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J Acquir Immune Defic Syndr. 2015 May 1;69(1):126-30. doi: 10.1097/QAI.0000000000000536.

Brief Report: Health-Seeking Behavior and Symptoms Associated With Early HIV Infection: Results From a Population-Based Cohort in Southern Malawi.

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  • 1*Department of Health and Behavioral Sciences, University of Colorado Denver, Denver, CO; †Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA; ‡Invest in Knowledge Initiative, Zomba, Malawi; §Karonga Prevention Study, Lilongwe, Malawi; ‖Kamuzu College of Nursing, Blantyre, Malawi; and ¶Department of Sociology and Population Research Institute, Penn State, University Park, PA.


HIV transmission is most likely to occur during the first few months after infection, yet few cases are identified during this period. Using a population-based cohort of young Malawian women, we identify the distinct symptomology and health-seeking behavior marking early HIV infection by comparing it with periods of seronegativity and chronic infection. During early HIV infection, women are more likely to report malaria-like symptoms and visit clinics for malaria care. In malaria-endemic contexts, where acute HIV symptoms are commonly mistaken for malaria, early diagnostic HIV testing and counseling should be integrated into health care settings where people commonly seek treatment for malaria.

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