HIV Screening Services Research Articles

Correlates of Intention to Utilize HIV Screening Services Among Adolescents In Selected Secondary Schools In Osogbo, Osun State Nigeria

Background The spread of HIV/AIDS among the productive age group particularly young adults is a major public health concern in Nigeria. HIV screening services are affordable interventions that offer chances to raise knowledge about HIV and preventive measures. They are crucial parts of HIV prevention initiatives. This study investigated the level of knowledge, and attitude as correlates of intention to Utilize HIV Screening Services Among Adolescents in Selected Secondary Schools in Osogbo, Osun State, Nigeria. Methods Data were collected from 120 respondents who were conveniently selected from two senior secondary school at the two Local government areas in Osogbo, Osun state with semi-structured questionnaire (83% reliability). Data were analyzed using appropriate statistical tools. Results Most of the students were in the middle adolescence (14 – 16 years) age group. The Knowledge responses were grouped on a scale and the results showed that most of the adolescents had a moderate level of knowledge regarding HIV/AIDS and HIV Screening Services. Further results showed a fairly high and positive attitude for the participants (76.66%). There were significant correlations (at p < 0.05) between knowledge level (R = 0.348), attitude (R = 0.432), and Intention to Utilize HIV Screening Services. These factors are still quite modest, though. Additionally, knowledge level indicated that most participants were unaware of any importance of the utilization of HIV Screening services. Conclusions The report suggested launching vigorous campaigns of public health education and awareness that highlight the importance of utilizing HIV Screening services.

Increasing uptake of integrated schistosomiasis treatment and HIV screening services in fishermen at high risk of comorbidities in Malawi

Increasing uptake of integrated schistosomiasis treatment and HIV screening services in fishermen at high risk of comorbidities in Malawi

The tale of two Badakhshans: Determinants of access and utilization of HIV preventive services along the Afghan-Tajik border.

Injection of opioids has contributed to growing HIV epidemics in Tajikistan and Afghanistan. This qualitative study explored determinants of access to primary prevention and screening for HIV among people who inject drugs (PWID) residing in border communities of Gorno-Badakhshan, Tajikistan and Badakhshan, Afghanistan. Semi-structured interviews were conducted with PWID, community leaders, and healthcare workers. The social-ecological model was used to inform a thematic analysis of determinants of access. There were no preventive or screening services for HIV in the border districts of Afghanistan. Barriers to accessing HIV-related services in Tajikistan, and to accessing general health services in Afghanistan, included: lack of knowledge about HIV, inaccessible communities with poor infrastructure, discrimination and violence against women, and stigmatization of PWID and people living with HIV. Access to HIV-related and other health services by PWID was facilitated by community leader support, family support, outreach services, and linkage of harm reduction services with HIV testing and care. Urgent interventions are needed to stem the escalating HIV epidemic in Afghanistan and enhance existing services in Tajik border communities. This qualitative study offers insights into barriers and facilitators for accessing HIV prevention and screening services among PWID, suggesting potential interventions.

Assessing the Awareness, Attitude, and Intention of Adolescents for HIV Screening Services Utilization in Osogbo, Osun State, Nigeria

Information on efficient HIV prevention strategies especially among adolescents in the region is still crucial because more than 70% of all HIV cases worldwide are in Sub-Saharan Africa. This study assessed the awareness, attitude an Intentions of Adolescents for HIV Screening Services Utilization among secondary school students in Osogbo, Osun state, Nigeria. Using multi-stage sampling, 120 students were selected from Selected Secondary Schools (s1-s3). A semi-structured questionnaire was used to collect data to measure the awareness, attitudes and Intentions of Adolescents to utilize HIV Screening Services. The data were presented as descriptive statistics subjected to independent t-test statistics at p ≤0.05 level of significance. The mean age, for the respondents was 15.73±1.461. Regarding awareness, About 70% of all students reported not to have individually sought information about HIV Screening at some period and the preferred source of information for the adolescents was in their schools. Further results showed a fairly high and positive attitude for the participants (76.66%) but the mean score for intention was 26.11±5.386. The need to raise awareness of the target population through education is recommended.

