Uptake Of Human Immunodeficiency Virus Testing Research Articles

Socio-demographic correlates of knowledge, perceived risk and uptake of HIV testing among Nurses in Osogbo, South-western Nigeria.

Introduction: Human Immunodeficiency Virus (HIV)testing is a crucial step in the prevention and control of HIV. Nurses, as primary healthcare providers, play a vital role in promoting HIV testing service and providing accurate information to patients. This study assessed the sociodemographic correlates of HIV knowledge, perceived risk and uptake of HIV testing among nurses in Osogbo.Methods: This was a cross-sectional study design using multistage sampling method for selection of 220 nurses from both private and public health facilities in Osogbo. Data was collected using a semi-structured self-administered questionnaire and IBM SPSS version 23 was used for data analysis.Results: The knowledge of HIV/AIDs was good among the respondents (74.4%), 63.6% of the respondents had perceived high-risk of contracting HIV while 89.3% had uptake HIV testing service. Statistical significance was found with nurses in private hospitals who were more knowledgeable on HIV/AIDs than those who work in a public hospital (x2= 4.136, P= 0.042), none of the socio-demographic characteristics was statistically associated with perceived high-risk of the disease.Conclusion: The study found that a significant number of respondents had poor knowledge on HIV/AIDS despite being health workers, there was a gap in their perceived risk and a satisfactoryuptake of HIV testing. However, the socio-demographic characteristics that had a statistical relationship with HIV knowledge and uptake of HIV test were facility category and gender

Partying in Thailand: Never Testing Among Men Who Have Sex With Men Who Attend Sexualized (Drug) Parties.

Human immunodeficiency virus (HIV) testing for Thai men who have sex with men (MSM) is suboptimal, which undermines their linkage to care and subsequent HIV preexposure prophylaxis (PrEP) uptake. We analyzed a cross-sectional survey conducted in 2021 among Thai MSM who attended any private sex parties or circuit parties in the past 3 years ("sexualized parties"). Of the 424 men included in our analysis, 47.6% had been recently tested for HIV in the past 1 year, 30.2% had not recently been tested, and 22.2% had never been tested. In our multivariable analysis, relative to participants who had recently tested for HIV, those who have never tested were more likely to have lower education or to live outside of Bangkok, and to have attended both circuit and private sex parties (vs. private sex party only) but were less likely to report any sexually transmitted infection diagnosis or to have heard of PrEP. Participants who had an HIV test more than a year ago were more likely to have attended both circuit and private sex parties (vs. private sex parties only) but were less likely to have any sexually transmitted infection diagnosis, meet sexual partners online, or have heard of PrEP. Rates of condomless anal sex and willingness to use PrEP were similar across groups. Despite the high rates of sexual risk-taking, sexualized party attendees reported suboptimal HIV testing uptake. The joint promotion of HIV testing and PrEP is warranted-especially on-premise HIV testing at circuit parties and outreach at online platforms to reach sexualized party attendees.

Outreach strategies to promote HIV testing and linkage-to-care focusing on a young sexual and gender-diverse population in Bangkok, Thailand.

Human Immunodeficiency Virus (HIV) prevalence among young gender-diverse (a wide range of gender identities for people whose gender identity is different from the sex that they were assigned at birth) individuals is high but testing coverage among this key population remains low. We aim to evaluate strategies for outreach, HIV testing, and linkage to proper management in young men-who-have-had-sex-with-men (MSM, homosexual male) and transgender women (TGW) in Bangkok, Thailand. The "YM2M outreach program" consisted of two strategies: 1) online platforms (OP) and 2) physical outreach activities (POA). Participant questionnaires were completed on a voluntary basis during outreach activities during 2018-2021. Demographic and behavioral characteristics were assessed for association with HIV positivity. A total of 3,972 homosexual male and TGW participated in the YM2M program: 2,973 by OP and 999 by POA. Of 2,230 participants who reported gender identity, 603/1,392 (43.3%) of OP and 252/985 (25.6%) of POA were gender diverse. Of 631 (21.2%) participants in OP and 970 (97.1%) in POA who underwent testing, 286 (45.3%) in OP and 41 (4.2%) in POA were HIV-positive. The venue reporting highest HIV yield was the Mor-Lam (11.5%). Among those with an HIV-positive test, 175 (61.2%) from OP and 23 (51.1%) from POA were successfully linked to HIV care. The independent factors associated with HIV positive in OP were being youth (adjusted odd ratio (aOR), 0.37; 95%CI 0.16-0.81; P = 0.01) and suspected or confirmed STI (aOR 15.39; 95%CI 7.17-33.03, P<0.01); while those in in POA at Mor-Lam were being gender diverse (aOR, 8.43; 95%CI 1.94-36.62; P<0.01) and reactive syphilis test (aOR, 5.40;95%CI 2.45-11.88; P<0.01). Linkage to pre-exposure prophylaxis (PrEP) among HIV-negative participants was low, 4.9% and 2.6% in OP and POA participants, respectively. While uptake of HIV testing was higher in POA while OP was more effective in identifying undiagnosed people living with HIV/AIDS and linking them to care. Neither strategy was considered effective in linkage to PrEP.

