HIV Testing Coverage Research Articles

Analysis of characteristics of types of primary sexual partners and related factors of not being tested for HIV among men who have sex with men

Objective: To compare the characteristics of MSM with different types of primary sexual partners and to analyze the factors associated with MSM not being tested for HIV in the last six months. Methods: MSM were recruited in nine cities of Shandong Province from April to July 2021, and face-to-face questionnaires were conducted to collect information on sociodemographic characteristics, high-risk behaviors, and HIV testing of MSM. Blood samples were taken for serological tests of HIV and syphilis antibodies. Results: A total of 3 008 men who had anal sex with men in the last six months were divided into three groups according to the type of primary sexual partner in the last six months: the fixed sexual partner group (36.83%, 1 108/3 008), the commercial sexual partner group (3.06%, 92/3 008), and casual sexual partner group (60.11%, 1 808/3 008). There were statistically significant differences in the distribution of age, local residence time, education level, the primary place to find male sexual partners, use of new-type drugs in the last six months, consistent condom use every time during same-sex anal sex in the last six months, group sex in the last six months, no HIV testing in the last six months, having had a sexually transmitted disease in the last year, receiving peer education in the last year, and frequency of syphilis testing in the last year among different groups (P<0.05). Multivariable logistic regression analysis showed that related factors of not being tested for HIV in the last six months in MSM were those aged less than 30 years old (aOR=1.39, 95%CI: 1.06-1.83), married/cohabiting (aOR=1.74, 95%CI: 1.39-2.16), high school education or less (aOR=1.39, 95%CI: 1.15-1.67), had not used new-type drugs in the last six months (aOR=2.27, 95%CI: 1.89-2.71), had not received peer education in the last year (aOR=1.59, 95%CI: 1.28-1.98), had never been tested for syphilis (aOR=11.30, 95%CI: 8.15-15.66), had not been tested in the last year but had been previously tested for syphilis (aOR=5.65, 95%CI: 4.19-7.62), the type of primary sexual partner in the last six months being a commercial sexual partner (aOR=1.80, 95%CI: 1.01-3.20), and the type of primary sexual partner in the last six months being a casual sexual partner (aOR=1.50, 95%CI: 1.26-1.80). Conclusions: The characteristics of MSM with different types of primary sexual partners are different, and the proportion of HIV testing still needs to be improved. In the future, we should make full use of the Internet and peer education to expand the coverage of HIV testing for MSM, targeting the characteristics of MSM with different types of primary sexual partners.

Eliminating Vertical Transmission of HIV in South Africa: Establishing a Baseline for the Global Alliance to End AIDS in Children.

To gain a detailed overview of vertical transmission in South Africa, we describe insights from the triangulation of data sources used to monitor the national HIV program. HIV PCR results from the National Health Laboratory Service (NHLS) were analysed from the National Institute of Communicable Diseases (NICD) data warehouse to describe HIV testing coverage and positivity among children <2 years old from 2017-2021. NICD data were compared and triangulated with the District Health Information System (DHIS) and the Thembisa 4.6 model. For 2021, Thembisa estimates a third of children living with HIV go undiagnosed, with NICD and DHIS data indicating low HIV testing coverage at 6 months (49%) and 18 months (33%) of age, respectively. As immunisation coverage is reported at 84% and 66% at these time points, better integration of HIV testing services within the Expanded Programme for Immunization is likely to yield improved case findings. Thembisa projects a gradual decrease in vertical transmission to 450 cases per 100,000 live births by 2030. Unless major advances and strengthening of maternal and child health services, including HIV prevention, diagnosis, and care, can be achieved, the goal to end AIDS in children by 2030 in South Africa is unlikely to be realised.

