Voluntary Human Immunodeficiency Virus Counseling Research Articles

HIV Voluntary Counselling and Testing Utilisation among School of Healthcare Sciences Undergraduate Students at the University of Limpopo.

Existing evidence indicates that South African university students have low utilisation of Human Immunodeficiency Virus (HIV) Voluntary Counselling and Testing (VCT). A cross-sectional survey was conducted to determine the utilisation of HIV VCT among undergraduate students in the School of Healthcare Sciences. Structured questionnaires were used to collect data through Google Forms. The results are presented through descriptions and percentages and illustrated in tables. Out of 389 undergraduate students, only 324 completed the questionnaire. The majority (97.2%) were aware of the health centre on campus, while only (74.7%) knew about the HIV VCT services offered on campus. Despite the awareness, many (36.7%) do not utilise the campus HIV VCT services, and some (9.6%) have never tested for HIV. There was an association between awareness of Voluntary Counselling and Testing of HIV services offered at the campus health and wellness centre and utilisation of HIV Voluntary Counselling and Testing at (<0.001). Therefore, it is imperative to urgently escalate the level of HIV/AIDS education in higher institutions of learning and emphasise the mounting danger of HIV infection and the immense importance of regular HIV testing. The findings of this study could serve as a foundation for creating HIV prevention and control programmes for youth, particularly in higher education institutions.

Perception and Uptake of HIV/AIDS Voluntary Counselling and Testing Among Women in Akinyele Local Government Area, Ibadan.

Introduction: At the end of 2020, there were reportedly 37.7 million HIV-positive individuals. HIV testing has been marketed as a crucial first step method to diagnose, treat, and prevent human immunodeficiency virus (HIV) infection. It is the cornerstone of all HIV prevention initiatives. The study's main aim was to ascertain the degree of HIV and HIV VCT (voluntary counselling and testing) awareness among women in Akinyele Local Government Area, Ibadan, as well as their attitudes towards HIV VCT and the rate at which they adopted the treatment. Method: This study employed a descriptive study design aimed at assessing the perception and uptake of HIV VCT among women residing in Akinyele Local Government Area, Ibadan, Oyo state. The total population of the women was 410. The sample size was determined using the Taro Yamane formula and the sample size was 220 women which was allocated proportionally to each primary health care center. The research instrument used for the study is a self-administered questionnaire. Results: The results showed that more than 75% of respondents had good understanding of HIV and HIV VCT, and that 65% had positive perceptions of HIV VCT. The study found that there is no significant association between women's level of education and their level of knowledge on HIV and HIV VCT and conclude that there is no significant association between women's perception of HIV and HIV VCT and HIV VCT uptake. Conclusion: In conclusion, the result revealed like other related studies that the attitude of women in Akinyele local government towards HIV Voluntary Counselling and Testing is just a little above average which means quite a number of the respondents are still not willing to take HIV VCT. Hence, the women need more sensitization on the importance and benefits of HIV VCT.

HIV voluntary counseling and testing uptake and associated factors among Ethiopian youths: evidence from the 2016 EDHS using multilevel modeling

BackgroundExisting evidence showed that Human Immunodeficiency Virus counselling and testing uptake among Ethiopian youths is low, and factors contributing to it are not well studied. Therefore, this study aims to assess the status of uptake and identify its determinants using the 2016 Ethiopia Demographic and Health Survey data.MethodData of 10,903 Ethiopian youths were extracted from the 2016 Ethiopian Demographic and Health Survey. The association between the response variable and the predictors was modeled by multilevel binary logistic regression, whereas adjusted odds ratio and confidence intervals were used to measure associations and their statistical significance. The variation in the uptake of counselling and testing of HIV across regions of Ethiopia was quantified by intra-class correlation.ResultThe current study revealed that, overall, 34.9% (95% CI: 33.5, 36.2%) Ethiopian youths were ever tested for human immunodeficiency virus. Results show that about 9% of the variation in the probability of being tested for the disease was due to the regional variations. Moreover, having moderate and comprehensive HIV knowledge, being rich, having risky sexual behaviour, having a better educational level, having professional work, being married, owning of mobile, and having access to media were positively associated with human immunodeficiency virus voluntary counselling and testing uptake. On the other hand, being male, following protestant religion, following Muslim religion, and following other religions than orthodox religion were negatively associated with the uptake of human immunodeficiency virus counselling and testing.ConclusionVoluntary human immunodeficiency virus counselling and testing uptake among Ethiopian youths is very low and varies across the regions which might hamper the ambitious plan of Ethiopia to end the disease as a public health threat by 2030. Emphasis should be given to promoting the youths’ HIV-related knowledge through community-based education, encouraging and empowering the youths to participate in professional works by giving due focus to poor youths, and promoting mass media utilization to better achieve the plan.