1826. Demographics and Risk Factors Associated with HIV Testing among Uninsured Patients Accessing a Free PrEP Program in Northwest Florida

Abstract Background Underserved communities in the south are disproportionally affected by the Human Immunodeficiency Virus (HIV). Despite highly effective prevention methods, communities such as sexual minority men (SMM), persons of color (POC) and individuals experiencing multiple social determinants of health (e.g. lack of insurance, poverty) face many obstacles to HIV testing and Pre-Exposure Prophylaxis (PrEP). This study describes demographic characteristics and risk factors associated with HIV testing within the context of a no-cost PrEP program for uninsured persons living in Escambia County, FL. Methods Enrollment data from the program was used to characterize the relationship between HIV testing, race/ethnicity, prior PrEP use, among other factors. Chi-square and Fisher Exact tests between HIV testing and risk factors were examined, and program demographics were compared to the county’s census data to see if the program reached more POC. With approval from the Florida Department of Health, OASIS provided a limited data set containing all HIPAA compliant information in their enrollment and HIV test forms. Statistical analysis was conducted using Stata v16. Results Of the 107 participants, 13% reported never been tested for HIV and 63.5% reported never been on PrEP. Findings suggest that HIV testing differed by gender, ethnicity, sexual orientation, number of sexual partners, prior STI diagnosis, and sex with an anonymous partner (p&amp;lt; 0.05). For example, White patients were more likely to have never had an HIV test as compared to Black participants (p&amp;lt; 0.05). When reviewed, the program's profile contains 5.53% more people of color as compared to Escambia County's Census demographics for 2020. Conclusion Our findings suggest that many factors are associated with HIV testing uptake in this population of uninsured patients served by the OASIS program. Understanding the demographic and health factors associated with lower uptake can help clinicians target populations who can benefit from HIV education and testing. Disclosures All Authors: No reported disclosures

HIV testing attitudes among fishers of Elmina fishing community in Ghana: A cross‐sectional study

AbstractThis study examined factors affecting fishers' interest in participating in human immunodeficiency virus (HIV) testing at Elmina fishing community in the Central Region of Ghana. The study additionally inquired of respondents if they would be willing to submit to an HIV test and, if so, if they knew where to go for the test. The study also looked at the barriers that prevented fishers from getting tested for HIV. A cross‐sectional convergent parallel mixed‐method design was used to examine 385 fishers who were at least 18 years old and engaged in any form of fishing activity. Only about 9% of respondents reported having ever tested for HIV. Although the overall testing rate was low, the results indicate a higher testing rate in females than among males. Multivariate analysis shows that sex, age and type of fishing occupation are significant predictors of willingness to test for HIV among the study participants. Even though many people in the study location may know where to get tested for HIV, they are unwilling to do so. Many residents of the research area may be aware of where to get tested for HIV, but they are unwilling to go. This suggests a lack of enthusiasm due to misunderstandings and misconceptions about what HIV testing uptake entails. Additionally, stigmatization is a significant barrier to the acceptance of HIV testing in the study area and needs to be reduced by increased education.