Evaluating an Innovative HIV Self-Testing Service With Web-Based, Real-Time Counseling Provided by an Artificial Intelligence Chatbot (HIVST-Chatbot) in Increasing HIV Self-Testing Use Among Chinese Men Who Have Sex With Men: Protocol for a Noninferiority Randomized Controlled Trial

Background Counseling support for HIV self-testing (HIVST) users is essential to ensure support and linkage to care among men who have sex with men (MSM). An HIVST service with web-based real-time instruction, pretest, and posttest counseling provided by trained administrators (HIVST-OIC) was developed by previous projects. Although the HIVST-OIC was highly effective in increasing HIVST uptake and the proportion of HIVST users receiving counseling along with testing, it required intensive resources to implement and sustain. The service capacity of HIVST-OIC cannot meet the increasing demands of HIVST. Objective This randomized controlled trial primarily aims to establish whether HIVST-chatbot, an innovative HIVST service with web-based real-time instruction and counseling provided by a fully automated chatbot, would produce effects that are similar to HIVST-OIC in increasing HIVST uptake and the proportion of HIVST users receiving counseling alongside testing among MSM within a 6-month follow-up period. Methods A parallel-group, noninferiority randomized controlled trial will be conducted with Chinese-speaking MSM aged ≥18 years with access to live-chat applications. A total of 528 participants will be recruited through multiple sources, including outreach in gay venues, web-based advertisement, and peer referral. After completing the baseline telephone survey, participants will be randomized evenly into the intervention or control groups. Intervention group participants will watch a web-based video promoting HIVST-chatbot and receive a free HIVST kit. The chatbot will contact the participant to implement HIVST and provide standard-of-care, real-time pretest and posttest counseling and instructions on how to use the HIVST kit through WhatsApp. Control group participants will watch a web-based video promoting HIVST-OIC and receive a free HIVST kit in the same manner. Upon appointment, a trained testing administrator will implement HIVST and provide standard-of-care, real-time pretest and posttest counseling and instructions on how to use the HIVST kit through live-chat applications. All participants will complete a telephone follow-up survey 6 months after the baseline. The primary outcomes are HIVST uptake and the proportion of HIVST users receiving counseling support along with testing in the past 6 months, measured at month 6. Secondary outcomes include sexual risk behaviors and uptake of HIV testing other than HIVST during the follow-up period. Intention-to-treat analysis will be used. Results Recruitment and enrollment of participants started in April 2023. Conclusions This study will generate important research and policy implications regarding chatbot use in HIVST services. If HIVST-chatbot is proven noninferior to HIVST-OIC, it can be easily integrated into existing HIVST services in Hong Kong, given its relatively low resource requirements for implementation and maintenance. HIVST-chatbot can potentially overcome the barriers to using HIVST. Therefore, the coverage of HIV testing, the level of support, and the linkage to care for MSM HIVST users will be increased. Trial Registration ClinicalTrial.gov NCT05796622; https://clinicaltrials.gov/ct2/show/NCT05796622 International Registered Report Identifier (IRRID) PRR1-10.2196/48447

Whether HIV Discordance Among Couples Is Getting Altered Due to the Changing Discourseof the HIV Epidemic in India? Evidence fromTwo Rounds of National Family Health Survey

This article aims to analyse the role of dual challenges in the HIV epidemic in India, especially in the context of the criticality of the emerging epidemic, in altering the HIV discordance among couples. Analysis of the evidence from two rounds of community-based HIV testing (NFHS-3&amp;4) portrays that coverage of HIV testing in India has remarkably increased (91%) over the last decade. Although the overall prevalence of HIV in the country has declined, a noticeable decline can be found only among the males. The percentage of HIV concordant among couples in India remains unchanged (0.11%). Whereas, HIV prevalence among the couples where only the male partner is HIV positive has declined to 0.17% in NFHS-4 from 0.32% in NFHS-3. On the other hand, among couples where only the woman is HIV positive, the prevalence has increased. This shows that Indian women are in a disadvantageous position, and the gender difference in new infections is narrowing down. Thus, it can be said that the emerging HIV epidemic is altering the HIV discordance among couples in India, which poses the need to effectively and rapidly refine the HIV prevention strategies to target the sub-typologies and vulnerabilities.

