Human Immunodeficiency Virus Counseling Research Articles

Predictive ability of the health belief model in HIV testing and counselling uptake among youth aged 15–24 in La-Nkwantanang-Madina Municipality, Ghana

BackgroundMajority of new Human Immunodeficiency Virus (HIV)-positive persons in Ghana are aged 15–24. HIV prevalence among persons aged 15–24 years, a proxy for new infections, remained stable at 1.5% for 2017 and 2018, making it a significant public health concern. Yet only 26.4% of females and 8.6% of males aged 15–24 years know their HIV status. This study determined the predictive ability of the Health Belief Model (HBM) in HIV testing and counselling (HTC) uptake among youth (15–24 years) in the La-Nkwantanang Madina Municipality, Ghana.MethodsA cross-sectional design was adopted for the study, using a multistage sampling method to select 415 youth aged 15–24. Data were collected using a structured interviewer-administered questionnaire, and analysed using binomial logistic regression with STATA software version 16.0 at p < 0.05 significance level and at 95% confidence interval.ResultsHTC uptake was 29.2%. Perceived susceptibility, perceived barriers, and perceived self-efficacy predicted HTC uptake. Youths with a high-risk perception for contracting HIV [OR = 3.03; 95% CI = 1.46, 6.30, p = 0.003], who perceived that they can contract HIV if not protected [OR = 3.69; 95% CI = 1.47, 9.22, p = 0.005], and worry about getting HIV [OR = 3.03, 95% CI = 1.61, 5.69, p < 0.001] (perceived susceptibility) were more likely to uptake HTC. Youths who had no trust issues with health workers [OR = 3.53; 95% CI = 1.46, 8.53, p = 0.005] and those who were not afraid of positive HIV test results [OR = 5.29; 95% CI = 2.66, 10.51, p,0.001] (perceived barriers) were more likely to uptake HTC. Youths who had no difficulties in turning up for appointments (perceived self-efficacy) had higher odds of HTC uptake [OR = 11.89, 95% CI = 6.73, 20.98, P < 0.001]. For the modifying factors, being married [OR = 2.96; 95% CI = 1.65–5.33], and having knowledge of HTC [OR = 9.10; 95% CI = 2.16–38.3], significantly influenced HTC uptake.ConclusionHealth promotion interventions to increase HTC uptake should focus on heightening the perception of susceptibility to HIV, reducing the barriers to HTC uptake, and increasing the self-efficacy for HTC uptake. The interventions should also target the significant modifying factors.

Predictive ability of the health belief model in HIV testing and counselling uptake among youth aged 15–24 in La-Nkwantanang-Madina Municipality, Ghana

BackgroundMajority of new Human Immunodeficiency Virus (HIV)-positive persons in Ghana are aged 15–24. HIV prevalence among persons aged 15–24 years, a proxy for new infections, remained stable at 1.5% for 2017 and 2018, making it a significant public health concern. Yet only 26.4% of females and 8.6% of males aged 15–24 years know their HIV status. This study determined the predictive ability of the Health Belief Model (HBM) in HIV testing and counselling (HTC) uptake among youth (15–24 years) in the La-Nkwantanang Madina Municipality, Ghana.MethodsA cross-sectional design was adopted for the study, using a multistage sampling method to select 415 youth aged 15–24. Data were collected using a structured interviewer-administered questionnaire, and analysed using binomial logistic regression with STATA software version 16.0 at p < 0.05 significance level and at 95% confidence interval.ResultsHTC uptake was 29.2%. Perceived susceptibility, perceived barriers, and perceived self-efficacy predicted HTC uptake. Youths with a high-risk perception for contracting HIV [OR = 3.03; 95% CI = 1.46, 6.30, p = 0.003], who perceived that they can contract HIV if not protected [OR = 3.69; 95% CI = 1.47, 9.22, p = 0.005], and worry about getting HIV [OR = 3.03, 95% CI = 1.61, 5.69, p < 0.001] (perceived susceptibility) were more likely to uptake HTC. Youths who had no trust issues with health workers [OR = 3.53; 95% CI = 1.46, 8.53, p = 0.005] and those who were not afraid of positive HIV test results [OR = 5.29; 95% CI = 2.66, 10.51, p,0.001] (perceived barriers) were more likely to uptake HTC. Youths who had no difficulties in turning up for appointments (perceived self-efficacy) had higher odds of HTC uptake [OR = 11.89, 95% CI = 6.73, 20.98, P < 0.001]. For the modifying factors, being married [OR = 2.96; 95% CI = 1.65–5.33], and having knowledge of HTC [OR = 9.10; 95% CI = 2.16–38.3], significantly influenced HTC uptake.ConclusionHealth promotion interventions to increase HTC uptake should focus on heightening the perception of susceptibility to HIV, reducing the barriers to HTC uptake, and increasing the self-efficacy for HTC uptake. The interventions should also target the significant modifying factors.