HIV self-testing: A highly acceptable and feasible strategy for reconnecting street adolescents with HIV screening and prevention services in Togo (The STADOS study).

HIV self-testing is a complementary screening strategy that could facilitate access to HIV care services for street adolescents. The objectives of this study were to assess the acceptability and feasibility of HIV self-testing and their associated factors, to estimate HIV prevalence among street adolescents in Togo, and to describe the sexual behavior of this population. A cross-sectional study was conducted between July 2021 and May 2022 in Lomé and Kara (Togolese cities with the highest number of street adolescents). Street adolescents aged 13-19 years were included. An oral HIV self-test (OraQuick®) was used. Acceptability was defined as the proportion of adolescents who completed the test, and feasibility was defined as the proportion of adolescents who reported a test with a valid result. An HIV serological test was performed for all participants. A weighted logistic regression model was used to identify the factors associated with the acceptability and feasibility of HIV self-testing. A total of 432 street adolescents (12.3% female) with a median age of 15 years, interquartile range (IQR) [14-17], were included in this study. Of the 231 sexually active adolescents, only 30.3% (n = 70) reported having used a condom during their last sexual intercourse. HIV self-test was offered to a sub-sample of 294 street adolescents. Acceptability was 96.6% (284/294), (95%CI = [93.8-98.3]) and feasibility 98.9% (281/284), (95%CI = [97.0-100.0]). Being 16 years of age or older (aOR = 28.84; p<0.001) was associated with HIV self-test acceptability. Reporting drug abuse (aOR = 0.47; p = 0.020) was negatively associated to acceptability. Having an educational level at least equivalent to secondary school was associated to HIV self-testing feasibility (aOR = 3.92; p = 0.040). Self-test results were correctly interpreted by 98.6% of street adolescents. HIV prevalence was estimated at 0.9% (95%CI [0.4-2.4]). HIV self-testing is acceptable and feasible among street adolescents, a population at high risk of HIV infection in Togo. The provision of HIV self-testing kits, coupled with condom distribution, represents an opportunity to improve access to HIV care services.

HIV Prevalence and HIV Screening History Among a Veterans Association Cohort of People with Opioid and Alcohol Use Disorders.

Veterans face high risk for HIV and substance use, and thus could be disproportionately impacted by the HIV and substance use disorder (SUD) "syndemic." HIV prevalence among veterans with SUD is unknown. To project HIV prevalence and lifetime HIV screening history among US veterans with alcohol use disorder (AUD), opioid use disorder (OUD), or both. We conducted a retrospective cohort analysis using national Veterans Health Administration (VHA) data. We selected three cohorts of veterans with SUD: (1) AUD, (2) OUD, and (3) AUD/OUD. Included veterans had ICD codes for AUD/OUD from 2016 to 2022 recorded in VHA electronic medical records, sourced from the VA Corporate Data Warehouse (CDW). We estimated HIV prevalence by dividing the number of veterans who met two out of three criteria (codes for HIV diagnosis, antiretroviral therapy, or HIV screening/monitoring) by the total number of veterans in each cohort. We also estimated lifetime HIV screening history (as documented in VHA data) by cohort. We reported HIV prevalence and screening history by cohort and across demographic/clinical subgroups. Our sample included 669,595 veterans with AUD, 63,787 with OUD, and 57,015 with AUD/OUD. HIV prevalence was highest in the AUD/OUD cohort (3.9%), followed by the OUD (2.1%) and AUD (1.1%) cohorts. Veterans of Black race and Hispanic/Latinx ethnicity, with HCV diagnoses, and aged 50-64 had the highest HIV prevalence in all cohorts. Overall, 12.8%, 29.1%, and 33.1% of the AUD/OUD, OUD, and AUD cohorts did not have history of HIV screening, respectively. HIV prevalence was high in all SUD cohorts, and was highest among veterans with AUD/OUD, with disparities by race/ethnicity and age. A substantial portion of veterans had not received HIV screening in the VHA. Findings highlight room for improvement in HIV prevention and screening services for veterans with SUD.