Uptake of HIV Self-Testing and Associated Factors Among Female Sex Workers at Non-Governmental HIV Testing Facilities in Debre Markos and Bahir Dar Towns, Northwest Ethiopia, 2022.

Human immunodeficiency virus self-testing (HIVST) is universally accepted as an HIV testing option to achieve the United Nations Agency for International Development first 95 goal by 2030. HIV testing coverage through voluntary counseling and testing and provider initiated testing and counseling is low among female sex workers (FSWs). However, there is no evidence on the level of HIVST among FSWs in the study area. To assess the uptake of HIVST and associated factors among FSWs at non-governmental facilities in Debre Markos and Bahir Dar towns, Northwest Ethiopia, 2022. An institution-based cross-sectional study design was employed. A total of 423 study participants were selected by systematic random sampling technique. The data were collected using a structured and pre-tested questionnaire; entered into EpiData version 3.1 and exported to SPSS version 25 for analysis. An adjusted odds ratio (AOR) with a 95% confidence interval (CI) was estimated to assess the strength of association between independent variables and dependent variable. Bivariable logistic regression was done for each variable and those with a P-value of < 0.25% were selected for multivariable analysis. Finally, P-value < 0.05% was declared statistically significant. The magnitude of HIVST uptake among FSWs was 59.3%. Time since engagement of sex work > 5 years [AOR 2.16 (95% CI: 1.158-4.013)], age of first sexual debut >19 years [AOR 3.23 (95% CI: 2.045-5.093)], previous urban residence [AOR 3.99 (95% CI: 2.58-6.18)], good knowledge towards HIVST [AOR 1.78 (95% CI: 1.066-2.964)], education status being college and above [AOR 5.6 (95% CI: 3.12-9.30)] were significantly associated factors. HIVST uptake among FSWs was 59.3% which is lower than expected at national level. Educational status, age at first sexual debut, knowledge towards HIVST, and time since engagement in sex work were significantly associated with HIVST uptake.

Factors associated with lifetime HIV testing among women in four Southeast Asian countries: Evidence from the demographic and health surveys.

Southeast Asian countries have been trying to increase HIV testing coverage of women since awareness of HIV status is essential to eliminate mother-to-child transmission of HIV. This study determined factors related to lifetime HIV testing uptake among women aged 15-49years in four Southeast Asian countries: Myanmar, Cambodia, the Philippines and Timor-Leste. This study used cross-sectional data from the 2015-16 Myanmar Demographic and Health Survey (DHS), the 2014 Cambodia DHS, the 2017 Philippines National DHS and the 2016 Timor-Leste DHS. We conducted multivariable logistic regression analyses to identify factors associated with lifetime HIV testing among women aged 15-49 years who completed the surveys in each country and ran a fixed effects logistic regression model using pooled data. The proportions of lifetime HIV testing uptake among women aged 15-49years were 42.1% in Cambodia, 19.5% in Myanmar, 4.6% in the Philippines, and 3.7% in Timor-Leste. Marital status, age, education, and wealth were significantly associated with lifetime HIV testing uptake among women in all four countries. Other factors (e.g., comprehensive knowledge of HIV, rural/urban residence, positive attitudes towards negotiation for safer sex) were also significant determinants of HIV testing uptake among women in some of these countries. A multi-sectoral collaboration of related sectors and organizations is necessary to increase access to HIV testing and HIV knowledge of women to overcome the barriers to HIV testing. It is critical to make HIV testing services available and accessible to women, especially in rural areas.

Scholarly literature in HIV-related lesbian, gay, bisexual, and transgender studies: A bibliometric analysis.