Risky sexual behavior and associated factors among reproductive age women in eastern African countries: a multilevel analysis of the recent demographic and health survey

IntroductionRisky sexual behavior exposes an individual to the risk of contracting sexually transmitted infections including human immunodeficiency virus (HIV). Even though risky sexual behavior is a devastating problem in low- and middle-income countries, studies on risky sexual behavior and associated factors among reproductive-age women in Eastern African countries are limited. Therefore, this study aimed to assess the magnitude of risky sexual behavior and associated factors among reproductive-age women in Eastern African countries that help to target high-risk groups and set appropriate intervention.MethodThe appended and recent Demographic and Health Survey dataset of 10 Eastern African countries from 2012 to 2022 was used for data analysis. A total of 111,895 participants were included in this study as a weighted sample. Associated factors were determined using a multilevel mixed-effects logistic regression model. Significant factors in the multilevel mixed-effect logistic regression model were declared significant at p-values < 0.05. The adjusted odds ratio (AOR) and confidence interval (CI) were used to interpret the results.ResultThe overall magnitude of risky sexual behavior among reproductive-age women in Eastern African countries was 28.16% (95% CI 27.90%, 28.43%), which ranged from 3.80% in Ethiopia to 67.13% in Kenya. In the multivariable analysis, being a younger woman, being an educated woman, being tested for human immunodeficiency virus, having work, drinking alcohol, and being an urban dweller were factors that were significantly associated with higher odds of risky sexual behavior.ConclusionThe overall magnitude of risky sexual behavior among reproductive-age women in Eastern African countries was high. Individual-level (being a younger woman, being an educated woman, being tested for human immunodeficiency virus, having work, and drinking alcohol) and community-level (being an urban dweller) variables were associated with higher odds of risky sexual behavior. Therefore, policymakers and other stakeholders should give special consideration to urban dwellers, educated, worker and younger women. Better to improve the healthy behavior of women by minimizing alcohol consumption and strengthening HIV testing and counseling services to reduce the magnitude of risky sexual behavior.

Knowledge, acceptance, and uptake of voluntary counseling and testing for human immunodeficiency virus/acquired immunodeficiency syndrome among undergraduates of a public university in Southwestern Nigeria

Objectives: Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) is a global public health problem, and Nigeria has about 1.9 million people living with the virus. HIV testing and counseling services serve as a very important entry point to HIV/AIDS care and treatment. Voluntary counseling and testing (VCT) is one of the interventions developed to tackle the HIV/AIDS epidemic in Africa. This study determined the knowledge, acceptance, and utilization of VCT for HIV/AIDS among undergraduates in a public University in Southwestern Nigeria. Material and Methods: The study adopted a descriptive cross-sectional design, using the multistage sampling technique to select 425 respondents. A self-administered questionnaire was used for data collection. Data analysis was done using Statistical package for the social sciences (SPSS), version 25. Descriptive statistics were presented in tables and figures, and inferential statistics were analyzed at a level of significance of 0.05. Results: Over half of the respondents, 226 (53.2%) were within the age range of 18–25 years. The majority were female, 345 (81.2%), single 403 (94.8%), and had never had sexual intercourse 300 (70.6%). Over half of the respondents’ 240 (57%), had above average knowledge of VCT for HIV/AIDs, had above average levels of acceptance 254 (59%), and the majority 326 (76.2%) of the respondents had very low level of utilization of VCT for HIV/AIDS. There was a significant association between respondents’ age (χ2 = 55.599a, P = 0.000), gender (χ2 = 19.094a, P = 0.000), religion (χ2 = 8.990a, P = 0,038), marital status (χ2 = 8.411a, P = 0.038), age at first sex (χ2 = 61.847a, P = 0.000), knowledge of VCT (χ2 = 5.297a, P = 0.021), acceptance of VCT (χ2 = 80.235a, P = 0.000), and their uptake of VCT for HIV/AIDs. Furthermore, selected socio-demographic characteristics, knowledge, and acceptance of VCT significantly predicted the uptake of VCT among respondents (F [8,416] = 20.163, P &lt; 0.05). Conclusion: The study concluded that respondents had an above average knowledge and acceptance of VCT but a low level of utilization. To increase the utilization of VCT for HIV/AIDS among undergraduates, public health programs should focus on educating undergraduates and significant others on the importance of VCT in the context of HIV prevention, care, and treatment.