How Taiwan has responded to COVID-19 and how COVID-19 has affected Taiwan, 2020-2022.

From January 2020 to December 2022, there was a total of 8,872,955 confirmed COVID-19 cases in Taiwan. In addition, a total of 15,253 COVID-19 related deaths were reported. During these three years, the government and health authority did many efforts to response this pandemic. In the early pandemic, Taiwan Central Epidemic Command Center was established in the early 2020 to organize associated resource, develop effective policy and implement strict intervention. In response to COVID-19 pandemic, many infection control policy and interventions, including universal mask wearing with increasing production of face mask, hand hygiene, border control, introduce of digital technology incorporating big data, quarantine of COVID-19 cases, travel and gathering restriction, were implemented. In the meanwhile, two COVID-19 vaccines, namely MVC-COV1901 and UB-612, have been developed under the support of government. Furthermore, MVC-COV1901 was taken into clinical practice after received emergency use approval. In addition, two traditional Chinese medicines, including NRICM101 and NRICM102 showed their promising effect against SARS-CoV-2 infection and were recommended as potential therapeutic options for COVID-19. During the pandemic, the nonpharmacologic intervention help reduce many infectious diseases, especially for airborne/droplet-transmitted diseases. However, COVID-19 exhibited some adverse impacts on the healthcare systems, such as emergency medical service on out of hospital cardiac arrest, cancer screening, HIV screening and prevention services, and public health, namely the psychosocial status of healthcare workers. Although the outbreak of SARS-CoV-2 infections may gradually subsided, we should keep monitoring its associated impact and appropriately response to this pandemic.

Provider perspectives on clinical decision support to improve HIV prevention in pediatric primary care: a multiple methods study

BackgroundClinical decision support (CDS) is a promising intervention for improving uptake of HIV testing and pre-exposure prophylaxis (PrEP). However, little is known regarding provider perspectives on acceptability, appropriateness, and feasibility of CDS for HIV prevention in pediatric primary care, a key implementation setting.MethodsThis was a cross-sectional multiple methods study utilizing surveys and in-depth interviews with pediatricians to assess acceptability, appropriateness, and feasibility of CDS for HIV prevention, as well as to identify contextual barriers and facilitators to CDS. Qualitative analysis utilized work domain analysis and a deductive coding approach grounded in the Consolidated Framework of Implementation Research. Quantitative and qualitative data were merged to develop an Implementation Research Logic Model to conceptualize implementation determinants, strategies, mechanisms, and outcomes of potential CDS use.ResultsParticipants (n = 26) were primarily white (92%), female (88%), and physicians (73%). Using CDS to improve HIV testing and PrEP delivery was perceived as highly acceptable (median score 5), IQR [4–5]), appropriate (5, IQR [4–5]), and feasible (4, IQR [3.75–4.75]) using a 5-point Likert scale. Providers identified confidentiality and time constraints as two key barriers to HIV prevention care spanning every workflow step. With respect to desired CDS features, providers sought interventions that were integrated into the primary care workflow, standardized to promote universal testing yet adaptable to the level of a patient’s HIV risk, and addressed providers’ knowledge gaps and bolstered self-efficacy in providing HIV prevention services.ConclusionsThis multiple methods study indicates that clinical decision support in the pediatric primary care setting may be an acceptable, feasible, and appropriate intervention for improving the reach and equitable delivery of HIV screening and PrEP services. Design considerations for CDS in this setting should include deploying CDS interventions early in the visit workflow and prioritizing standardized but flexible designs.

Access to Cervical Cancer Screening for Women Living With HIV: A Record Linkage Study.