Comparison of HIV-Positive Incidence Among Transgender Women and Men Who Have Sex with Men at Stand-Alone and Mobile Voluntary Counseling and Testing Facilities in Chiang Mai Province, Thailand

Human immunodeficiency virus (HIV) infection is still a major cause of death in Thais and new cases of infection are still emerging among the key population comprising men who have sex with men (MSM), sex workers and their clients, and transgender women (TGW) and people who inject drugs. The objective of this study was to compare the incidence of HIV infection between MSM and TGW who were tested at stand-alone and mobile HIV voluntary counseling and testing (VCT) centers and to identify factors associated with HIV-positive individuals from the two services. We conducted an observational study using MSM and TGW individuals with unknown HIV status from the databases at a stand-alone center and a mobile VCT belonging to the MPlus in Chiang Mai province, Thailand. Factors associated with HIV-positive status were identified using logistic regression model. HIV VCT data were obtained for 6971 individuals at both MPlus center and mobile care unit. Among 3033 and 3938 clients tested at each facility, respectively, 168 (5.6%) and 101 (2.6%) clients were HIV positive. Individuals tested at the stand-alone centers were at a 1.91-fold higher risk of being HIV positive compared with those tested at the mobile VCT unit. Individuals who were 20-24 or >24 years old, sex workers, or sexually transmitted infection positive were more likely to be HIV positive. Our results show the beneficial effect of mobile HIV VCT facilities that enable testing of more of the at-risk population. Developing mobile VCT activities that attract a particular target population is needed to be able to reach the 90-90-90 goals. This study was approved by the Ethics Committee of the Faculty of Medicine, Chiang Mai University (0BG-2562-06418).

HIV Seroprevalence among the Patients or Clients Obtaining Blood Sample at BSMMU Virology Laboratory

Departments of Virology (DVs), BSMMU receive patients from every background, socioeconomic group and health status. Hence, DVs can play a critical role in offering human immunodeficiency virus (HIV) testing and help in the national strategy of early HIV detection. The present study was conducted on 1208 patients attending DVs after taking Institutional Review Board approval. They were screened for HIV antibodies by three rapid/simple assay tests having different principles/antigens as per the WHO guidelines. Forty four (13.6%) of the 1208 patients were HIV reactive and 1164(96.4%) were negative respectively. Distribution of patients on the basis of gender where 894 (74.1%) were male and 313 (25.9%) were female out of 1208 patients or clients. Distribution of study subject on the basis of exposure history where 378(38.8%) patients or clients had history of exposure and 830 (68.7%) patients or clients did not. Distribution of the patients on the basis of purpose of screening where patients were in three groups (Screening before operation, Positive exposure history and To exclude HIV infection during failure of drug Rx) where 776(64.2%) patients were done anti-HIV test due to screening purpose before operation, 378(31.1%) patients were done this test due to Positive exposure history exposure history and 54(4.5%) patients done this due to exclude HIV infection during failure of drug treatment. Prevalence of HIV infection was more among 21-40yrs age group than other age group(18mon-20yrs,41-60yrs&amp;&gt;60yrs) which is not significant . Data shows there was significant association of anti-HIV positivity with exposure history of the patients or clients. Prevalence of HIV infection was more among patients or clients who had history of exposure. Prevalence of HIV was more among the patients who were done screening test due to failure of drugs than other two purposes. Bangladesh is still considered as a low HIV/AIDS prevalent country. However, it is at a critical moment in the course of its AIDS epidemic. It is estimated that there are 13,000 HIV-positive people in the country and that HIV prevalence in the adult population is less than 0.01%. However, the country's vulnerability is very high. National HIV surveillance indicates that the rate of HIV infection among street-based sex workers in central Bangladesh is high compared with sex workers in other parts of South Asia. HIV among injecting drug users is already 10.5%.The presence of covert multi-partner sexual activity and denial, the low level of knowledge and low condom use, unsafe professional blood donations, lack of a desirable environment and violation of Human Rights, all contribute to the spread of HIV in Bangladesh. Thus, the study emphasizes the need for expansion of routine voluntary HIV counseling and testing to all the patients who come to the DV and practicing universal work precautions by health care workers.&#x0D;