Uptake of HIV testing and its correlates among sexually experienced college students in Southwestern, China: a Web-Based online cross-sectional study

BackgroundThe prevalence of human immunodeficiency virus (HIV) is becoming more common among college students in China. However, latest data on the prevalence and correlates of HIV testing among sexually experienced college students is rarely.MethodsAn online survey was conducted among college students aged 18 years or older using multistage stratified cluster sampling from 16 colleges. Data on socio-demographic, HIV testing, HIV-related awareness, attitudes, sexual education and behaviors were collected. Propensity score matching (PSM) and logistic regression model were used to identify factors associated with HIV testing.ResultA total of 108,987 students participated the survey, of which 13,201 sexually experienced college students were included in this study. 1,939 (14.69%) college students with sexual experience reported uptake of HIV testing in the preceding year. The uptake of HIV testing increased for college students with a rising HIV knowledge score and sexual health knowledge. Being awareness of HIV-related knowledge (aOR = 1.15, 95%CI: 1.01–1.30), accepting one-night stands (aOR = 1.16, 95%CI:1.03–1.32), obtaining satisfactory sexual interpretation from parent(s) (aOR = 1.24, 95%CI: 1.07–1.43), ever had unintended pregnancy (aOR = 1.78, 95%CI: 1.32–2.38), ever had received HIV-related preventive service(s) (aOR = 1.37, 95%CI: 1.10–1.70), ever had participated HIV-related preventive services (aOR = 3.76, 95%CI: 2.99–4.75) and ever had anal sex (aOR = 2.66, 95%CI: 2.11–3.34) were positively associated with uptake of HIV testing. However, accepting premarital sex (aOR = 0.76, 95%CI: 0.66–0.88), accepting cohabitation (aOR = 0.75, 95%CI: 0.61–0.92), occasionally discussing sex with parent(s) (aOR = 0.68, 95%CI: 0.50–0.91), and being with moderate satisfaction of school sex courses (aOR = 0.74, 95%CI: 0.58–0.95) were negatively associated with uptake of HIV testing.ConclusionThe prevalence of HIV testing was relatively low. Participation in HIV-related services and high-risk sexual behaviors were important enablers for testing. Improving sex education for students, increasing HIV preventive services on campus, and improving family sex education are necessary to increase HIV testing among college sexually experienced students.

HIV testing and knowledge on mother-to-child transmission among pregnant women attending antenatal care at Vanga Hospital, Democratic Republic of Congo.

Human immunodeficiency virus (HIV) causes an infectious disease that can be transmitted from an infected mother to her child. Prevention of Mother-to-Child Transmission (PMTCT) programs provide a range of services to women and children that can reduce the risk of vertical transmission of HIV. Unfortunately, PMTCT programs face many challenges in the rural Democratic Republic of Congo (DRC). A cross-sectional study was conducted among 460 pregnant women attending antenatal care at Vanga Hospital in the Vanga health zone, DRC from March 11th to June 25th, 2019. Serological tests were performed and a pre-tested questionnaire regarding HIV knowledge was given to all participants. Data were analyzed with STATA 13.0. Descriptive statistics of key variables were computed and logistic regression was used to assess the association between participant's characteristics and knowledge of MTCT. Among the participants, 95.4% (439/460) reported that they have heard about HIV, 82.4% (378/460) indicated sexual intercourse as one of the routes of HIV transmission but only 30.4% (139/460) mentioned MTCT as one of the routes. In addition, only 10.1% (46/460) had knowledge of the existence of PMTCT. Participants' age (>29 years), education level, previous antenatal care, and previous HIV tests were significantly associated with knowledge of MTCT. Also, age (>29 years) and education level were significantly associated with previous HIV test uptake. Most pregnant women 82.3% (376/460) reported that they have never been tested in the past for HIV infection and the prevalence was at 0.9% (4/460). Knowledge of MTCT of HIV, previous uptake of HIV testing, and prevalence was low. The rural setting of Vanga and insufficient HIV sensitization activities are considered contributors to this. While the low prevalence is a positive finding, much needs to be done to improve the uptake of HIV testing and knowledge of HIV MTCT.

HIV Testing Uptake Among Ethiopian Rural Men: Evidence from 2016 Ethiopian Demography and Health Survey Data.