BackgroundAccording to the Global Strategy to Accelerate the Elimination of Cervical Cancer launched by the World Health Organizations (WHO), 70% of all women should undergo cervical cancer (CC) screening by 2030. While integrated HIV care and CC screening services exist, lack of unified data and patient management systems hinder reaching the set WHO goals. We used record linkage methods to assess the number of women receiving HIV care and visual inspection with acetic acid (VIA) based CC screening at Kanyama First Level Hospital (FLH) in Lusaka, Zambia.&#x0D; MethodsWe retrieved HIV patient records from SmartCare, Zambia’s National Electronic Health Records system, and the CC screening database for the years 2004 to 2018, and 2010 to 2018, respectively. We restricted this pilot study to women attending Kanyama FLH for HIV services, and its surrounding clinics for CC screening. We used the following linkage variables: first name, last name, facility, and year of birth. We used a machine learning based approach with Random Forest classifiers to identify records from the HIV and CC screening services belonging to the same person. We created synthetic patient record datasets to train and test the linkages. After the linkage, we anonymized the data and retrieved screening status from the CC screening database. We assessed the percentage of women in HIV care undergoing CC screening and the respective screening results. We calculated the time to CC screening with reference to the start of the HIV Antiretroviral Therapy treatment (ART).&#x0D; ResultsWe retrieved a total of 32,970 records from SmartCare and 176,736 records from CC screening databases. With the linkage we determined that of all women that ever accessed HIV treatment services at Kanyama FLH between 2004 and 2018, 2,999 (9%) received CC screening. Of those that were screened, 30% received the CC service at Kanyama FLH, while the rest from 13 surrounding facilities. 61% of women accessed CC services before starting ART. Of the women screened for CC, 371 had a positive VIA result (12%), 2,395 (80%) a negative and 233 (8%) had a missing or indeterminate result. When we restricted the analysis to women, who were eligible for screening (aged 25 to 59 years), the screening coverage was 9.6%.&#x0D; ConclusionOur study demonstrates the significance of record linkage efforts in determining CC screening coverage among women living with HIV. According to these findings, CC screening coverage among patients receiving ART services between 2004 and 2018 was at 9%, showing the depth of effort required to meet WHO targets at the time. The linkage output was primarily influenced by the scarcity of available linkage variables and data missingness, resulting in potentially overestimating or underestimating the CC coverage. This is typical of data systems in low- and middle-income countries; however, this study demonstrates that record linkage is useful in bridging these widespread data gaps.

PREVALENCE AND SEVERITY OF DEPRESSION AMONG PEOPLE LIVING WITH HUMAN IMMUNODEFICIENCY VIRUS IN YENAGOA, SOUTHERN NIGERIA

Background: Depression is a mental health condition that affects approximately 350 million people worldwide. People living with HIV and AIDS (PLWHA) are at increased risk of developing this condition. Identification of location-specific factors is crucial to minimizing this presentation in this sub-population. Aim: The aim of this study was to measure the prevalence, severity, and associated sociodemographic and comorbidity of depression among people living with HIV and AIDS in a laboratory setting in Yenagoa, southern Nigeria. Methods: This is a cross-sectional study carried out on 282 PLWHA, aged 18 years and over. They receive HIV screening services in the laboratory of the Federal Medical Center, Yenagoa from March to April 2017. Sociodemographic data of respondents and selected comorbidities were collected using a modified structured questionnaire from the World Health Organization STEPS tool. Retrieving CD4+ count results from the laboratory registry, and height, weight, and body mass index (BMI) were measured. The presence of depression was assessed using the Patients Health Questionnaire-9 tool and performed a multivariate logistic regression analysis to identify factors associated with depression with a 95% confidence level. Results: The mean age of the respondents was 40±8.8 years and most of them were females 195 (69.2%). Seventy-five (26.6%) of the respondents were depressed, of whom 10 (13.3%) had severe depression, while 41 (54.7%) had mild depression. The most common symptoms of depression were fatigue (30.1%) and dysphoria (28.7%). There was an association between depression and CD4+ count &lt;350 cells/µL with an adjusted odds ratio (aOR) of 2.04 (95%CI: 1.14-3.63) and underweight with an aOR of 2.56 (95%CI: 1.01-6.47), while HAART with an aOR of 0.38 (95%CI: 0.18-0.84) was associated with decreased odds of developing depression. Conclusion: Depression appeared among a significant proportion of people living with HIV and AIDS in Yenagoa, southern Nigeria, and fatigue was the most common symptom of depression. Lack of HAART, low CD4+ count, and being underweight appear to be the major factors negatively associated with depression. There is therefore a need to ensure people living with HIV and AIDS continue to receive HAART to improve CD4+ count and increase BMI. Peer Review History: Received: 28 February 2022; Revised: 17 March; Accepted: 21 April, Available online: 15 May 2022 Academic Editor: Dr. Sally A. El-Zahaby, Pharos University in Alexandria, Egypt, sally.elzahaby@yahoo.com UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file: Reviewer's Comments: Average Peer review marks at initial stage: 5.5/10 Average Peer review marks at publication stage: 7.0/10 Reviewers: Prof. Dr. Hassan A.H. Al-Shamahy, Sana'a University, Yemen, shmahe@yemen.net.ye Dr. Asia Selman Abdullah, University of Basrah, Iraq, asia_abdullah65@yahoo.com Similar Articles: THE RELATION BETWEEN GENERAL HEALTH AND ORGANIZATIONAL PERFORMANCE IN PERSONNEL OF SHIRAZ CITY EMERGENCY IN 2017