Knowledge, attitudes, and practices of male partners on antenatal human immunodeficiency virus screening for the prevention of mother-to-child human immunodeficiency virus transmission in a private tertiary hospital

Background: Human immunodeficiency virus (HIV) transmission remains to be a significant problem in the country despite preventive efforts in the past years. In children, mother-to-child vertical transmission during pregnancy is the most common route. The World Health Organization has implemented the Prevention of Mother-to-Child HIV Transmission (PMTCT) program, which promotes a comprehensive approach in addressing this problem. Male partner involvement in antenatal voluntary HIV counseling and testing has been proposed to be a vital part of this approach. Their role in the process has not been studied in depth in the local setting. Objectives: The study aimed to describe the knowledge, attitudes, and practices of male partners of pregnant women toward antenatal HIV screening in a local private tertiary hospital using a survey created by Belato et al. in 2016. Methodology: A descriptive analysis was done to present the sociodemographic and clinical characteristics of the participants. The association between the level of male partner involvement and independent variables was also tested. Results and Conclusions: The results of the study revealed a high level of male partner involvement in the PMTCT of HIV services at 69.1%. Age of the male partner and the duration of the couple living together were significant factors associated with male partner involvement. However, there was lack of knowledge regarding HIV transmission, antenatal HIV testing, and PMTCT services among majority of the male partners. Community sensitization of men about the benefits of antenatal HIV testing and PMTCT services need to be prioritized to improve their awareness and their involvement in the program.

HIV Voluntary Counseling and Testing Uptake and Associated Factors Among Sexually Active Men in Ethiopia: Analysis of the 2016 Ethiopian Demographic and Health Survey Data.

BackgroundHuman immuno-deficiency virus (HIV) counseling affirms that people exercise the right to know their HIV status, which opens the gateway to care, treatment, and support for a person in need. HIV counseling and testing uptake among sexually active males in Ethiopia is too low. Moreover, existing studies were not done at country level and the contributing factors were not well studied. Therefore, the aim of this study is to determine the status of uptake and identify its correlates using the 2016 Ethiopia Demographic and Health Survey.MethodsData on 12,688 participants were utilized in this study. Descriptive statistics and multilevel logistic regression were used to summarize the data and investigate the associations between predictors and HIV counseling and testing uptake.ResultsThe overall HIV voluntary counseling and testing uptake among sexually active men in Ethiopia was 45.69%; 95% CI [43.08%, 48.33%]. About 13% of the variation in the likelihood of being tested for HIV was due to the variation among the regions. On the other hand, age, religion, education, occupation, marital status, HIV knowledge, health insurance coverage, wealth status, risky sexual behavior, family planning discussion with health workers, owning a mobile, frequency of watching television, and listening to the radio were significantly associated with the uptake of HIV voluntary counseling and testing.ConclusionHIV voluntary counseling and testing uptake in Ethiopia is still low and varies across the regions, which might hamper the ambitious plan of Ethiopia to end AIDS as a public health threat by 2030. Therefore, giving due consideration to scale up HIV knowledge to avoid risky sexual behavior, improving access to health insurance and media, and working on the significant modifiable sociodemographic determinants are worthy to boost HIV voluntary counselling and testing uptake, which is an integral component of the strategies to efficiently prevent and control HIV.