Healthcare policy to support people living with HIV infection and AIDS patients

Background: Individuals living with human immunodeficiency virus (HIV) encounter challenges throughout the care continuum, right from the time of diagnosis to the culmination of the treatment process.Current Concepts: The Republic of Korea, like many other countries, has been addressing the needs of people living with HIV (PLWH) by providing financial support for medical expenditures. Currently, HIV counseling specialist nurses offer psychological support at 28 institutions, assisting patients in maintaining viral suppression state and adhering to antiretroviral therapy. Care and welfare services are also provided by non-governmental organizations funded by the Korean Disease Control and Prevention Agency (KDCA). The accessibility of medical institutions for PLWH has seen gradual improvement, with KDCA issuing guidelines for healthcare facilities catering to this population. In addition, the legal and medical insurance coverage issues related to long-term care institutionalization have been addressed. However, PLWH continues to face challenges in treatment and hospitalization, especially with a recent increase in immigrant PLWH, highlighting a lack of support for undocumented immigrants seeking treatment.Discussion and Conclusion: Healthcare policies are shifting from merely managing, isolating, and treating PLWH to prioritizing their human rights. Going forward, it is imperative to empower PLWH and support their self-care efforts.

Provider and female client economic costs of integrated sexual and reproductive health and HIV services in Zimbabwe.

A retrospective facility-based costing study was undertaken to estimate the comparative cost per visit of five integrated sexual and reproductive health and HIV (human immuno-deficiency virus) services (provider perspective) within five clinic sites. These five clinics were part of four service delivery models: Non-governmental-organisation (NGO) directly managed model (Chitungwiza and New Africa House sites), NGO partner managed site (Mutare site), private-public-partnership (PPP) model (Chitungwiza Profam Clinic), and NGO directly managed outreach (operating from New Africa House site. In addition client cost exit interviews (client perspective) were conducted among 856 female clients exiting integrated services at three of the sites. Our costing approach involved first a facility bottom-up costing exercise (February to April 2015), conducted to quantify and value each resource input required to provide individual SRH and HIV services. Secondly overhead financial expenditures were allocated top-down from central office to sites and then respective integrated service based on pre-defined allocation factors derived from both the site facility observations and programme data for the prior 12 months. Costs were assessed in 2015 United States dollars (USD). Costs were assessed for HIV testing and counselling, screening and treatment of sexually transmitted infections, tuberculosis screening with smear microscopy, family planning, and cervical cancer screening and treatment employing visual inspection with acetic acid and cervicography and cryotherapy. Variability in costs per visit was evident across the models being highest for cervical cancer screening and cryotherapy (range: US$6.98-US$49.66). HIV testing and counselling showed least variability (range; US$10.96-US$16.28). In general the PPP model offered integrated services at the lowest unit costs whereas the partner managed site was highest. Significant client costs remain despite availability of integrated sexual and reproductive health and HIV services free of charge in our Zimbabwe study setting. Situating services closer to communities, incentives, transport reimbursements, reducing waiting times and co-location of sexual and reproductive health and HIV services may help minimise impact of client costs.

HIV counseling, testing, and test result receipt among East African women of reproductive age using recent national health surveys.

One of the most important public health concerns is still the Human Immunodeficiency Virus (HIV) and acquired immunodeficiency syndrome (AIDS), particularly in developing countries. Although HIV testing is an important step in both prevention and treatment, its uptake remains low, and no study has looked into the scale of HIV counseling, testing, and test result receipt among East African women all at the same time. Therefore, this study aimed to investigate HIV counseling, testing, and test result receipt, as well as the factors that influence them, among East African women. This analysis used Demographic and Health Survey data collected from 10 East African countries between 2011 and 2022. We examined the coverage of HIV counseling, testing, and test result receipt among East African women, as well as other characteristics. To select candidate factors and identify significant explanatory variables related to the outcome variable, binary and multiple logistic regression analyses were conducted, and the results were presented using adjusted odds ratios (AORs) with 95% confidence intervals. In the binary and multiple logistic regression analyses, P values of less than or equal to 0.2 and <0.05 were used to assess significant variables, respectively. A total of 41,627 weighted women included to this study. HIV counseling, testing, and test result receipt among East African women were found to be 77.86% (95% CI = 77.46, 78.26). Being 25-34 years old (AOR = 1.13, 95% CI, 1.06, 1.21), 35-49 years old (AOR = 1.15, 95% CI, 1.05, 1.26) as compared to 15-24 years old women, primary education (AOR = 1.75, 95% CI, 1.64, 1.86), secondary/higher education level (AOR = 1.96, 95% CI, 1.82, 2.13) as compared to not educated women, poor, (AOR = 1.22, 95% CI, 1.14, 1.29), middle wealth (AOR = 1.12, 95% CI, 1.04, 1.21) as compared to rich wealth index, mass media exposure (AOR = 1.29, 95% CI, 1.22, 1.35), 3-5 parity (AOR = 1.29, 95% CI, 1.21, 1.37), more than 5 parity (AOR = 1.46, 95% CI, 1.33, 1.61) as compared to <3 parity, health institution delivery (AOR = 1.65, 95% CI, 1.53, 1.76), were associated positively with the outcome variable respectively. However, being married (AOR = 0.79, 95% CI, 0.72, 0.87), not using contraceptive (AOR = 0.58, 95% CI, 0.51, 0.61), and traditional contraceptive method user (AOR = 0.47, 95% CI, 0.41, 0.54) as compared to modern users were associated negatively with outcome variable respectively. This study found that HIV counseling, testing, and test result receipt are still unsatisfactory. Strengthening maternal health services such as institutional delivery, family planning, and women's empowerment, as well as changing mass media and taking advantage of these opportunities, will boost the region's coverage of HIV counseling, testing, and obtaining results.

