HIV-1 infection recency among individuals newly diagnosed with HIV in Greater Gaborone, Botswana

Abstract

OBJECTIVE : We characterized individuals with human immunodeficiency virus type 1 (HIV-1) recent infection using a two-step recent infection testing algorithm (RITA) in recently diagnosed, antiretroviral therapy (ART) naive individuals within the Greater Gaborone area in Botswana. DESIGN : Plasma samples from a prospective longitudinal cohort study of individuals recently diagnosed with HIV within the Greater Gaborone area (2023 – 2024), the Tekodiso study, were used. METHODS : Recent infection classification was determined using Limiting Antigen Avidity (LAg-Avidity), as well as HIV viral load (VL) > 1000 copies/mL. LAg-normalized optical density (ODn) ≤ 1·5 represented a recency window of within 130 days post-infection. HIV VL in plasma was quantified by Abbott m2000sp/Abbott m2000rt. RESULTS : A total of 157 participants were included in this analysis. Median age at enrolment was 34 years (Q1, Q3: 27, 41) and majority 102 (65%) were female. The median log10 HIV VL was 4.6 copies/mL (Q1, Q3: 3.9, 5.2). A total of 12/157: 7.6% (95% CI 4.0: 13.0) individuals were classified as having a recent infection. Recent infection was not associated with age, employment status, or nationality. We observed a lower likelihood of recent HIV infection with secondary or higher education level (OR = 0.1; 95% CI: 0.1– 0.9). CONCLUSIONS : We report a 7.6% rate of HIV recent infection by LAg-based RITA in recently diagnosed ART naïve individuals in Botswana. Our results highlight the need for continued HIV infection surveillance to improve targeted interventions for the prevention of HIV acquisition within the country.