Barriers to Voluntary HIV Counselling and Testing among undergraduate students of the Faculty of Health Sciences and Technology, University of Nigeria Enugu Campus- Enugu State, Nigeria

Background: Despite the increase in the level of awareness and usefulness of HIV counselling, Voluntary Counselling and Testing (VCT) &amp; its utilization remains low most especially among vulnerable groups such as university students. Method: A descriptive survey was utilized for the study. A structured questionnaire was used to collect data from undergraduate students of the faculty of health sciences and technology.Descriptive and inferential statistical methods were used for data analysis. Result: The mean ageof the respondents was 22.34±2.97, majority (87.1%) had high level of knowledge of voluntary HIV counselling and testing; few (42.6%) respondents had uptake of voluntary HIV counselling and testing, a major personal barrier was low risk perception for HIV as the uptake of voluntary HIV counselling differ among those who perceived vulnerability (52.0%) to HIV/AIDS and those who did not (38.5%), p = 0.021 a major academic institutional barrier was non-availability of VCT centres and services in the schools. Also, non-availability of VCT centre and location of VCT centre far away from respondents’ area of resident were identified as the health institutional barriers. There is no significant difference in the uptake of voluntary HIV counselling and testing among the respondents based on gender and department. Inconclusion, there is low uptake of voluntary HIV counselling and testing among undergraduate health science students andthe major barriers were personal, academic institutional and health institutional barriers. The school authorities should ensure that the awareness campaign on HIV/AIDS and VCT in the campus is intensified to enhance students’ knowledge and the government should establish a functional voluntary counselling and testing centre in the campus to enhance the uptake by the students. Key words : Human Immunodeficiency Virus (HIV); Voluntary HIV counselling and testing; Barriers, Undergraduate students.

Cascade Analysis of Anonymous Voluntary HIV Counseling and Testing Among Patients with HIV Infection in Taiwan.

Despite successful implementation of anonymous voluntary human immunodeficiency virus (HIV) counseling and testing (aVCT) in Taiwan, the trend of late HIV presentation in sexually active populations has remained unchanged in Taiwan over the past decade. We evaluated the effect and acceptance of an aVCT cascade program among Taiwanese individuals by surveying 572 participants (mean age: 29.6 years; 99.3% men; and 79.5% same-sex sexual contact) diagnosed with HIV/acquired immune deficiency syndrome (AIDS) from 2015 to 2019. We designed a five-stage continuum based on acceptance of the program before HIV diagnosis: at high risk of HIV infection (Stage 1), heard of aVCT (Stage 2), wants to receive aVCT (Stage 3), has received aVCT (Stage 4), and regularly receives aVCT (Stage 5). Four domains established from exploratory factor analysis described reasons for inability to reach the next aVCT stage: low perceived HIV risk, fear of testing positive because of discrimination/stigmatization, and structural barriers to aVCT. Regular aVCT (vs. never receiving aVCT) protected against AIDS on diagnosis (p < 0.001). There were no significant differences in program acceptance across 2015-2019. However, uptake reduced markedly across the program; the largest reduction (37.4.0-61.0%) occurred from Stage 4 to Stage 5. Fear of testing positive because of discrimination/stigmatization was the main reason for not proceeding to the next aVCT stage. Although the findings indicate the benefits of regular aVCT for early HIV diagnosis, additional strategies to reduce fear of negative social consequences of HIV infection are prioritized to optimize aVCT in Taiwan.

Spatial characteristics of men who have sex with men and transgender women attending HIV voluntary counselling and testing in Bangkok, Thailand, 2005-2015.