Human immunodeficiency virus (HIV) testing coverage among men remains low in Ethiopia; the problem of limited HIV testing coverage is worst in rural areas. Therefore, this study aims to identify factors associated with HIV testing uptake among rural men in Ethiopia. Data from 10,187 rural men was extracted from the 2016 Ethiopian Demography and Health Survey. All analyses were performed using the complex sample analysis procedure to account for the multistage sampling. Bivariable and multivariable regression analyses were performed to identify factors associated with HIV testing uptake. Statistical significance was defined as a 95% Confidence Interval (CI) with a p-value of less than 0.05. Overall, only 40.3% of rural men have ever been tested for HIV. Being aged 31-44 years (Adjusted Odds Ratio (AOR) =1.12, 95% CI [1.01-1.42]), living in developed regions (AOR=1.43, 95% CI [1.09-1.88]), engaging in non-agricultural activities (AOR = 1.27, 95% CI [1.05-1.52]), being Muslim (AOR = 2.07; 95% CI [1.67-2.67]), having comprehensive knowledge about HIV (AOR =1.31, 95% CI [1.12-1.54]), being from a medium (AOR = 0.56, 95% CI [0.47-0.93]) and rich (AOR = 0.80, 95% CI [0.56-0.80]) households, attending primary (AOR = 0.21, 95% CI [0.16-0.28]) and secondary (AOR = 0.35, 95% CI [0.25-0.35]) school, having their first sexual experience at the age of 17 or younger (AOR = 0.26, 95% CI [0.19-0.93]), having discriminatory attitudes towards HIV patients (AOR = 0.67, 95% CI: 0.47-0.93) and having no health insurance coverage (AOR = 0.54, 95% CI [0.42-0.69]) were significantly associated with HIV testing uptake. HIV testing uptake among rural men was low. Strengthening awareness programmes on HIV and HIV testing, integrating HIV testing with all other healthcare, strengthening partner accompany and HIV testing during pregnancy and delivery, and providing home-based HIV testing may increase HIV testing uptake.

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.

Descriptive study: Feasibility of integrating hypertension screening into HIV assisted partner notification services model in Kenya.

Prevalence of hypertension (HTN) and human immunodeficiency virus (HIV) are high among men while screening rates are low. Assisted partner notification service is a strategy recommended by the World Health Organization that aims to increase HIV testing and treatment uptake and may present an opportunity to offer integrated HIV/HTN screening and treatment services. In this prospective cohort study, we assessed the feasibility of integrating HTN screening for male sexual partners of females newly tested HIV-positive in 10 health facilities in Kenya. Participants were notified of the exposure and offered HIV testing and HTN screening; if they accepted and tested positive for either HTN, HIV, or both, they were referred for care. HTN was defined as systolic blood pressure ≥ 140 mm Hg, diastolic blood pressure ≥ 90, or the use of antihypertensive medication. Among 1313 male partners traced, 99% accepted HIV testing and HTN screening. Overall, 4% were found to have HTN, 29% were in the pre-HTN stage, and 9% were HIV-positive. Only 75% had previously been screened for HTN compared to 95% who had previously tested for HIV. A majority preferred non-facility-based screening. The participants who refused HTN screening noted time constraints as a significant hindrance. HIV and HTN screening uptake was high in this hard-to-reach population of men aged 25 to 50. Although HTN rates were low, an integrated approach provided an opportunity to detect those with pre-HTN and intervene early. Strategic integration of HTN services within assisted partners services may promote and normalize testing by offering inclusive and accessible services to men.

Learning from community-based HIV prevention to inform control and mitigation of the COVID-19 pandemic