Impact of the initial wave of COVID-19 pandemic in Taiwan on local HIV services: Results from a cross-sectional online survey.

PurposeThis study aimed to investigate the impact of the initial wave of the COVID-19 pandemic on HIV services in Taiwan.MethodsAn online, cross-sectional survey was conducted among people living with HIV (PLWH), individuals at risk of HIV infection (IAR), and service prescribers between 20th October and 30th November, 2020. Representatives from patient advocacy groups were interviewed.ResultsIn total, 66 PLWH, 104 IAR, and 32 prescribers from Taiwan completed the survey. Mild to moderate disruptions to HIV-related services (including medical consultation, HIV-related testing, and medications) were found by the survey, with IAR appearing more affected than PLWH. Nine (13.6%) PLWH and 31 (29.8%) IAR reported disruptions in hospital/clinic visits and two (3.0%) PLWH and 25 (24.0%) IAR reported decreased frequency of HIV testing. Similar observations were also made by four patient advocacy group representatives interviewed. Telehealth services were received by only limited proportions of PLWH and IAR who participated in the survey.ConclusionHIV services in Taiwan were not severely affected by the initial wave of COVID-19, but notable disruptions were still observed in HIV screening and prevention services. Multi-pronged strategies, including telehealth services, are warranted to overcome new challenges in HIV care in the COVID-19 era.

Increasing TB/HIV Case Notification through an Active Case-Finding Approach among Rural and Mining Communities in Northwest Tanzania.

While Tanzania is among the high TB burden countries to reach the WHO's End TB 2030 milestones, 41% of the people estimated to have had TB in 2020 were not diagnosed and notified. As part of the response to close the TB treatment coverage gap, SHDEPHA+ Kahama conducted a TB REACH active case-finding (ACF) intervention among rural and mining communities in Northwest Tanzania to increase TB/HIV case notification from July 2017 to June 2020. The intervention successfully linked marginalized mining communities with integrated TB/HIV screening, diagnostic, and referral services, screening 144,707 people for TB of whom 24,200 were tested for TB and 4,478 were tested for HIV, diagnosing 1,499 people with TB and 1,273 people with HIV (including at least 154 people with TB/HIV coinfection). The intervention revealed that community-based ACF can ensure high rates of linkage to care among hard-to-reach populations for TB. Providing integrated TB and HIV screening and diagnostic services during evening hours (Moonlight Events) in and around mining settlements can yield a large number of people with undiagnosed TB and HIV. For TB, this is true not only amongst miners but also FSW living in the same communities, who appear to be at similar or equally high risk of infection. Local NGOs can help to bridge the TB treatment coverage gap and to improve TB and HIV health outcomes by linking these marginalized groups with public sector services. Capturing the number of referrals arriving at CTCs is an important next step to identify how well the integrated TB/HIV outreach services operate and how they can be strengthened.