Spatiotemporal analyses can support Human Immuno-deficiency Virus (HIV) prevention programmes by identifying locations of at-risk populations in space and time, and their proximity to HIV testing and prevention services. We assessed residential proximity to HIV testing venues for Men who have Sex with Men (MSM) and Transgender Women (TGW) attending Voluntary Counselling and Testing (VCT) at a large urban MSM clinic in Bangkok, Thailand in the period 2005-2015. We mapped clientprovided spatial data and HIV testing venues, calculating distance from residence to venues for VCT clients between i) September 2005-December 2009; ii) January 2010-September 2013; and iii) October 2013-May 2015. We assessed spatial characteristics across times, evaluating autocorrelation of HIV prevalence and visit density using Moran's I. Among 8,758 first-time VCT clients reporting geographic information from 2005-2015 (by period: 2737, 3917, 2104), 1329 (15.2%) lived in postal codes ≤5 km from the clinic. Over time, the proportion living in areas covered by Bangkok postal codes ≤2 km from any MSM HIV testing venue increased from 12.6% to 41.0% (p<0.01). The proportion living ≤5 km from the clinic decreased from 16.6% to 13.0% (p<0.01). HIV prevalence and clinic visit density demonstrated statistically significant non-random spatial patterning. Significant non-random patterning of prevalent infection and client visits highlighted Bangkok's urban HIV epidemic, clinic proximity to clients, and geographic reach. Clients lived closer to testing venues, yet farther from the urban MSM clinic, over time. Spatiotemporal characteristics of VCT clients can help assess service accessibility and guide targeted prevention planning.

Predictors of condom use behavior among men who have sex with men in China using a modified information-motivation-behavioral skills (IMB) model

BackgroundMen who have sex with men (MSM) are at high risk for human immunodeficiency virus (HIV) infection in China. Correct and consistent condom use is one of the most effective strategies for preventing the spread of HIV. This study developed a modified Information-Motivation-Behavioral Skills (IMB) model to predict condom use behavior among Chinese MSM.MethodsA cross-sectional study was conducted to collect data using self-administered electronic questionnaire. Participants were recruited from HIV Voluntary Counseling and Testing clinics in six district Centers for Disease Control and Prevention in Guangzhou and two community-based HIV service centers (Lingnan Partners and Zhitong Charity) from May to September 2017. Structural equation modeling was performed to develop the modified IMB model with extended multilevel factors.ResultsAmong the 976 MSM included, 52.05% had engaged in anal intercourse with a condom every time. The final modified IMB model fitted the data more ideally than the conventional model. The final modified IMB model revealed that behavioral skills positively contributed directly to condom use (β = 0.385, p < 0.001) and partially mediated the associations between information (β = 0.106, p = 0.005) and motivation (β = 0.390, p < 0.001) and condom use. Regarding the extended multilevel factors, education, income, receiving HIV prevention services, sexual partner seeking behavior, depression, intimate partner violence, and child sexual abuse had indirect impacts on condom use that were mediated by information, motivation, and/or behavioral skills (p < 0.05). All paths from the latent variable to the corresponding observed variables were statistically significant (p < 0.001).ConclusionThe modified IMB model with extended multilevel factors could serve as a theoretical framework for behavioral interventions for condom use among Chinese MSM. Further prospective studies are needed to examine the predictive power of the modified IMB model.

Why we need pre-exposure prophylaxis: incident HIV and syphilis among men, and transgender women, who have sex with men, Bangkok, Thailand, 2005-2015.

We describe incident human immunodeficiency virus (HIV) and syphilis trends in men who have sex with men (MSM) and transgender women (TGW) presenting for HIV voluntary counseling and testing (VCT) services and sexually transmitted infection (STI) management at the Silom Community Clinic, Bangkok, Thailand. Clients underwent rapid HIV testing and syphilis rapid plasma reagin (RPR) testing. For incidence analysis, we included clients with >1 follow-up visit. Initial negative HIV with subsequent positive HIV defined incident HIV infection; incident syphilis infection was defined as negative RPR followed by positive RPR (titer ≥1:8) and confirmatory anti- Treponema pallidum antibodies. Calculation of incidence using Poisson regression assumed a uniform probability distribution throughout the seroconversion interval. From 15 September 2005 to 31 December 2015, we tested 10,158 clients for HIV and 10,324 for syphilis. Overall, 7109 clients tested HIV-seronegative and contributed 7157 person-years (PY). Three-hundred forty-seven incident HIV infections resulted in an incidence rate of 4.8 per 100 PY (95% confidence interval [CI] 4.4-5.4). We found an inverted U-shape trend of HIV incidence over time with a peak of 6.4 per 100 PY in quarter 2/2011 ( p < 0.01) (Poisson with RCS function, p = 0.001). Overall, 8713 clients tested seronegative for syphilis and contributed 8623 PY. The incidence of syphilis infection was 4.4 per 100 PY (95% CI 3.9-4.8). Despite an apparent decline in HIV incidence among MSM and TGW attending VCT services, syphilis incidence rose and remained high. Evaluating temporal trends of HIV and syphilis incidence provides an opportunity to evaluate epidemic trajectories and target limited program funding. We recommend focused HIV and STI prevention interventions for MSM in Bangkok.