Knowledge of Human Immuno Deficiency Virus (HIV) Status and Preferred Testing Approach among Men in Bono Region, Ghana

Background: Countries are making progress towards the global goal of 90% of people with HIV knowing their status by 2020 and 95% by 2030. In 2019 about 19% of all those living with HIV worldwide were undiagnosed. The study sought to assess the knowledge of HIV status and preferred testing approach among men in the Bono Region, Ghana.&#x0D; Methods: A cross-sectional survey involving 403 men aged 18 years and above who were accessing HIV counselling and testing services in seven major health facilities in the Bono region was employed. The data were analysed by using SPSS version 25.0 software with both descriptive and inferential analysis. Data were presented using frequencies, tables and charts. Statistical significance for all testing was set as 0.05.&#x0D; Results: The results revealed that most of the respondents were below 30 years with mean age of 42.5 and standard deviation of 6.8. The prevalence rate of men who knew their HIV status in the Bono region was 55.6% and the preferred HIV testing approach was self-testing (61.3%). The reasons for the preferred approach was privacy (41%) and the predictor of HIV status was awareness (source of knowledge was significant; OR= 0.67 (95%CI=0.32,1.4); p-value=0.003. The location of the testing facility was statistically significant with OR= 1.66(95%CI=0.94,2.93); p-value=0.002 as well as marital status and occupation of the respondents were also statistically significant with OR=4.86 (95%CI=1.8-79); p-value=0.000 respectively.&#x0D; Conclusion: The study concludes that if men are exposed to the facts about HIV testing services, the misconception about the disease will be reduced and more men will be involved in the HIV testing services. The study recommends that Policies, interventions and measures on testing should be integrated in a common health problem that brings men to hospitals just as done in women. Management of the health facilities should continue with the education on HIV testing services especially among men who are yet to undertake such services to prevent fear and anxiety. Further study is required to guide a differentiated approach to programmatic interventions. Encourage a similar survey in different region to confirm or disconfirm the findings of this study.

A case report : 34 y.o male with incidental histopathological findings of Kaposi sarcoma without clinical history of human immunodeficiency virus (HIV)

Introduction: Kaposi sarcoma is a rare and challenging case especially in immunosuppressed patients that frequently doesn’t have specific manifestation. It usually caused by human herpes virus 8 virus infection and male patient with multiple lesion has high mortality rates. The aim of this study is to report 34 y.o Male with incidental histopathological findings of kaposi sarcoma without clinical history of Human Immunodeficiency Virus (HIV). Methodology: Descriptive study of the case report type, whose data were obtained from the patient's medical record. Result: This paper will report 34-year-old young adult male with clinically diagnosed with poroma and differential diagnosis of squamous cell carcinoma and pyogenic granuloma. The clinical sign was multiple skin lesion appear on his right nose and thumb in the last 6 months. The nodules are solitary with oval shape, erythema, firm borders and the nodule surface covered with brownish-yellow squama. In addition, imaging examination suspicious for soft tissue mass. The biopsy was performed, and histopathological finding exhibit a tumor mass consists of Kaposi sarcoma. Discussion: Furthermore, after pathological report revealed the diagnosis of Kaposi sarcoma then a provider-initiated HIV testing and counseling (PITC) examination is carried out and the test result showed reactive for HIV infection. So that, patient concluded to have predisposition of HIV infection with Kaposi sarcoma and treated for antiretrovirals (ARV), chemotherapy and routine clinical follow up. Conclusion : Kaposi sarcoma is a rare cancer caused by infection with the human herpesvirus 8 (HHV8). These lesions are often found in immunosuppressed patients such as HIV sufferers characterized by vascular proliferation. Through the incidental findings of Kaposi's sarcoma in patients who are not clinically suspected of having HIV, clinicopathological correlation is highly recommended. Therefore, the purpose of this writing can be a strong reference so that clinicians are more thorough in reviewing clinical patients and more detailed physical examinations.

Costing of HIV services, Uganda and United Republic of Tanzania.