Lesbian, gay, bisexual, and transgendered (LGBT) people are marginalized and understudied. Analyzing research activity worldwide is vital to better understand their needs in confronting the HIV epidemic. This study aimed to evaluate the global literature to identify the research collaboration, content, and tendency in HIV-related issues among the LGBT populations. Peer-reviewed original articles and reviews were achieved from the Web of Science Core Collection database. Country's collaborations and co-occurrence of most frequent terms were illustrated by VOSviewer software. The Latent Dirichlet Allocation (LDA) and the linear regression model were utilized to uncover the hidden topics and examine the research trend. From 1990 to 2019, a total of 13,096 publications were found. Stigma, sexual risk behaviors and HIV testing were the major topics in the LGBT research during the study period. Among 15 topics, topics about HIV/Sexually transmitted infections (STIs) prevalence, Outcomes of HIV/AIDS care and treatment, and Opportunistic infections in HIV-positive LGBT people showed decreasing attention over years, while other topics had a slight to moderate increase. Our study underlined the exponential growth of publications on the LGBT population in HIV research, and suggested the importance of performing regional collaborations in improving research capacity. Moreover, further research should focus on examining the manner to increase the coverage of HIV testing and treatment, as well as implement HIV-interventions with low cost and easy to scale-up.

Динамика развития эпидемического процесса ВИЧ-инфекции на юге России

The objective of this study is to describe the distinguishing feature of HIV spread within the southern regions of Russia. Materials and methods. Analysis of regional HIV surveillance data covering the period 2005–2021 in the South of Russia collected from the Federal Statistical Reports and additional requests with the appropriate regional authorities. Results. In 2021 in the South of Russia, there was a decrease in the incidence of HIV infection compared to 2019, which is associated with increased anti-epidemic work in recent years. The positive dynamics of HIV testing coverage in the Southern Federal District and the North Caucasus Federal District since 2005 has been traced, to 2021 reaching a level of 26.8 tests per 100 people. In the southern regions, there was a territorial unevenness of the HIV infection rate, which was 3 times lower than the national average. In recent years, the trend has been towards increasing a proportion of HIV patients in 30–49 age cohort. We observe a high coverage of HIV patients with clinical monitoring and ART. The analysis of HIV-associated mortality over the years reveals its decrease during 2019–2020 with a further increase in 2021 to 3.3 per 100,000 population, which is explained by the overall increase in mortality in Russia, associated with the COVID-19 pandemic. Conclusions. The deceleration of the growth of HIV rates along with the increase in the coverage of ART in HIV patients, observed in the south of Russia, may indicate the positive impact of counter epidemic activities, carried out during 2016–2021. Key words: antiretroviral therapy, HIV infection, HIV monitoring, HIV testing, HIV epidemic COVID-19

Age-of-consent requirements and adolescent HIV testing in low-and middle-income countries: multinational insights from 51 population-based surveys.

Pervasive social and structural barriers-including national policies-inhibit HIV testing uptake among priority populations, including adolescents. We assessed the relationship between age-of-consent policies for HIV testing and adolescent HIV testing coverage in 51 low- and middle-income countries. We pooled data from household surveys (2010-2020) and calculated the weighted country-level prevalence of lifetime HIV testing separately for adolescent girls and boys (ages 15-19). We then abstracted age-of-consent requirements for HIV testing across countries. Using multivariable linear regression, we estimated the average difference in national HIV testing coverage estimates for adolescent girls and boys by age-of-consent restrictions for HIV testing. National HIV testing coverage estimates ranged from 0.7% to 72.5% among girls (median: 18.0%) and 0% to 73.2% among boys (median: 7.5%) in Pakistan and Lesotho, respectively. In adjusted models, HIV testing coverage in countries requiring parental consent for individuals <18 years was, on average, 9.4 percentage-points (pp) lower (95% confidence interval [95%CI] -17.9pp to -0.9pp) among girls and 9.3pp lower (95%CI: -17.3pp to -1.2pp) among boys, relative to countries with less restrictive policies (age-of-consent: ≤16 years). Compared to countries with less restrictive (age-of-consent: ≤14 years) policies, HIV testing prevalence was significantly lower among girls (β -10.5pp, 95%CI: -19.7pp to -1.3pp) and boys (β -10.5pp, 95%CI -19.2pp to -1.8pp) in countries with more restrictive (age-of-consent: 18 years) parental consent requirements. Age-of-consent policies are persistent obstacles to adolescent HIV testing. Repealing parental consent requirements for HIV testing is needed to expand coverage and accelerate progress towards global HIV treatment and prevention targets.