Prevalence and genotypes of anal human papillomavirus infection among HIV-positive vs. HIV-negative men in Taizhou, China.

This study aims to investigate the prevalence and genotype distribution of anal human papillomavirus (HPV) infection among men with different sexual orientations with or without human immunodeficiency virus (HIV) in China. A cross-sectional study was conducted during 2016-2017 in Taizhou City, Zhejiang Province. Convenient sampling was used to recruit male participants from HIV voluntary counselling and testing clinics and Center for Disease Control and Prevention. A face-to-face questionnaire interview was administered and an anal-canal swab was collected for HPV genotyping. A total of 160 HIV-positive and 113 HIV-negative men participated in the study. The prevalence of any type HPV was 30.6% for heterosexual men, 74.1% for homosexual and 63.6% for bisexual men among HIV-positive participants, while the prevalence was 8.3%, 29.2% and 23.8% respectively among HIV-negatives. The most prevalent genotypes were HPV-58 (16.9%), HPV-6 (15.6%) and HPV-11 (15.0%) among HIV-positive men, and were HPV-16 (4.4%), HPV-52 (4.4%) and HPV-6 (3.5%) among HIV-negative men. Having ever had haemorrhoids and having ever seen blood on tissue after defaecation was associated with HPV infection. One-fourth of the HPV infections in this study population can be covered by the quadrivalent vaccine in market. The highly prevalent anal HPV infection among men especially HIV-infected men calls for close observation and further investigation for anal cancer prevention.

Assessment of Knowledge, Attitude and Practice towards Voluntary HIV Testing and Counselling among Mizan High School Students Benchi Maji Zone, Southwest Ethiopia, 2017

Background: Acquired immunodeficiency syndrome (AIDS) is a disease of Human immune system caused by the human immunodeficiency virus (HIV). It is a major public health problem in many parts of the world, and is considered as a pandemic disease. Voluntary test and counseling of HIV is internationally acknowledged to be an essential strategy for HIV prevention and also entry point to AIDS care.Objective: To assess knowledge, attitude and practice toward HIV voluntary testing and counseling among students of Mizan High School, in Mizan-Aman town, SNNPR, South-West Ethiopia.Methods: Institutional based descriptive cross-sectional study design was used from March 01-March 20, 2017. The total sample size (341) of the study participants were selected by using systematic sampling techniques. Data was collected by using structured self-administered questionnaire. Prior to analysis, data was entered using Epi data and cleaned and exported in to SPSS version 20.00 and descriptive statistics was computed.Results: A total of 329 students participated in the study with non-response rate 3.6%. Almost all 325 (98.8%) of respondents had heard about HIV/AIDS and 311 (94%) were heard about voluntary HIV testing and counseling. Two hundred sixty four 264 (80.2%) agreed that voluntary HIV testing and counseling service was necessary. Majority 297 (90.3%) the study participants were knowledgeable about voluntary testing and counseling of HIV and 243 (73.8%) of the study participants had positive attitude towards voluntary testing and counseling of HIV. According to this study, only 103 (31.3%) of the respondents had voluntary testing and counseling of HIV.Conclusion: The finding of this study showed that most of the youths have a good level of knowledge regarding HIV/AIDS and VTC. Majority 243 (73.8%) of the study participants had positive attitude towards voluntary testing and counseling of HIV. Still the practice of voluntary test and counseling of HIV was very low among students of Mizan High school

CD4 Decay Rate as an Indicator of the Time Interval between Initial Infection and First Diagnosis among Drug-Naïve Human Immunodeficiency Virus Seropositive Individuals in Lagos, Nigeria