To evaluate resource allocation and costs associated with delivery of human immunodeficiency virus (HIV) services in Uganda and the United Republic of Tanzania. We used time-driven activity-based costing to determine the resources consumed and costs of providing five HIV services in Uganda and the United Republic of Tanzania: antiretroviral therapy (ART); HIV testing and counselling; prevention of mother-to-child transmission; voluntary male medical circumcision; and pre-exposure prophylaxis. Country-based teams undertook time-driven activity-based costing with 1119 adults in Uganda and 886 adults in the United Republic of Tanzania. In Uganda, service delivery costs ranged from 8.18 United States dollars (US$) per visit for HIV testing and counselling to US$43.43 for ART (for clients in whom HIV was suppressed). In the United Republic of Tanzania, these costs ranged from US$3.67 per visit for HIV testing and counselling to US$28.00 for voluntary male medical circumcision. In both countries, consumables were the main cost driver, accounting for more than 60% of expenditure. Process maps showed that in both countries, registration, measurement of vital signs, consultation and medication dispensing were the steps that occurred most frequently for ART clients. Establishing a rigorous, longitudinal system for tracking investments in HIV services that includes thousands of clients and numerous facilities is achievable in different settings with a high HIV burden. Consistent engagement of implementation partners and standardized training and data collection instruments proved essential for the success of these exercises.

Impact of COVID-19 pandemic on Tuberculosis and HIV services in Ghana: An interrupted time series analysis.

The Coronavirus disease 2019 (COVID-19) burden, coupled with unprecedented control measures including physical distancing, travel bans, and lockdowns of cities, implemented to stop the spread of the virus, have undoubtedly far-reaching aftereffects on other diseases. In low and middle-income countries (LMICs), a particular worry is the potential impact on Human Immunodeficiency Virus (HIV) and Tuberculosis (TB), as a consequence of possible disruption to health services and limiting access to needed life-saving health care. In Ghana, there is a paucity of information regarding the impact of COVID-19 on disease control, particularly TB and HIV control. This study sought to contribute to bridging this knowledge gap. The study involved the analysis of secondary data obtained from the District Health Information Management System-2 (DHIMS-2) database of Ghana Health Service, from 2016 to 2020. Data were analysed using an interrupted time-series regression approach to estimate the impact of COVID-19 on TB case notification, HIV testing, and Antiretroviral Therapy (ART) initiations, using March 2020 as the event period. The study showed that during the COVID-19 pandemic period, there was an abrupt decline of 20.5% (955CI: 16.0%, 24.5%) in TB case notifications in April and 32.7% (95%CI: 28.8%, 39.1%) in May 2020, with a median monthly decline of 21.4% from April-December 2020. A cumulative loss of 2,128 (20%; 95%CI: 13.3%, 26.7%) TB cases was observed nationwide as of December 2020. There was also a 40.3% decrease in people presenting for HIV tests in the first month of COVID-19 (April 2020) and a cumulative loss of 262620 (26.5%) HIV tests as of December 2020 attributable to the COVID-19 pandemic. ART initiations increased by 39.2% in the first month and thereafter decreased by an average of 10% per month from May to September 2020. Cumulatively, 443 (1.9%) more of the people living with HIV initiated ART during the pandemic period, however, this was not statistically significant. This study demonstrated that the COVID-19 pandemic negatively impacted TB case notifications and HIV testing and counselling services, However, ART initiation was generally not impacted during the first year of the pandemic. Proactive approaches aimed at actively finding the thousands of individuals with TB who were missed in 2020 and increasing HIV testing and counselling and subsequent treatment initiations should be prioritised.

Predictive ability of the Health Belief Model in HIV prevention and management in sub-Saharan Africa: a systematic review

ABSTRACT Around 70% of global Human Immunodeficiency Virus (HIV) diagnoses are in sub-Saharan Africa (SSA), where sexual transmission remains the primary mode of HIV transmission. Poor outcomes among persons living with HIV (PLHIV) in SSA are linked to delayed diagnosis (HIV Testing and Counselling [HTC] uptake), poor linkage to HIV care and suboptimal adherence to antiretroviral therapy (ART). This study is a systematic review of published articles on the predictive ability of the Health Belief Model in HIV prevention (condom use and sexual abstinence, Pre-Exposure Prophylaxis [PrEP], Voluntary Medical Male circumcision [VMMC]) and management (HTC uptake, Post-Exposure Prophylaxis [PEP] and ART adherence) in SSA. A systematic search was conducted in PubMed, Science Direct, Google Scholar, Scopus and institutional library databases. The search followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The HBM as a holistic model was useful in predicting HIV prevention and management in SSA. Perceived benefit, susceptibility, self-efficacy, barrier and cues to action were important predictors of the likelihood of uptake of HIV prevention and management intervention. Overall, the perceived benefit was found by the majority of the studies and showed high variance to predict the likelihood of individuals taking up interventions to prevent and manage HIV in SSA. Interventions should, therefore, focus on increasing perceived benefits associated with preventing and managing HIV.