Factors Associated with First-Time HIV Testing Among MSM via Secondary Distribution of HIV Self-test Kits in Zhuhai, China.

HIV self-testing (HIVST) is an effective method to expand HIV testing coverage worldwide. We analyze the results of HIVST and sexual behaviors of first-time testers among Men who have sex with men (MSM) who participated in a secondary distribution of HIVST kits. A total of 589 participants were recruited, including 173 first-time testers and 416 non-first-time testers. The first-time testers were mainly of Han ethnicity (aOR 1.88, 95% CI 1.10, 3.24), more likely to be HIV positive (aOR 7.18, 95% CI 2.37, 21.72), and had higher income (aOR 2.01, 95% CI 1.10, 3.69). Both groups were less likely to have anal sex with male partners (χ2: 146.24, P < 0.01), (χ2: 582.72, P < 0.01) or have sex with female partners (χ2: 19.01, P < 0.01), (χ2: 35.74, P < 0.01) after HIVST. We should expand HIVST among MSM and other key populations to identify first-time testers.

Prevalence of HIV testing and associated factors among young adolescents in Eswatini: a secondary data analysis

BackgroundHIV testing is a crucial starting point for prevention, early diagnosis, and treatment of HIV. Sub-Saharan Africa has the highest global HIV/AIDS prevalence and mortality, yet HIV testing remains sub-optimal. Thus, this study aimed to identify the prevalence of HIV testing and associated factors among young adolescents aged 10 to 14 years in Eswatini, a country with the highest HIV prevalence in the world.MethodsData were obtained from Swaziland HIV Incidence Measurement Survey between 2016 and 2017 (SHIMS 2), an internationally supported national survey aimed at combating HIV/AIDS. A total of 739 young adolescents aged 10 to 14 years were selected for the final analysis after deleting cases with missing values for the key variables. The effects of demographic characteristics, HIV knowledge, HIV risk perception, belief about HIV testing, perceived service accessibility, and parent-child sexual and reproductive health communication on lifetime HIV testing as an outcome variable, were explored using multivariable logistic regression.ResultsOnly 52.0% of young adolescents reported “ever tested” for HIV in their lifetime. Age (OR = 0.81, 95% CI = 0.73–0.90), residence (OR = 0.56, 95% CI = 0.43–0.74), and perceived service accessibility (OR = 3.10, (95% CI = 1.47–6.56) were identified as important factors associated with receiving HIV testing among young adolescents.ConclusionsA low rate of HIV testing was identified among young adolescents in Eswatini compared to the intended global goal of HIV testing coverage. Our findings suggested the importance of young adolescent-friendly educational and environmental interventions needed to improve the prevalence of HIV testing by reducing misperceptions about the risk of HIV and alleviating environmental constraints to access to HIV services.

MPrEP+ study protocol: a prospective cohort study assessing the feasibility and acceptability of an HIV pre-exposure prophylaxis (PrEP) strategy for male clients of female sex workers in Kisumu, Kenya

IntroductionMale clients (MCs) are integral to sex work-driven HIV transmission dynamics as sexual partners of female sex worker (FSW). MCs contribute disproportionately to incident HIV globally and in sub-Saharan Africa,...

Role of NIH in the Ending the HIV Epidemic in the US Initiative: Research Improving Practice.