The current COVID-19 pandemic and the likelihood of future viral pandemics demonstrate a need for strategic prevention campaigns that integrate biomedical, structural, and behavioral interventions within larger scale comprehensive public health initiatives. In Human Immunodeficiency Virus (HIV) prevention, community-based efforts have resulted in reductions in transmission rates, increases in testing, increases in biomedical prevention uptake, and increased engagement in secondary and tertiary prevention efforts. In this paper, we review three community-based strategies (health communication, accessible screening, and accessible prevention resources) that have demonstrated effectiveness in HIV prevention and offer recommendations for utilizing these strategies in the COVID-19 pandemic. For example, health communication strategies have positively influenced HIV testing behavior, sex communication, and condom use among HIV negative individuals and treatment initiation, treatment adherence, and retention in care among people living with HIV. In addition, studies have shown that improving accessibility of HIV screening and prevention resources in community venues such as schools, pharmacies, mobile-testing sites, churches, hair salons, and bars is useful for increasing the uptake of HIV testing, especially among disproportionately affected populations and those deemed hard to reach. Despite differences in modes of transmission, it is plausible that a synergistic multilevel response with emphasis on community-based efforts could lead to similar outcomes for the current COVID-19 pandemic and future viral pandemics. Community-based prevention strategies offer an opportunity to integrate, and bolster disconnected and siloed initiatives that achieve limited impacts independently.

National HIV programme testing recommendations.

In recognition of the morbidity and mortality associated with human immunodeficiency virus (HIV), the Joint United Nations Programme on HIV/acquired immunodeficiency syndrome (AIDS) (UNAIDS) aims to end the epidemic by setting and striving to achieve the ambitious 95-95-95 targets. However, Singapore is still not performing well in the first UNAIDS target. The National HIV Programme (NHIVP) developed this set of recommendations based on an adaptation of major international guidelines from the World Health Organization and the US Centers for Disease Control and Prevention. The goals of this recommendation are: (1) to increase the uptake of HIV testing; (2) to allow earlier detection and identification of individuals with unrecognised HIV infection; (3) to facilitate linkage to clinical services; and (4) reduce further transmission of HIV infection in Singapore.

THE RELATIONSHIP BETWEEN THE UPTAKE OF HUMAN IMMUNODEFICIENCY VIRUS (HIV) TESTING AND STIGMA AMONG UNIVERSITY STUDENTS IN THE KLANG VALLEY

The prevalence of Human Immunodeficiency Virus (HIV) is on the rise among adolescents and young people and these people are frequently subjected to significant levels of stigma, resulting in most of them avoiding HIV testing services. This study aimed to identify the prevalence of HIV testing uptake and its associated factors among students who were willing to undergo HIV testing. A cross-sectional study across five campuses within the Klang Valley was conducted between March to May 2020. Data were collected using an online self-administered questionnaire and the HIV Stigma Scale (HSS) was used to assess perceived stigma towards people with HIV. The results were analyzed using SPSS 26.0 and the prevalence of HIV testing uptake and its associated factors were assessed using multiple logistic regression. A total of 305 students showed a willingness to undergo HIV testing, with only 17% (95% CI; 13.0,21.0)(N=52) of the students ever undergoing an HIV test. The overall stigma associated with HIV was found to be high (93.4%) among the students. Students enrolled in non-health-related courses (AOR=0.33, 95% CI; 0.15,0.73), 5th year students (AOR=0.13, 95%CI; 0.02, 0.78), older aged people (AOR=1.35, 95% CI; 1.03,1.78), and those who had multiple sexual partners (AOR=5.28, 95% CI 1.42,19.60) were significantly associated with HIV testing uptake. Although stigma was associated with HIV testing in simple logistic regression, it was not significant in the multivariate logistic analysis and there was no correlation between HIV uptake and HIV-related stigma. The prevalence of HIV uptake among students was low, and it was discovered that variables acting as facilitators were students who engaged in risky behaviors, and that these variables should be formulated and incorporated into advanced university-based programs to harness the potential of testing and expand it to periodic HIV testing.

HIV testing uptake, enablers, and barriers among African migrants in China: A nationwide cross-sectional study