Understanding the quality of life of people living with HIV in rural and urban areas in Indonesia.

Human Immunodeficiency Virus (HIV) is a major global public health issue that affects the quality of life (QoL) of people living with HIV (PLHIV) globally and in Indonesia. As a part of a large-scale qualitative study investigating HIV risk factors and impacts on PLHIV and facilitators of and barriers to their access to HIV care services in Yogyakarta and Belu, Indonesia, this paper describes their in-depth views and experiences of the influence of HIV on their QoL. Ninety-two participants were recruited using the snowball sampling technique. Data were collected using in-depth interviews. In addition, the World Health Organisation Quality of Life questionnaire (WHOQOL-HIV BREF) was also distributed to each of them to fill out prior to the interviews. Chi-Square analysis was used to analyse data from the survey and a framework analysis was applied to guide qualitative data analysis. The findings reported several factors affecting the QoL of the participants. These included (i) environmental factors, such as living in rural areas, the unavailability of HIV care services and public transport, and long-distance travel to healthcare facilities; (ii) personal beliefs associated with HIV; (iii) sexual and social relationships and their influence of the QoL of participants; and (iv) level of independence and physical health condition following HIV diagnosis. The findings indicate the need for intervention programs that address the availability and accessibility of HIV care services to PLHIV within rural communities and support various physical, psychological, and financial needs of PLHIV. These can be implemented by providing supplements and nutritious food, HIV counselling and door-to-door/community-based ART service delivery to PLHIV, which may increase their engagement in and adherence to the treatment and improve their physical and psychological condition and QoL.

Frequency of HIV serodifferent couples within TB-affected households in a setting with a high burden of HIV-associated TB

IntroductionStrong epidemiological links between human immunodeficiency virus (HIV) and tuberculosis (TB) may make household TB contact investigation an efficient strategy for HIV screening and finding individuals in serodifferent partnerships at risk of HIV and linking them to HIV prevention services. We aimed to compare the proportions of HIV serodifferent couples in TB-affected households and in the general population of Kampala, Uganda.MethodsWe included data from a cross-sectional trial of HIV counselling and testing (HCT) in the context of home-based TB evaluation in Kampala, Uganda in 2016–2017. After obtaining consent, community health workers visited the homes of participants with TB to screen contacts for TB and offer HCT to household members ≥ 15 years. We defined index participants and their spouses or parents as couples. Couples were classified as serodifferent if confirmed by self-reported HIV status or by HIV testing results. We used a two-sample test of proportions to compare the frequency of HIV serodifference among couples in the study to its prevalence among couples in Kampala in the 2011 Uganda AIDS Indicator Survey (UAIS).ResultsWe included 323 index TB participants and 507 household contacts aged ≥ 18 years. Most index participants (55%) were male, while most (68%) adult contacts were female. There was ≥ 1 couple in 115/323 (35.6%) households, with most couples (98/115, 85.2%) including the index participant and spouse. The proportion of households with HIV-serodifferent couples was 18/323 (5.6%), giving a number-needed-to-screen of 18 households. The proportion of HIV serodifference among couples identified in the trial was significantly higher than among couples in the UAIS (15.7% vs. 8%, p = 0.039). The 18 serodifferent couples included 14 (77.8%) where the index participant was living with HIV and the spouse was HIV-negative, and 4 (22.2%) where the index partner was HIV-negative, while the spouse was living with HIV.ConclusionsThe frequency of HIV serodifference among couples identified in TB-affected households was higher than in the general population. TB household contact investigation may be an efficient strategy for identifying people with substantial exposure to HIV and linking them to HIV prevention services.

Patriarchy, couple counselling and testing in preventing mother-to-child transmission of HIV in Zimbabwe

The World Health Organization (WHO) recommends couple human immunodeficiency virus (HIV) counselling and testing (CHCT) as one of the beneficial and cost-effective means for the prevention of mother-to-child transmission (PMTCT) of HIV within couple’s relationships. However, CHCT within the PMTCT of HIV settings in Zimbabwe remains low. This study explored adult men and women’s views from a rural district of Zimbabwe regarding the possible factors that facilitate or inhibit the uptake of CHCT for the PMTCT of HIV. The study utilised qualitative methods. Data were collected by conducting eight focus group discussions among adult men and women, as well as eight in-depth interviews with pregnant women admitted in antenatal wards in local hospitals. Thematic analysis was used for analysing the data with the aid of NVivo software. The study revealed that CHCT initiatives were hampered by certain patriarchal behaviours and beliefs that make it acceptable for men to have multiple sexual partners, thereby exposing their marriages and relationships to HIV. Social constructions around gender roles tend to prescribe women as the sole custodians of children’s health, and this led to stigmatisation against men who participated in PMTCT programmes. In addition, certain religious practices do not allow the use of medicine, which makes CHCT a nonevent. However, engaging men on platforms that advocate for progressive masculinities and raising awareness of this practice through information dissemination were identified as enablers in increasing CHCT.Contribution: The significant contribution of this study is that it demonstrated the importance of acknowledging the societal, cultural and religious practices inherent in a community, as they are central to their responses to HIV prevention interventions.