Objective: The aim of this study was to determine the time interval between human immunodeficiency virus (HIV) infection and the first diagnosis among drug-naïve individuals in Badagry, Nigeria. Subjects and Methods: A sample of 213 subjects who tested HIV positive for the first time were enrolled in this study. The HIV diagnosis was performed using Startpak® and Determine® kits, and a CD4 count was carried out using a FACS Count® flow cytometer. The mean CD4 values were determined by gender and age groups. The time interval between initial HIV infection and first testing was calculated based on the average CD4 decay rate per calendar year, and data analysis was performed using SPSS software. Results: At diagnosis, the mean CD4 values showed that females recorded 270 cells/µl and males 244 cells/µl. By age range, individuals <25 years recorded 437 cells/µl, those between 25 and 40 years of age had 237 cells/µl, and those aged ≥41 years had 192 cells/µl. There was a significant difference between CD4 cell categorization and age range (p < 0.001). Subjects aged between 25 and 40 years recorded the highest distribution of all CD4 cell counts. The time interval between infection and testing for females was 8.1 years and for males 6.7 years. Within the age group <25 years the interval was 5.1 years, whilst it was 8.1 years for those aged ≥41 years. Conclusion: Most of the population presented for testing during the advanced stages of infection. We suggest an upscaling of HIV voluntary counseling and testing to encourage early detection and better treatment outcomes.

Voluntary HIV Counseling and Testing Service Utilization among Pregnant Mothers in North West Ethiopia In 2014

Introduction: According to 2011 Ethiopian demographic health survey result, about 2.2% mothers were HIV (Human Immunodeficiency Virus) positive in Amhara regional state. HIV testing during pregnancy is the gateway for PMTCT (Prevention of Mother to Child Transmission) of HIV though its coverage was 72.0% to 82.5% in North-West Ethiopia. Objective: To assess VHCT (Voluntary HIV Counseling and Testing) service utilization and its determinants among pregnant mothers in North-West Ethiopia in 2014. Methods: A community based cross sectional study using both quantitative and qualitative research methods was conducted in Enemay woreda/district. Data was collected on systematically selected 386 pregnant mothers and 4 FGDs (Focus Group Discussion) on purposively selected pregnant mothers and their partners. A pre tested closed ended structured questionnaire and open ended questions were used to collect the quantitative and qualitative data respectively. Binary logistic regression was used for multivariate analysis of quantitative data. Result: Majority (81.6%) of participants were known transmission of HIV during pregnancy and about three quarter (76.2%) of them were tested for HIV in current pregnancy. In FGD, all participants were not agreed as HIV testing was important during pregnancy. The repeatedly cited reason for not up taking HIV testing during pregnancy was fear of stigma and discrimination if test result becomes positive. Pregnant mothers not knowledgeable about MTCT (Mother to Child Transmission) of HIV; have not intension for ARV Prophylaxisis, unable to bring their partner for test and mothers who believe VHCT was importance before marriage only were less likely utilizing VHCT service thus organizations working on VHCT should further enhance awareness creation by giving especial attention for these groups of pregnant mothers.

HIV testing and counselling in Estonian prisons, 2012 to 2013: aims, processes and impacts.

We present data from an observational cohort study on human immunodeficiency virus (HIV) prevention and control measures in prisons in Estonia to assess the potential for HIV transmission in this setting. HIV testing and retesting data from the Estonian prison health department were used to estimate HIV prevalence and incidence in prison. Since 2002, voluntary HIV counselling and testing has routinely been offered to all prisoners and has been part of the new prisoners health check. At the end of 2012, there were 3,289 prisoners in Estonia, including 170 women: 28.5% were drug users and 15.6% were infected with HIV. Of the HIV-positive inmates, 8.3% were newly diagnosed on prison entry. In 2012, 4,387 HIV tests (including retests) were performed in Estonian prisons. Among 1,756 initially HIV-negative prisoners who were in prison for more than one year and therefore tested for HIV twice within 12 months (at entry and annual testing), one new HIV infection was detected, an incidence of 0.067 per 100 person-years (95% confidence interval (CI): 0.025–5.572). This analysis indicates low risk of HIV transmission in Estonian prisons. Implementation of HIV management interventions could impact positively on the health of prisoners and the communities to which they return.