African migrants in China face social, structural, and cultural barriers to human immunodeficiency virus (HIV) testing with scarce information on their HIV testing behaviours. This study estimated the prevalence of HIV testing and its social and behavioural correlates to understand how to better provide HIV testing services for African migrants living in China. We conducted a national cross-sectional survey among adult African migrants who lived in China for more than one month between January 19 to February 7, 2021. The survey was disseminated online through six African community organizations and via participant referrals. We collected data on HIV testing behaviours and history of HIV testing, social, and cultural factors and applied univariate and multivariable logistic regression to identify testing correlates. Among a total of 1305 participants, 72.9% (n = 951/1305) tested for HIV during their stay in China and yielded a self-reported HIV prevalence of 0.4% (n = 4/951). The most common reason for HIV testing was to comply with Chinese residence policy requirements (88.5%, n = 842/951); for not testing was "no need to be tested" (79.4%, n = 281/354). We found most African migrants have experienced low acculturation stress (54.5%, n = 750/1305), low social discrimination (65.6%, n = 856/1305), have a moderate stigma towards HIV (54.3%, n = 709/1305), and low community engagement around sexual health and HIV topics. In multivariable analysis, African migrants who were students (adjusted odds ratio (aOR) = 3.36, 95% CI = 2.40-4.71), living in student dormitories (aOR = 3.86, 95% CI = 1.51-9.84), received health services in China in past year (aOR = 1.67, 95% CI = 1.25-2.23), had lifetime sexually transmitted infections (STI) testing (aOR = 1.95, 95% CI = 1.23-3.10), had HIV testing before coming to China (aOR = 13.56, 95% CI = 9.36-19.65), and those engaged in community discussions of HIV and sexual health (aOR = 2.77, 95% CI = 1.31-5.83) were more likely to test for HIV in China. Despite 73% of African migrants having tested for HIV in China, there are unmet needs and barriers identified in our study, such as language barriers. Access to HIV knowledge and testing services were the most important enablers for testing, including studentship, past STI/HIV testing, and community discussion on sexual health. Culturally appropriate and community-based outreach programs to provide information on HIV and testing venues for African migrants might be helpful to promote testing uptake.

Implementation strategies to promote linkage to care for key populations after HIV self-testing: a scoping review

Background In human immunodeficiency virus (HIV) care, key populations are sex workers, people who inject drugs, prisoners, transgender people, and men who have sex with men (MSM), who are at high risk and burden of HIV infection but face barriers to HIV prevention, treatment, and health services. HIV self-testing (HIVST) is effective in scaling up HIV testing uptake among key populations due to its cost-effective, confidential, and convenient feature. However, lacking linkage to care support remains a key challenge. This scoping synthesised the global evidence regarding implementing strategies to promote linkage to care for key populations after HIVST. Methods This scoping review was conducted according to the Joanna Briggs Institute Manual for Evidence Synthesis. A data search was conducted on September 1, 2021. The searched databases were PubMed, Embase, EBSCOhost, Cochrane Library, Wan Fang Data (Chinese), China National Knowledge Infrastructure (Chinese), and Japan Medical Abstracts Society (Japanese). Results Twenty studies from 2011 records met the eligibility criteria and were included for review. The study populations were MSM (9), mixed high-risk populations (7), female sex workers (3), and transgender youth (1). Implementation strategies to promote linkage to care for key populations after HIVST were classified into seven categories: 1) HIVST kits with linkage-to-care information, 2) web-based or mobile app-guided HIVST, 3) remote HIVST counselling, 4) intensive follow-up, 5) HIVST promotion through social media and key opinion leaders, 6) community engagement in HIVST and 7) financial incentive. The digital-supported intervention mainly targeted MSM in high-income settings, and the community-based approach and financial incentive strategies were mainly implemented in low and middle-income settings. Comparison of linkage outcomes between studies is problematic due to mixed interpretation and measurement of linkage to care after HIVST. Conclusions Implementation strategies to promote linkage to care for key populations are diverse and should be incorporated in different settings and backgrounds. Innovative digital-supported HIVST research for female sex workers and high-risk populations in low and middle-income settings is warranted. A standardised definition of linkage to care following HIVST and a unified measurement of linkage outcomes should be developed and applied in future research.

HIV testing and associated factors among men (15-64 years) in Eastern Africa: a multilevel analysis using the recent demographic and health survey