In 2019, approximately 1.2 M persons were living with HIV and an estimated 34,800 new HIV infections occurred in the United States (U.S.). Significant disparities in HIV burden exist among persons of color, those with male-to-male sexual contact, young people, and persons experiencing barriers to consistent uptake of HIV interventions and services. These disparities are the root of major gaps in coverage of HIV testing, linkage to prevention and treatment, adherence, and retention in services in the United States. These gaps help fuel the American HIV epidemic. The Ending the HIV Epidemic in the U.S. Initiative (EHE) is built on 4 decades of federal domestic and international responses to HIV/AIDS. As the largest health research agency in the world, the National Institutes for Health (NIH) funds extensive basic, clinical, translational, and implementation HIV research that is crucial to achieving HIV epidemic control. Addressing the gaps and meeting EHE milestones will be accomplished in part through a combination of adaptation, implementation, and scale-up of existing HIV interventions. New discoveries will also be needed to create improved and novel diagnostics, monitor viral loads, and develop new prevention and treatment tools and approaches. HIV implementation research is essential to demonstrate the most effective strategies to facilitate the adaptation, adoption, and integration of evidence-based HIV interventions in real-world settings. This article outlines current NIH research plans to reduce and identify new HIV infections, improve treatment coverage and outcomes among persons with HIV, and effectively respond to HIV transmission outbreaks in the United States.

Evaluasi Program Provider Initiated Testing And Counseling (PITC) Pada Ibu Hamil Pada Masa Pandemi Covid-19 Di Puskesmas Muara Badak

Provider Initiated Testing and Counseling (PITC) is an important strategy to increase coverage of HIV testing for pregnant women as well as efforts to control HIV/AIDS in Indonesia and is part of the Maternal and Child Health (KIA) program. During the COVID-19 pandemic, new HIV/AIDS infections tended to increase, especially among housewives. During the COVID-19 pandemic, the Muara Badak Health Center found new HIV cases and tended to increase, while HIV screening for pregnant women decreased. This study aims to determine the implementation of the Provider Initiated Testing and Counseling (PITC) program for pregnant women during the COVID-19 pandemic at the Muara Badak Health Center in terms of process (assessment of the mechanism for implementing the PITC program for pregnant women) and output (factors related to pregnancy). with program success). This type of research is cross sectional and the sampling technique used is accidental sampling. Collecting data using questionnaires and observation sheets with a sample of 86 pregnant women, Bivariate analysis using the Fisher's Exact Test and the Kolmogorov-Smirnov Test with a 95% confidence level (α = 0.05). The results showed that the implementation of the Provider Initiated Testing and Counseling (PITC) program evaluation activities for pregnant women during the COVID-19 pandemic at the Muara Badak Health Center in terms of process, was declared to have gone quite well with a score of 32 (63%), while the implementation of evaluation activities the PITC program for pregnant women during the COVID-19 pandemic at the Muara Badak Health Center in terms of output stated, the results of statistical tests between the success of the PITC program and the basic principles of PITC (p=1,000), knowledge (p=1,000), attitudes (p=0.000) using the Kolmogorov-Smirnov Test, and resistance (p=1,000). In conclusion, there is no relationship between the success of the PITC program and the basic principles of PITC, knowledge, and barriers. There is a relationship between the success of the PITC program and attitude. Muara Badak Health Center is expected to be able to monitor and evaluate the implementation of PITC.

