/1560-7917.ES.202... )	United States/2018	Antibody detection by agglutination-PCR (ADAP) enables early diagnosis of HIV infection by oral fluid analysis	Clinical trial
E12(²⁰20 Tsai CT, Robinson PT, Cortez FJ, Elma MLB, Seftel D, Pourmandi N, et al. Antibody detection by agglutination-PCR (ADAP) enables early diagnosis of HIV infection by oral fluid analysis. Proc Natl Acad Sci. 2018;115(6):1250-5. https://doi.org/10.1073/pnas.1711004115 https://doi.org/10.1073/pnas.1711004115... )	Spain/2019	Evaluación de un programa de salud pública sobre diagnóstico de VIH con prueba rápida	Descriptive study
E13(²¹21 Gómez MAB, Soria OC, Blasco JB, Rodríguez IC, Riquelme FP, Piqueras OM. Evaluación de un programa de salud pública sobre diagnostico de VIH con prueba rápida. Rev Esp Salud Pública. [Internet]. 2019 [cited 2022 Jun. 03];93:e1-10. Available from: https://scielo.isciii.es/pdf/resp/v93/1135-5727-resp-93-e201912119.pdf https://scielo.isciii.es/pdf/resp/v93/11... )	USA/2020	Identifying and predicting longitudinal trajectories of care for people newly diagnosed with HIV in South Africa	Randomized controlled trial
E14(²²22 Platt L, Xu A, Giddy J, Bogart LM, Boulle A, Parker RA, et al. Identifying and predicting longitudinal trajectories of care for people newly diagnosed with HIV in South Africa. PLoS One. 2020;15(9):e0238975. https://doi.org/10.1371/journal.pone.0238975 https://doi.org/10.1371/journal.pone.023... )	Spain/2020	Recomendaciones dirigidas a los servicios de urgências para el diagnóstico precoz de pacientes con sospecha de infección por VIH y su derivación para estúdio y seguimento	Literature review
E15(²³23 Castillo JG, Putze GB, Cabello A, Curran A, Saavedra EJ, Malchair P, et al. Recomendaciones dirigidas a los servicios de urgencias para el diagnóstico precoz de pacientes con sospecha de infección por VIH y su derivación para estudio y seguimiento. Emergencias[Internet]. 2020 [cited 2022 Jun 03];32(6):416-26. Available from: https://dialnet.unirioja.es/servlet/articulo?codigo=7653890 https://dialnet.unirioja.es/servlet/arti... )	United Kingdom/ 2020	Evaluating the impact of post-trial implementation of RHIVA nurse-led HIV screening on HIV testing, diagnosis and earlier diagnosis in general practice in London, UK	Pragmatic study
E16(²⁴24 Leber W, Griffiths JP, Martin P, Morris S, Barbosa EC, Estcourt C, et al. Evaluating the impact of post-trial implementation of RHIVA nurse-led HIV screening on HIV testing, diagnosis and earlier diagnosis in general practice in London, UK. EClinicalMedicine. 2020;19:100229. https://doi.org/10.1016/j.eclinm.2019.11.022 https://doi.org/10.1016/j.eclinm.2019.11... )	Netherlands/ 2022	Testing and healthcare seeking behavior preceding HIV diagnosis among migrant and non-migrant individuals living in the Netherlands: Directions for early-case finding	Cross section

Essential elements	^* * ID - article identification; †F - absolute frequency; ‡% - Relative frequency ID	†F	‡%
Antecedents
Risky behavior	E1, E2, E3, E4, E8, E9, E11, E12, E14, E15 e E16	19	12%
Information	E1, E2, E4, E13, E15 e E16	18	11%
Injectable drugs	E2, E3, E4, E10, E12, E14, E15 e E16	10	6%
Unprotected sexual relations	E1, E4, E8, E12, E14, E15 e E16	9	5,5%
Access to the service	E4, E5 e E9	4	2,5%
Prevention	E3 e E8	3	2%
Consequential
Antiretroviral treatment	E1, E6, E7 E8, E9, E10 e E13	15	9,5%
Seroconversion	E1, E2, E8, E11 E12, E14 e E15	13	8%
Transmission	E2, E4, E7, E8, E9, E12, E14, E15 e E16	11	6,8%
Appointments	E6, E7, E8, E10 e E15	10	6%
Advice	E5, E7, E8, E15 e E16	10	6%
Promotion of quality of life	E1, E4, E5, E7 e E9	9	5,5%
Treatment	E1, E4, E5 e E9	8	5%
Antiretroviral drug	E1, E2, E4, E6 e E7	7	4,3%
Patient	E1, E2, E3, E4 e E8	6	3,8%
Social inclusion	E1, E2, E4, E6 e E7 e E10	6	3,8%
Chronic disease	E2, E4, E6 e E7	5	3,2%
Sexual conduct	E1, E2, E4, E6 e E7	5	3,2%
Prevention of opportunistic diseases	E1, E4, E5 e E9	4	2,5%
Examination	E2, E4 e E6	3	2%
Economic implications	E2, E4 e E9	3	2%

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