Uptake Of Voluntary HIV Testing Research Articles

Psychosocial and Behavioral Characteristics of High-Risk Men Who Have Sex with Men (MSM) of Unknown HIV Positive Serostatus in Bangkok, Thailand.

HIV prevalence remains high in men who have sex with men (MSM) in Bangkok. Even though resources for HIV testing and treatment are available for all, a large proportion of MSM still do not get HIV tested. We studied high risk MSM who are unaware of their HIV status to help maximize effectiveness of our resources. Convenience sampling was conducted among MSM who came for HIV testing at the Thai Red Cross Anonymous Clinic and two popular drop-in centers in Bangkok. Inclusion criteria were MSM aged >18years, have not been tested positive for HIV, who reported ≥1 of the following in the previous 6months: condomless sex with a male, being a sex worker, or having a sexual transmitted infection diagnosis. Audio-Computer-Assisted Self-Interview was used to assess psychosocial profile, sexual risks, and HIV testing patterns prior to being informed of their HIV positive status. Among 499 high-risk MSM enrolled, themedian age was 24.8years and 112 (22%) tested HIV-positive. Among the HIV-positive participants, 92% self-identified as gay (versus bisexual), 39% attained a bachelors degree or higher, 65% had monthly income 10,000-29,999 baht ($280-830 USD), 10% had vaginal or anal sex with a woman in the past 12months, 39% had condomless receptive sex with men and 21% went to Lat Phrao to find a sexual partner. Compared to HIV negative MSM, HIV-positive MSM had less HIV testing: 31% had ever been tested for HIV, 12% had been tested in the past 6months; but were more likely to guess correctly their positive status (31%). Regarding psychosocial variables among HIV-positive MSM, 7% had regular methamphetamine use in the past 3months, 10% had >2 sources of discrimination, and 8% had >2 sources of discrimination due to being MSM. In multivariable model, age<30year old, self-identified as gay, had monthly income <50,000 baht ($1400 USD), had anal sex with men in past 12months, had >2 sources of discrimination because of being MSM, did not get HIV test in past 6months, and guess of positive HIV were significantly associated with HIV positive status. Young MSM with lower socioeconomic status (SES) should be prioritized for innovative approaches to promoting awareness and uptake of HIV testing. Societal stigmatization of MSM should be addressed as a potential barrier to uptake of voluntary HIV testing. Resilience factors among these marginalized MSM who still test frequently and remain HIV-negative despite residing in a context with community viral loads and discrimination should also be studied in order to curb the HIV epidemic in Bangkok.

DP4 - Factors associated with voluntary HIV testing uptake among young people in Saudi Arabia

DP4 - Factors associated with voluntary HIV testing uptake among young people in Saudi Arabia

Barriers and facilitators to voluntary HIV testing uptake among communities at high risk of HIV exposure in Chennai, India

In India, increasing uptake of voluntary HIV testing among ‘core risk groups’ is a national public health priority. While HIV testing uptake has been studied among key populations in India, limited information is available on multi-level barriers and facilitators to HIV testing, and experiences with free, publicly available testing services, among key populations. We conducted 12 focus groups (n = 84) and 12 key informant interviews to explore these topics among men who have sex with men, transgender women, cisgender female sex workers, and injecting drug users in the city of Chennai. We identified inter-related barriers at social-structural, health-care system, interpersonal, and individual levels. Barriers included HIV stigma, marginalised-group stigma, discrimination in health-care settings, including government testing centres, and fears of adverse social consequences of testing HIV positive. Facilitators included outreach programmes operated by community-based/non-governmental organisations, accurate HIV knowledge and risk perception for HIV, and access to drug dependence treatment for injecting drug users. Promoting HIV testing among these key populations requires interventions at several levels: reducing HIV-related and marginalised-group stigma, addressing the fears of consequences of testing, promoting pro-testing peer and social norms, providing options for rapid and non-blood-based HIV tests, and ensuring non-judgmental and culturally competent HIV counselling and testing services.