‘When I have these kits … I have confidence’ – HIV self-testing provides agency for women in their sexual decision-making

ABSTRACT Oral fluid-based HIV self-testing (HIVST) has emerged as a promising approach to increasing HIV testing coverage, particularly among high-risk populations. Understanding the experiences of women using self-tests and offering them to their sexual partners (secondary distribution) is crucial for determining the potential of HIVST. Qualitative in-depth interviews were conducted among 32 women at high risk of HIV infection, including women who engage in transactional sex, who participated in a cluster randomised trial of a secondary distribution strategy in western Kenya. Interviews explored how women used self-tests within relationships and how this affected their sexual decision-making. Three key themes emerged: women used HIVST to assess risk prior to engaging in sex with partners; HIVST provided women with increased agency to engage in or end relationships; and women appreciated these benefits and urged expanded access to self-tests. HIVST has the potential to support HIV prevention objectives in settings with high prevalence of HIV. Trial registration: ClinicalTrials.gov identifier: NCT03135067.

STRATEGY TO INCREASE THE COVERAGE OF HIV TESTING AMONG ADOLESCENT: A SYSTEMATICAL LITERATURE REVIEW TO SEEK EFFECTIVE INTERVENTION

Background: HIV testing programs have not been able to reach all populations at risk of HIV transmission. Lodging in adolescents vulnerable to HIV, program coverage is low. The purpose of this article is to identify various models of effective interventions that can improve the coverage of HIV testing among adolescents. Methods: This study is a systematic literature review with a time frame from 2011 to the present, with a geographical reach across the country. Rate the quality of the research methodology conducted by several components of the assessment indicators. Results: By keyword intervention strategies, increase coverage of HIV testing and adolescents 2343 articles obtained from a number of online journals database. Screening with inclusion criteria yielded 94 articles, and by exclusion criteria obtained 13 articles. Generally, coverage of HIV testing interventions in adolescents at increased each strategy. Community-based strategies appear to be more effective based on WHO standards, with coverage achieved around 80%, compared to health facility-based strategies with an average coverage of around 50%. HIV positive number reached 16% of health facilities. While the value of the highest achievements in community based around 12%. Conclussions:Community-based intervention is better to reach teens, but the community component must collaborate well with the ease of access to health facilities for HIV testing services. Development interventions in adolescents need to be equipped with a research method that can provide a strong evidens about the effectiveness of coverage of HIV testing among adolescents. Such research is not yet performed in Indonesia.

Reaching Men and Young Adults in a Pharmacy-Based HIV Self-Testing Strategy: Results from an Acceptability Study in Mozambique.

HIV self-testing (HIVST) is a WHO-recommended strategy to increase testing, especially among key populations, men, and young adults. Between May and December 2019, a pilot was implemented in Zambézia province, Mozambique, allowing clients to purchase HIV self-tests in 14 public/private pharmacies. The study assessed the strategy's acceptability and uptake. Pharmacy-based exit surveys were conducted among a random sample of clients, during the first three months of the pilot, independent of HIVST purchase. Another random sample of clients who bought an HIVST completed a survey 1-12 weeks after purchase. Chi-square and Mann-Whitney tests were used for the analysis, comparing clients who purchased an HIVST versus not. A total of 1,139 adults purchased 1,344 tests. Buyers were predominantly male (70%) and younger (52% between 15 and 34 years of age). Surveys were completed by 280 exiting pharmacy clients and 82 clients who purchased an HIVST. Main advantages were confidentiality and lack of need of a health provider visit, with main disadvantages being absence of nearby counseling and fear of results. No differences were seen between buyers and non-buyers for these factors. Among all undergoing HIVST, 71 (92%) perceived the instructions to be clear, however, 29 (38%) stated they would have benefitted from additional pre-test information or counseling. Ten (13%) reported following up at a nearby health facility to confirm results and/or receive care. Offering HIVST at public/private pharmacies was acceptable among people who traditionally tend to have a lower HIV testing coverage, such as men and young adults. However, additional resources and/or enhanced educational materials to address the lack of counseling, and linkage-to-care systems need to be put into place before scaling up this strategy.

Pediatric HIV Pre-test Informational Video is Associated with Higher Knowledge Scores Compared to Counselor-Delivered Information.