Health Care Providers’ Perspective on Voluntary HIV Counseling and Testing in Health Clinics in Tanzania - A Qualitative Study

The aim of this study was to explore the perspectives of health care providers on voluntary counseling and testing (VCT) patients for human immunodeficiency virus (HIV) or counseling those living with the virus. Semi-structured interviews were conducted with 12 Tanzanian HIV counselors in different health service clinics in Dar es Salaam, Tanzania. The interviews were analyzed using a qualitative method. Three themes emerged from the interviews: a person-centered approach is necessary to build trusting relationships to negotiate behavioral change; challenges in the variations in counseling sessions as well as the maintenance of confidentiality; and the requirement for privacy and disclosure only with the patient/client's consent. The health care providers, who all had considerably long experiences of VCT, showed confidence in the counseling situation and were aware of the many challenges and barriers they encountered at work as a counselor. They stressed that the basis for creating a trusting relationship between a counselor and a patient was a person-centered approach. Patient confidentiality was an important factor in the counseling work, but confidentiality could also be a challenge and dilemma to protect both the patient and sexual partners at risk, and this should be taken into consideration in counseling guidelines.

Healthcare workers' experiences of HIV testing in Tshwane, South Africa.

In an era when antiretroviral (ARV) therapy has become part of the Human Immunodeficiency Virus (HIV) prevention strategy, early testing and introduction to ARVs iscritical for improving public health outcomes in general and, in particular, the lives of people living with HIV. South Africa has the highest number of people living with HIV as compared with the rest of the world. Initiated voluntary HIV counselling and testing and provider initiated counselling and testing (PICT) are required in order to increase the uptake of HIV testing. To explore and describe the experiences of healthcare workers who are themselves in need of HIV testing. A descriptive, exploratory design was used. In-depth interviews were conducted with the 26 healthcare workers who were involved in HIV testing in the Tshwane district of South Africa. The participants were sampled purposively from two healthcare settings. A thematic framework was used for data analysis. There was a complication with regard to PICT as healthcare workers felt they could not initiate HIV testing for themselves and or their work colleagues without their confidentiality being compromised. This was complicated further by both the perceived and actual fear of stigmatisation and discrimination. It was difficult for qualified staff to support and encourage the uptake of HIV testing by students nurses as this was seen, albeit incorrectly, as targeting the students in a negative manner. There is a need for accessible HIV testing policies for healthcare workers in order to increase access to HIV testing and prevent the progression of the disease.

On the role of HIV/AIDS support groups on combating new infections

AimSince its emergence in the 1980s, the human immunodeficiency virus (HIV), the causative agent of the acquired immune deficiency syndrome (AIDS), remain a major challenge to the global health and human development. We explore the role of optimal HIV counseling and support groups on combating new infections. BackgroundThe stigma surrounding HIV/AIDS makes life more difficult for people living with HIV/AIDS and their families. People living with HIV/AIDS needs a lot of emotional, spiritual, psychological, social, physical and clinical support. During voluntary HIV testing and counseling detected individuals are encouraged to become a member of an HIV/AIDS support group where they will receive useful information on how to live positively. MethodsMathematical model have become invaluable management for epidemiologists, both shedding light on mechanisms underlying observed dynamics as well as making quantitative predictions on the effectiveness of different control measures. Here, we propose a deterministic HIV model that incorporates HIV counseling and support groups. After qualitative analysis the model is extended to incorporate optimal control theory. The objective function minimizes the population of infectious individuals unaware of their HIV status and infectious individuals aware of their HIV status but are reluctant to completely desist from risk sexual activities. The optimal control is characterized and solved numerically for several cases. ResultsQualitative analysis of the proposed model show that voluntary HIV testing and HIV/AIDS support groups have a positive impact on effective control or elimination of the disease. It is shown that in the presence of time dependent HIV testing and support groups more reduction of new infections is achieved. For instance, if more effort and resource are availed on voluntary HIV testing than on support groups, then after a period of twenty years then the population of individuals unaware of their HIV status will decrease by more than fifty percent. ConclusionWith regard to voluntary HIV counseling and support groups results in this study provide a frame work for designing cost-effective strategies for effective control of HIV in the absence of HIV therapy.