Immigrant generational status and the uptake of HIV screening services among heterosexual men of African descent in Canada: Evidence from the weSpeak study

ObjectiveCanada became a preferred destination for many non-European and non-American migrants since the introduction of favorable immigration policies in the late 1960 s. Blackimmigrants from the African and Caribbean regions however are a known vulnerable population to HIV infection in Canada. Even though first-generation immigrants might differ from subsequent generations in terms of culture and beliefs which are important for health outcomes and behaviors, research examining disparities in their use of preventative healthcare is limited. This study aimed to examine generational disparities in the uptake of HIV screening services among a sample of heterosexual Black men in Ontario, Canada. MethodsWe used data from a cross-sectional survey sample (n = 829) that was collected from heterosexual Black men in four Ontarian cities (Toronto, Ottawa, London and Windsor) between March 2018 and February 2019. We used the negative log-log link function of the binomial family to examine the independent relationship between immigration status and the uptake of HIV testing and the cumulative effect of other predictor variables on HIV testing in nested models. ResultsFindings from multivariate analysis show second-generation immigrants were significantly less likely to test for HIV compared with their first-generation immigrant counterparts. After controlling for theoretically relevant variables, the second-generation immigrants were 53% less likely to test for HIV. We further observed that participants with good knowledge of HIV transmission (OR=1.05; p > 0.05) and those who were older were more likely to test for HIV. Those with masculine tendencies (OR=0.98; p > 0.05) and those who reported not having sexual partner were less likely to test (OR=0.57; p > 0.01). Religion emerged as a significant predictor of HIV testing as Christians (OR=1.62; p > 0.05) and other believers (OR=1.59; p > 0.05) were more likely to test for HIV when compared to their Muslim counterparts. ConclusionHIV prevention policies may need not only prioritize first-generation immigrants, but the wellbeing of their descendants as well. This could be achieved by implementing programs that will enhance second-generation immigrants’ use of HIV screening services. Additionally, HIV educational programs would be of relevance and especially so as respondents with good knowledge of HIV transmission consistently demonstrated higher likelihood of testing for their HIV status.

Concurrent sexual partnerships and HIV testing among heterosexual Black men in Ontario, Canada: findings from the weSpeak study

ABSTRACT Background African, Caribbean, and Black men constitute the second-highest category of males living with HIV in Ontario, which increased from 15.4% to 17% between 2011 and 2016. Previous studies have attributed this disproportionately higher rate to multiple concurrent sexual partnerships and low rates of HIV testing. Drawing on theoretical constructs of the health belief model (HBM), this study examined the relationship between multiple concurrent sexual partnerships and the uptake of HIV testing services among heterosexual Black men in Ontario. Methods Using a cross-sectional sample data of 829 individuals from four cities in Ontario, we employed the multinomial logit analysis to examine the relationship between multiple sexual partnerships and the uptake of HIV testing services among heterosexual Black men. Results The findings show that heterosexual Black men with multiple concurrent sexual partners were more than twice (RRR = 2.306, P < 0.01) as likely to test for HIV within the past 12 months when compared to those with one partner. Furthermore, being an immigrant, having good knowledge of HIV transmission, and earning lower annual income predicted higher odds of testing while sexual debut between the ages of 16 and 20 years, no visit to a healthcare provider in the past year and difficulty accessing healthcare significantly predicted lower likelihood of testing for HIV. Conclusions These findings align with the theoretical constructs of the health belief model but more importantly, they suggest heterosexual Black men with concurrent sexual partners may be aware of their HIV risk and are taking measures to know their serostatus. Hence, making HIV screening services accessible and at safer spaces could increase their use of HIV screening services.

Bisexual People’s Utilization of Sexual Health Services at an LGBTQ Community Center in Chicago