Video-based pre-test information is used in high resource settings to increase HIV testing coverage but remains untested in resource-limited settings. We conducted formative and evaluative focus group discussions with healthcare workers (HCWs) and caregivers of children in Kenya to develop and refine a pediatric HIV pre-test informational video. We then assessed HIV knowledge among caregivers sequentially enrolled in one of three pre-test information groups: (1) individual HCW-led (N = 50), (2) individual video-based (N = 50), and (3) group video-based (N = 50) sessions. A brief video incorporating information on national pediatric testing, modes of HIV transmission, and dramatized testimonials of caregivers who tested children was produced in three languages. Compared to individual HCW-led sessions (mean: 7.2/9; standard deviation [SD]: 1.3), both the group video-based (mean: 7.7; SD: 0.9) and individual video-based (mean: 7.6; SD: 0.9) sessions had higher mean knowledge scores. Video-based pre-test information could enhance existing pediatric HIV testing services.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10461-022-03706-5.

Determinan Perilaku Pemeriksaan HIV pada Wanita Penjaja Seks Langsung di Eks Lokalisasi

&lt;p&gt;HIV testing is the most important entry point in HIV/AIDS prevention, care, support, and treatment services. In implementing HIV/AIDS and STI control, the government recommends re-testing for HIV at least once every 6 months in groups with high-risk behavior. However, the coverage of HIV testing in key populations vulnerable to HIV infection, including Direct Female Sex Workers (DFSW) is still low. The purpose of this study was to determine the factors associated with HIV testing behavior among DFSW. The sample in this study amounted to 103 people. Data were analyzed using univariate, bivariate, and multivariate multiple logistic regression methods. The test results showed that the source of the information was related to HIV testing (p-value 0.045); odds ratio 4.401. Peer support was related to HIV testing (p-value 0.023) odds ratio 5.22. Support from field officers was related to compliance with HIV testing (p-value 0.000); odds ratio 19.02. There are two confounding variables, namely health worker support (p-value 0.28); odds ratio 3.747 and attitude (p-valule 0.242); odds ratio 0.461 as a protective factor. From the results of the analysis, it was found that field staff variables had more influence on HIV testing. Efforts to improve HIV testing behavior are carried out by increasing the number of information sources that are presented as attractive as possible. The role of field officers and peers as partners in encouraging DFSW to carry out HIV testing needs to be increased.&lt;/p&gt;

Clinical decision support systems to guide healthcare providers on HIV testing.

To understand the impact of clinical decision support systems (CDSSs) on improving HIV testing and diagnosis. An original global systematic review (PROSPERO Number: CRD42020175576) of peer-reviewed articles reporting on electronic CDSSs that generate triggers encouraging healthcare providers to perform an HIV test. Medline, Embase, Cochrane CENTRAL and CINAHL EBSCOhost were searched up to 17 November 2020 and reference lists of included articles were checked. Qualitative and quantitative syntheses (using meta-analyses) of identified studies were performed. The search identified 1424 records. Twenty-two articles met inclusion criteria (19 of 22 non-HIV endemic settings); 18 clinical and four laboratory-driven reminders. Reminders promoted 'universal' HIV testing for all patients without a known HIV infection and no recent documented HIV test, or 'targeted' HIV testing in patients with clinical risk-factors or specific diagnostic tests. CDSSs increased HIV testing in hospital and nonhospital setting, with the pooled risk-ratio amongst studies reporting comparable outcome measures in hospital settings (n = 3) of 2.57 [95% confidence interval (CI) 1.53-4.33, random-effect model] and in nonhospital settings (n = 4) of 2.13 (95% CI 1.78-4.14, random effect model). Results of the clinical impact of CDSSs on HIV diagnosis were mixed. CDSSs improve HIV testing and may, potentially, improve diagnosis. The data support the broader study of CDSSs in low- and high prevalent HIV settings to determine their precise impact on UNAIDS goals to reach universal HIV testing and treatment coverage.