BackgroundDespite significant efforts made to prevent human immunodeficiency virus (HIV) transmission, its testing coverage among men is still low and remains a major concern in low-income countries, particularly in East Africa. Therefore, this study aimed to determine the prevalence and associated factors of HIV testing among men in Eastern Africa.MethodsWe analyzed secondary data using Demographic and Health Surveys (DHS) drawn from Eastern African countries. Besides, we merged DHS data from eleven Eastern African countries. In this study, we included secondary data from 113, 270 men aged 15-64 years. The outcome variable of this study was “ever been tested for HIV”. Bivariable and multivariable multi-level logistic regression analyses were employed. In the bivariable analysis, variables having a P-value of less than 0.2 were selected for multivariable analysis. Lastly, variables with a P-value of < 0.05 in the multivariable analysis were declared as a significant factor associated with HIV testing and the adjusted odds ratio (AOR) with the 95% confidence interval (CI) were computed to determine the strength and direction of the association.ResultsThe overall prevalence of HIV testing among men in eastern Africa was 60.5% (95% CI: 60.2, 60.7%). In the multivariable multilevel analysis; participant’s older age, being married, increased poverty, HIV knowledge, risky sexual behavior, and being covered by health insurance were positively associated with HIV testing coverage among men. However, men with higher community illiteracy levels, residing in rural settings, age at first sex ≥20 years, and higher stigmatized attitudes towards HIV/AIDS had lower odds of being tested for HIV.ConclusionThe overall prevalence of HIV testing among men in eastern Africa was relatively higher than the previous studies. The study revealed that age, marital status, residence, age at first sex, community poverty level, community illiteracy level, HIV knowledge, HIV stigma indicator, risky sexual behavior, and health insurance were significantly associated with HIV testing coverage among men. Therefore, all the concerned stakeholders need to develop an integrated strategic plan through providing special attention to the factors that affect the uptake of HIV testing to raise awareness about the importance of HIV testing and to prevent HIV/AIDS transmission.

Changes in HIV Testing Utilization Among Chinese Men Who Have Sex With Men During the COVID-19 Pandemic in Shenzhen, China: An Observational Prospective Cohort Study.

BackgroundThe Coronavirus Diseases 2019 (COVID-19) directly affects HIV prevention and sexual health services utilization among men who have sex with men (MSM). This study investigated changes in human immunodeficiency virus (HIV) testing utilization among MSM before and after the COVID-19 pandemic received initial control in Shenzhen, China.MethodsThis study was a sub-analysis of a prospective observational cohort study conducted among MSM in Shenzhen, China between August 2020 and May 2021. Participants were recruited through outreaching in gay venues, online recruitment, and peer referral. Participants completed a baseline online survey between August and September 2020 and a follow-up online survey between April and May 2021. This study was based on 412 MSM who reported to be HIV-negative/unknown sero-status at baseline, 297 (72.1%) of them completed the follow-up online survey. Multilevel logistic regression models (level 1: sources of recruitment; level 2: individual participants) were fitted.ResultsWhen comparing follow-up data with baseline data, a significant increase was observed in the uptake of any type of HIV testing (77.9% at Month 6 vs. 59.2% at baseline, p < 0.001). After adjusting for age group, education level, current employment status and monthly personal income, two predisposing factors were associated with higher uptake of HIV testing during the follow-up period. They were: (1) condomless anal intercourse with male non-regular male sex partners at follow-up only (AOR: 5.29, 95%CI: 1.27, 22.01) and (2) sanitizing before and after sex at baseline (AOR: 1.26, 95%CI: 1.02, 1.47). Regarding enabling factors, utilization of HIV testing (AOR: 3.90, 95%CI: 2.27, 6.69) and STI testing (AOR: 2.43, 95%CI: 1.20, 4.93) 6 months prior to the baseline survey was associated with higher uptake of HIV testing during the follow-up period. Having the experience that HIV testing service providers reduced service hours during the follow-up period was also positively associated with the dependent variable (AOR: 3.45, 95%CI: 1.26, 9.41).ConclusionsHIV testing utilization among MSM might rebound to the level before the COVID-19 outbreak after the pandemic received initial control in China. This study offered a comprehensive overview to identify potential reasons that can influence the uptake of HIV testing among Chinese MSM.

Factors Associated with HIV Testing among Reproductive Women Aged 15-49 Years in the Gambia: Analysis of the 2019-2020 Gambian Demographic and Health Survey.