Bisexual people are at increased risk for sexually transmitted infections (STIs), including HIV. In STI data collection, bisexual people are often miscategorized as or conflated with heterosexual or gay/lesbian people. Such poor data capture practices invisibilize bisexual people and prevent the tailoring of HIV and STI services to cater to bisexual populations. The Center on Halsted (COH) is an LGBTQ community center in Chicago. COH’s HIV & STD Services Department provides HIV testing to people who present for HIV screening services age 12 and older. COH also administers the State of Illinois AIDS, HIV, & STD Hotline. This manuscript reports HIV-related service access patterns of COH clients by sexual identity, with an emphasis on reporting patterns among bisexual and other non-monosexual (e.g., “bi+”) populations in comparison with other sexual minority populations. Among COH’s HIV testing clients who were sexual minorities in fiscal years 2018 and 2019, 15.42% in 2018 and 16.71% in 2019 identified as bisexual, respectively. Among sexual minority hotline callers, approximately one quarter (25.1% in 2018 and 28.8% in 2019) identified as bisexual. Given that bisexual individuals comprise over half of sexual minority populations, these findings indicate that bi + individuals may be under-represented in accessing HIV and STI services at COH. These results provide previously unknown insight into the sexual identities of populations accessing HIV- and STD-related services within a LGBTQ community setting. Funders of HIV and STI surveillance services should change reporting requirements to make visible the HIV services access patterns and outcomes of bisexual populations.

Epidemiology of HIV Infection in the Amhara Region of Ethiopia, 2015 to 2018 Surveillance Data Analysis.

BackgroundGlobally, over 37.9 million people are living with HIV in 2018 and sub-Saharan Africa carries 71% of the global HIV epidemics. In Ethiopia, there were an estimated 613,000 HIV cases in 2017. This study aimed to assess the trend of HIV incidence in the Amhara Region, Ethiopia.MethodsA retrospective descriptive study was conducted using routine HIV data from 2015 to 2018. We extracted HIV records from the Amhara Regional Health Bureau database. Data confidentiality was secured through data anonymity. Data were entered, cleaned and analyzed by IBM SPSS version 22 (Armonk, NY, USA). Various descriptive statistics such as counts, proportions and trends were computed to see the magnitude of HIV in the study area.ResultsA total of 57,293 new HIV cases were reported from 2015 to 2018 and 33,720 (59%) were females. The majority, 40,054 (70%), of HIV cases were among people in 25−49 years. The overall incidence rate of HIV from 2015 to 2018 was 6.9 per 1000 population. The annual HIV incidence rates were 7.3. 6.3, 7.4 and 6.63 per 1000 population in 2015, 2016, 2017 and 2018, respectively. The incidence rate per 1000 population was high in Dessie town (5.74), Bahir Dar city (4.27) and Gondar town (3.00). About 49,564 (86.5%) of HIV cases have started ART and 33% of them had TB infection where 54% of them were females. Only 14869 (30%) people on ART had normal nutritional status.ConclusionHIV remains a public health concern in the Amhara Region and the burden varied by place, time, gender and age groups. Improving awareness creation and community mobilization, managing TB infection and undernutrition problems, and making HIV screening services available in all healthcare facilities are crucial to decrease HIV infection. Special attention is also required to avoid risk factors that increased HIV incidence among females.

Music Festivals Serving as a Catalyst for Collaborative HIV Prevention Education and Expanded HIV Testing in Rural Uganda

From 2014 through 2016, we produced a music festival in rural Kabale, Uganda in order to facilitate HIV testing and reproductive health services offered by NGOs specializing in HIV and sexual health. Our aim was to assess the effectiveness of a music festival to engage persons in sexual health and HIV screening services. Clinical service data was compiled and analyzed. Between 2014 and 2016, over 38,000 persons attended the annual festivals and were exposed to HIV prevention messaging. Over 7,000 persons have been tested for HIV. In 2016, 4,588 HIV tests were performed. In addition, 36 long-acting means of contraception were placed, 33 women were screened for cervical cancer, 2 tubal ligations were performed, and 193 men were referred for circumcision. Music festivals created a novel opportunity to provide sexual health services including prevention education, reproductive healthcare, and HIV testing to persons at risk for HIV in rural Uganda.

HIV/AIDS epidemic in West Bengal: An overview.