Barriers to HIV Testing among Clients of Female Sex Workers an Assessment of Ogoja Local Government Area

Frequent engagement of men in sexual encounters with female sex workers (FSWs) while not using condoms places them at high risk for Human Immunodeficiency Virus (HIV) infection. HIV testing has been noted to be among the necessary methods to stop HIV transmission and acquisition. However, it’s illustrious that not all men voluntarily test for Human Immunodeficiency Virus (HIV), take a look at how to stop Human immunodeficiency virus (HIV) transmission and/or acquisition. This study aimed to spot barriers to accessing Human immunodeficiency virus (HIV) testing services among men. World Health Organization square measure shoppers of female sex workers (clients) in Ogoja Cross River North, South-South Nigeria. A comprehensive search of recent literature uncovered a fancy array of social, Personal, and behavioural barriers, as well as knowledge/awareness of the Human immunodeficiency virus (HIV) infection’s existence, perception of human immunodeficiency (HIV) risk, stigma from care suppliers or family/partners/friends, distrust of care providers/systems. The purpose of this study is to explore possible barriers to HIV counseling and testing uptake among clients of Female Sex Workers in the Ogoja Local Government area of Cross River State, Nigeria, and to see possible ways of mitigating the barriers to epidemic control. This study was conducted in Ogoja Cross River State, Nigeria, with a sample size of 100 male clients of female sex workers, via random sampling technique through an online survey system known as Mwater for data collection. Frequency counts and percentages were used for data analysis. Vital findings of the study conclude: stigma and trust impact uptake of HIV test among male clients of female sex workers. Keywords: Acquired immunodeficiency syndromes, Barriers, Female sex workers, Human immunodeficiency virus, Human immunodeficiency virus testing, Male.

Understanding the relationship between the public sector healthcare workers and NGO-based HIV counsellors while providing HIV counselling and testing services to pregnant women: A Qualitative Study in Suva, Fiji

Human immunodeficiency virus (HIV) counselling and testing plays a significant role in the prevention of mother-to-child transmission of HIV. HIV counselling and testing during pregnancy is an essential gateway for HIV prevention, timely treatment, and care services. Lack of proper counselling could jeopardise the quality of services. This paper aims to understand the relationship between the government employed hospital healthcare workers and the Non-Governmental Organisation based counsellors while providing HIV counselling and testing services to pregnant women attending antenatal clinic in one of the main hospitals in Suva, Fiji. Data were collected via individual, in-depth, interviews held in a single hospital and an associated reproductive health centre in Suva in April-May 2013. A total of 15 healthcare providers including doctors (n = 4), midwives (n = 5), nurses (n = 4), and counsellors (n = 2) were interviewed. The data were analysed using thematic analysis. Ethical approvals were obtained.We found that there was tension between the government employed hospital healthcare workers and the Non-Governmental Organisation based counsellors involved in the provision of HIV counselling and testing services to pregnant women. The predominant causes of tension were poor referral for HIV test counselling, long counselling time, lack of cooperation and conflict due to the differences in counselling approaches.Tension between the government employed hospital healthcare workers and the Non- Governmental Organisation based HIV counsellors appear to be the main challenge to effective provision of HIV test counselling services in the hospital. Ongoing tension between both groups could restrict healthcare workers abilities to provide quality HIV counselling services. Our findings would be useful in developing strategies to overcome tension amongst healthcare workers as it would be an imperative step in providing streamlined HIV counselling services to women attending antenatal clinic in Fiji.