The influence of stigma on voluntary HIV testing among pregnant women in South Africa

Internal and external stigmas are often lumped together while addressing issues of stigma and HIV-testing, not considering that one of them may actually affect the disposition HIV-testing than the other. This study, therefore, investigated the effect of HIV/AIDS-related internal and external stigma on the disposition of pregnant women in the Limpopo Province of South Africa to go for voluntary HIV-testing. Four hundred and fifty seven (457) pregnant women from randomly sampled antenatal clinics in the province participated in the study. Using a quantitative method of research, a questionnaire which inquired about some of their demographic information, their disposition for voluntary HIV-testing uptake, and HIV/AIDS-related internal and external stigma, was administered to them in clinic/hospital settings. Data were analysed using the SPSS computer programme. Linear Regression analysis was employed. Results show that the majority of the pregnant women (88.6%) agreed to go for HIV testing, 4.6% of them did not agree, and 6.8% were undecided. Furthermore, HIV/AIDS-related internal stigma came out to be a significant factor. The more HIV/AIDS-related internal stigma expressed by the pregnant women, the more they are indisposed to go for HIV-testing. Although most of the pregnant women in the province would agree to go for voluntary HIV testing, the issue of HIV/AIDS-related internal stigma needs to be adequately addressed in any clinical psychological or health promotional programme designed to increase voluntary HIV testing uptake among pregnant women, and minimize mother-to-child transmission of the HIV. Often, both internal and external stigmas are equally addressed in health promotional programmes, but this result suggests that among pregnant women, more emphasis should be placed on internal stigma. Key words: Pregnant women, Stigmatization, HIV-testing uptake, South Africa. *This research project was sponsored by the Medical Research Council of South Africa.

Demographic and Behavioral Factors Associated With HIV Testing in China

HIV testing and counseling are entry points to HIV-related care and prevention services and provide opportunities for people to reduce their risk of acquiring or transmitting HIV. High priority should be given to scaling up HIV testing and counseling to maximize the opportunities to reach those with HIV infection or at high risk.1 Voluntary counseling and testing (VCT) is an important testing strategy for identifying HIV positives. VCT in China was not widely known and available until December 2003, when the Chinese government announced the “Four Frees and One Care” policy, which included free VCT.2 We conducted a study among a general population sample rather than a high-risk group, with the collection of both demographic and behavioral data, to examine potential factors associated with VCT uptake in the population.

Social, cultural and sexual behavioral determinants of observed decline in HIV infection trends: lessons from the Kagera Region, Tanzania

This paper is a follow-up of earlier findings by the Kagera AIDS Research Project (KARP), which documented declining trends in the prevalence and incidence of HIV infection in the Kagera region of Tanzania. The paper examines socio-cultural and sexual behavioral changes as possible determinants of the observed declining trends in Bukoba, the largest urban area of the region. The study used in-depth interviews, focus group discussions, field observations and ethnographic assessments to collect the required data. The findings suggest that since the initial years of the epidemic there have been significant changes in sexual behaviors, norms, values, and customs that are considered high-risk for HIV transmission. The findings show an increase in condom use, abstinence, zero grazing (sticking to one sexual partner) and uptake of voluntary HIV testing while traditional practices such as polygamy, widow inheritance, excessive alcohol consumption, and sexual networking are declining. We suggest that these changes are partly a result of the severity of the epidemic itself in the study area, and interventions that have been carried out in this area since 1987. The major interventions have included health education, the distribution of condoms, AIDS education in schools, voluntary HIV counseling and testing. These are encouraging findings that give hope and we believe that other places within Tanzania and other countries experiencing a severe AIDS crisis have much to learn from this experience. However, changes in norms and behavior are vulnerable; people in Kagera are still at risk and there is a need for continued intervention together with monitoring of the direction of the epidemic.

Access to HIV testing for homosexually active men

We report on homosexual men's uptake of voluntary HIV testing. A sample of 677 men was recruited from four different areas of England, which included 30% obtained via clinics. The criterion for inclusion was ‘any man who had had sex with another man in the previous 5 years’. Men were interviewed about their sexual behaviour, history of sexually transmitted diseases, reasons for seeking or not seeking an HIV test, experience of HIV tests and attitudes to the test. They were also asked to provide a sample of their saliva for anonymous screening for antibodies to HIV-1. The majority of men (63%) reported serological testing. Those who reported a history of sexually transmitted diseases, higher numbers of unprotected penetrative partners or unprotected anal sex in the last 5 years were significantly more likely to have had a test. Attitudes towards voluntary testing were largely favourable with 64% citing the availability of early treatment for HIV infection as a good reason for being tested. The findings suggest that those most at risk of infection are also those most likely to seek a test and that national voluntary testing data for homosexual men therefore overestimate HIV prevalence for homosexually active men as a whole.