Background:West Bengal is a low-prevalent state with high vulnerability for HIV. The state bears around 6% of HIV burden of India. With consistent effort on preventive, diagnostic, and curative services under National AIDS Control Program, HIV prevalence is gradually coming down. Our study objective is to determine the trend of HIV positivity among different groups/population attending Integrated Counseling and Testing Centres (ICTCs) over a period of 8 years and identify the group of population needing special attention.Methods:The study was conducted with available program data year-wise from 2008–2009 to 2014–2015 among different groups of population who attended ICTCs for HIV testing. Year-wise positivity was calculated and trend analysis was performed by linear regression method keeping year as regressor. Similar methodology was applied for different typologies among the high-risk groups (HRGs) and trend analysis was done using linear regression for the study period from 2012–2013 to 2014–2015.Results:HIV positivity among general male and non-pregnant individuals, HRG population, transgender (TG) population, and pregnant women showed a significant declining trend over the past 8 financial years, but the discordance rate remained almost the same. Regarding HIV positivity trend among different typologies of HRGs, trucker group showed a significant increase in HIV positivity over the past 3 years, whereas HIV positivity among other groups like female sex workers, men having sex with men, injecting drug users, and migrant labors did not undergo significant changes over the past 3 years.Conclusion:HIV-preventive services among truckers need to be emphasized. HIV screening services among the TG population should be further scaled up through more number of targeted interventions.

Community Based HIV Screening in Pregnant Women and Provision of Prevention of Mother to Child Transmission Care in Rural Zambia

Background: Providing care for pregnancy is compounded by high HIV prevalence in Zambia. Approximately 10% of new HIV infections in children 0-14 years old occur as mother to child transmission (MTCT). Objective: To establish the capacity of the community to screen for HIV in pregnant women with saliva test and provide PMTCT, in a continuum of care. Methods: This study is a sub-set of a community based prospective cluster randomized controlled trial, (RCT) conducted 2008 to 2013. Oraquick, an FDA approved technology uses saliva to screen for HIV1 and HIV2. CBAs were trained, supervised and provided with job aids. Results: From 3846 pregnant women in the RCT, 2018 were screened. Among the 2018, 1089 (45.8%) were screened using Oraquick saliva test. Of the total tested for HIV, 23.8% had Oraquick only testing, 46% routine tests only and 30.2% had both tests done. Of the 1089, 608 participants (55.85%) screened using Oraquick, also had their test results confirmed with routine antibody tests at nearby health centers. The community based agents counselled, screened, dispensed nevirapine and referred appropriately. Eighty two (4%) out of the 2018 women were recorded as HIV positive. These include 47 (5.93%) women tested with Oraquick and 35 who were tested at the health centres using routine HIV testing. Conclusion: CBAs demonstrated that when trained, equipped and supported with incentives, they are able to screen the community for HIV utilizing Oraquick saliva testing and provide PMTCT.They provided increased access to HIV screening and PMTCT services.

Latent class analysis of acceptability and willingness to pay for self-HIV testing in a United States urban neighbourhood with high rates of HIV infection.

Introduction: Acceptability and willingness to both take and pay for HIV self-tests (HIVSTs) in US neighbourhoods with high rates of HIV infection are not well understood. Methods: We surveyed 1,535 individuals about acceptability and willingness to take and pay for an HIVST in a predominately African American neighbourhood with 3% HIV seroprevalence. We recruited individuals presenting for HIV screening services in a community-based programme. Latent class analysis (LCA) grouped individuals with similar patterns of HIV-risk behaviours and determined which groups would be most willing to use and buy HIVSTs. Results: Nearly 90% of respondents were willing to use an HIVST; 55% were willing to buy HIVSTs, but only 23% were willing to pay the market price of US $40. Four distinct groups emerged and were characterized by risk behaviours: (1) low risk (N = 324); (2) concurrent partnerships (N = 346); (3) incarceration and substance use (N = 293); and (4) condomless sex/multiple partners (N = 538). Individuals in the low-risk class were less willing to self-test compared to concurrent sexual partners (OR = 0.39, p = .003) and incarceration and substance use (OR = 0.46, p = .011) classes. There were no significant differences across classes in the amount individuals were willing to pay for an HIVST. Conclusions: HIVSTs were overwhelmingly acceptable but cost prohibitive; most participants were unwilling to pay the market rate of US $40. Subsidizing and implementing HIVST programmes in communities with high rates of infection present a public health opportunity, particularly among individuals reporting condomless sex with multiple partners, concurrent sexual partnerships and those with incarceration and substance use histories.