Cost of Home-Based Couples Human Immunodeficiency Virus Counseling and Testing and Human Immunodeficiency Virus Self-Testing During Pregnancy and Postpartum in Southwestern Kenya

ObjectiveHome-based couples HIV testing and counseling and HIV self-testing (HIVST) for pregnant women can promote HIV status disclosure and male partner testing; however, cost data are lacking. We examined a home-based couples intervention (HBCI) and HIVST intervention costs per couple (unit cost) during pregnancy and postpartum in Kenya. MethodsThis randomized controlled trial is comparing HBCI and HIVST for couples among pregnant women attending antenatal care clinics in two counties in southwestern Kenya. We used micro-costing to estimate the unit cost per couple receiving the intervention as the total of direct and indirect costs for each study arm in 2019 US$. We used a one-month window to conduct a time and motion study to determine personnel effort and resources. We then compared the unit cost by arm, identified key cost drivers, and conducted sensitivity analyses for cost uncertainties. ResultsAt base-case, the unit cost was $129.01 and $41.99, respectively, for HBCI and HIVST. Personnel comprised half of the unit cost for both arms. Staff spent more time on activities related to participant engagement in HBCI (accounting for 6.4% of the unit cost) than in HIVST (2.3%). Staff training was another key cost driver in HBCI (20.1% of the unit cost compared to 12.5% in HIVST). Sensitivity analyses revealed that the unit cost ranges were $104.64-$154.54 for HBCI and $30.49-$56.59 for HIVST. ConclusionsOur findings may guide spending decisions for future HIV prevention and treatment programs for pregnant couples in resource-limited settings such as Kenya.

Improving the quality of HIV rapid testing in Ghana using the dried tube specimen-based proficiency testing program.

BackgroundThe introduction of human immunodeficiency virus (HIV) antibody rapid testing (RT) in resource-limited settings has proven to be a successful intervention to increase access to prevention measures and improve timely linkage to care. However, the quality of testing has not always kept pace with the scale-up of this testing strategy. To monitor the accuracy of HIV RT test results, a national proficiency testing (PT) program was rolled out at selected testing sites in Ghana using the dried tube specimen (DTS) approach.MethodsBetween 2015 and 2018, 635 HIV testing sites, located in five regions and supported by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), were enrolled in the HIV PT program of the Ghana Health Service National AIDS/STI Control Programme. These sites offered various services: HIV Testing and Counselling (HTC), prevention of mother-to-child transmission (PMTCT) and Antiretroviral Treatment (ART). The PT panels, composed of six DTS, were prepared by two regional laboratories, using fully characterized plasma obtained from the regional blood banks and distributed to the testing sites. The results were scored by the PT providers according to the predefined acceptable performance criteria which was set at ≥ 95%.ResultsSeven rounds of PT panels were completed successfully over three years. The number of sites enrolled increased from 205 in round 1 (June 2015) to 635 in round 7 (December 2018), with a noticeable increase in Greater Accra and Eastern regions. The average participation rates of enrolled sites ranged from 88.0% to 98.0% across the PT rounds. By round 7, HTC (257/635 (40.5%)) and PMTCT (237/635 (37.3%)) had a larger number of sites that participated in the PT program than laboratory (106/635 (16.7%)) and ART (12/635 (1.9%)) sites. The average testing performance rate improved significantly from 27% in round 1 to 80% in round 7 (p < 0.001). The highest performance rate was observed for ART (100%), HTC (92%), ANC/PMTCT (90%) and Laboratory (89%) in round 5.ConclusionThe DTS PT program showed a significant increase in the participation and performance rates during this period. Sub-optimal performances observed was attributed to non-compliance to the national testing algorithm and testing technique. However, the implementation of review meetings, peer-initiated corrective action, supportive supervisory training, and mentorship proved impactful. The decentralized approach to preparing the PT panels ensured ownership by the region and districts.

Hubungan Tingkat Pengetahuan dengan Motivasi Ibu Hamil Melakukan Konseling HIV/AIDS di Klinik Kandungan RSUD Dr. Doris Sylvanus Palangka Raya

Quality HIV (Human Immunodeficiency Virus) counseling is an effective component as a preventive effort to promote changes in sexual behavior to reduce HIV transmission. Pregnant women must know and understand to be motivated to do HIV/AIDS counseling as an effort to prevent HIV/AIDS transmission. But in reality, the motivation of pregnant women to do HIV counseling tends to be low, because pregnant women do not feel they have a vulnerability to HIV/AIDS transmission. This study was conducted to determine the relationship between the level of knowledge and the motivation of pregnant women to do HIV/AIDS counseling at the Obstetrics Clinic at RSUD dr. Doris Sylvanus Palangka Raya. This research uses correlation research with cross-sectional approach and non-probability sampling technique (accidental sampling). Respondents in this study amounted to 61 respondents who met the inclusion criteria. The data was collected using a questionnaire which was then analyzed using the sperman rank statistical test. From the 61 respondents, the results of statistical analysis showed that the level of knowledge of pregnant women was in the sufficient category 24 (39%), good category 21 (34%), poor category 16 (26%) and motivation of pregnant women in the medium category 38 (62%), strong category 16 (26%), weak category 7 (11%) with p value = 0, 000 (p &lt; 0, 05). There is a significant and significant relationship between the level of knowledge and the motivation of pregnant women in conducting HIV/AIDS counseling at the Obstetrics Clinic of RSUD dr. Doris Sylvanus.