Voluntary counselling and testing for Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) has always been one of the key policy interventions in the management and control of HIV/AIDS transmission. However, the prevalence of HIV testing among reproductive women in the Gambia remains low despite near universal information about HIV and Sexually Transmitted Infections (STIs) in the Gambia. Understanding factors influencing HIV testing uptake provides empirical data for the development of targeted evidenced-based strategies aimed at enhancing HIV testing uptake. Therefore, this study examined the factors associated with HIV testing among reproductive women aged 15–49 years in the Gambia. Data on weighted sample of 11,865 women from the 2019–2020 Gambia Demographic and Health Survey were analyzed in this study. Chi square, bivariate and multivariate logistic regression models were fitted and analysis conducted through Complex Samples Analysis in Statistical Package for Social Sciences (SPSS). Level of significance was set at p < 0.05 and 95% CI. Further analysis was conducted to determine the variability in HIV testing among women stratified by rural and urban centers. Prevalence of HIV testing among reproductive women was 42.1% (95% CI = 40.1–44.2%) in the Gambia. Women aged 20–24 years and 25–29 years (aOR = 3.10, 95% CI = 2.51–3.83) and (aOR = 4.52, 95% CI = 3.61–5.54) were more likely to test for HIV than those aged 15–19 years, respectively. Married women (aOR = 5.90, 95% CI = 4.84–7.02) were more likely to test for HIV compared to those who were not in any union. Respondents with higher education in urban centers (aOR = 2.65, 95% CI = 2.08–3.86) were likely to test for HIV compared to those in rural areas. HIV testing in the Gambia among reproductive women is low. Age, marital status, wealth index, place of residence, educational level, recent sexual activity, previous history of risky sexual behaviors, and history of an STI were associated with HIV testing. Health interventions targeted at increasing HIV testing uptake should factor in these.

Barriers to uptaking HIV testing among pregnant women attending antenatal clinics in low- and middle-income countries: A systematic review of qualitative findings.

Human immunodeficiency virus (HIV) testing is a gateway to HIV treatment, care and preventive services for pregnant women attending antenatal clinics. Despite this, uptake of HIV testing is not optimal among pregnant women in many low- and middle-income countries (LMICs) and it could negatively impact the effectiveness of prevention of mother-to-child transmission of HIV programs. To understand the factors that hinder the uptake of HIV testing among pregnant women attending antenatal clinics in LMICs. A systematic search of the CINAHL, EMBASE, JSTOR, Medline, PubMed and Web of Science electronic databases was performed. We limited the search to peer-reviewed qualitative studies including mixed method studies. The titles and abstracts of the retrieved publications were screened for relevance then information was extracted. Our search yielded 2179 citations, out of which 312 full-text articles were reviewed and 22 studies that met the eligibility criteria were included in this review. We found that a lack of HIV testing kits, poor health infrastructure and shortage of healthcare workers were the main health system-related factors. Poor HIV knowledge, fear of HIV test results, HIV-related stigma and social exclusion negatively influenced pregnant women's decision to be tested for HIV. This review has identified that pregnant women faced a wide range of health system, individual, social and lack of women's empowerment related challenges that negatively influenced the uptake of HIV testing among pregnant women in LMICs. Our findings would be useful in developing strategies to overcome barriers that could enhance the uptake of HIV testing among pregnant women.

Stepping up from opt-out: Achieving 100% uptake antenatal human immunodeficiency virus testing.

All pregnant women in the United Kingdom are offered and encouraged to take up screening for human immunodeficiency virus (HIV), hepatitis B and syphilis, with excellent uptake rates and engagement in care resulting in very few infants being infected with HIV in the United Kingdom. However, in that small number of women who decline testing, there remains an opportunity to offer further support to test and engage them and their baby in care, even if this happens in labour or immediately after birth. In addition, these women may be at increased risk of HIV. Our hospital is in an extremely high prevalence area for HIV, and most untested individuals are of childbearing age. We embarked on a quality improvement project to engage all women delivering at our unit in HIV testing or to test their babies via cord blood at birth. We sought to do this in a constructive and inclusive way, led by the HIV specialist midwife with the support of the HIV antenatal and the hospital senior management teams. Following an initial evaluation, the approach was modified and an innovative approach together with a trusted advocate was used to engage a particularly hard-to-reach group. We have achieved 100% uptake of HIV testing and made two HIV diagnoses that would not otherwise have been made; both in women who reported themselves not to be at risk and both engaged in care and delivered HIV-negative infants.