Voluntary Counseling Research Articles

Status of personal information sharing on HIV between sexual partners among men who have sex with men who met casual sexual partners on the internet in Zhejiang province

Objective: To identify the status and determinants of sharing personal HIV information with sexual partners among men who have sex with men (MSM) meeting their casual sexual partners on the internet. Methods: A cross-sectional study was conducted in five cities (Hangzhou, Ningbo, Wenzhou, Taizhou and Shaoxing) in Zhejiang province. The recruitment was enrolled by MSM social organization and in voluntary counseling and testing clinics, with a sample size of 793. A self-designed network questionnaire collected essential characteristics, HIV knowledge, sexual behavior, and sharing personal HIV status. SPSS 20.0 software was used for statistical analysis. Results: Among 767 MSM enrolled 302 MSM who reported finding casual sexual partners on the internet were enrolled in the analysis. MSM reported finding casual partners on the internet only, finding sexual partners online and in places were 62.6% (189/302) and 37.4% (113/302), respectively. Among those reporting web-based sexual behavior in the last six months, 54.6% (165/302) informed their partners of their HIV status, 49.2% (146/297) inquired about HIV status, and 42.9% (82/191) knew HIV status before sex intercourse, 75.8% (113/149) reported consistent condom use with HIV negative partners. The multivariable logistic regression analysis showed that related factors of inconsistent inquired HIV status of partners included 25-34 years old (aOR=2.17, 95%CI: 1.20-3.91), >2 partners on the internet in the last six months (aOR=2.13, 95%CI: 1.27-3.57), low-risk perception of HIV infection with online partners (aOR=1.96, 95%CI:1.14-3.35), numbers of HIV testing >1 times (aOR=0.38, 95%CI: 0.22-0.66). Conclusions: The willingness to know the HIV status of partners among MSM who met sexual partners on the internet was high but with a low rate of knowing their sex partner's HIV status in Zhejiang province. However, the successful implementation proportion was low. Therefore, it is necessary to pay attention to people who are elderly, with less conscience about the risk of the sex partners on the internet, have more sex partners, and have received few HIV tests. In addition, peer education was needed to promote related intervention programs.

Prevalence of HIV/AIDS Infection among Sexually Active Women in Ethiopia: Further Analysis of 2016 EDHS.

The issue of HIV/AIDS is prevalent around the world and in Ethiopia as well. The aim of this study was to determine the prevalence and risk factors of HIV/AIDS infection among sexually active women in Ethiopia. For this study, data were obtained from the Ethiopia Demographic and Health Survey conducted in 2016. This study contains 11,729 women who have had at least one episode of sexual intercourse in their lifetime. Interviewers for voluntary HIV testing collected finger-prick blood specimens from women who agreed to be tested for HIV. Based on factors at the individual and community levels, a multilevel logistic regression model was used. The study found that 2% of 11,729 sexually active women tested positive for HIV from all regions who received voluntary counseling and testing. The intraclass correlation coefficient findings showed that 32.844% of HIV/AIDS transmission among sexually active women was the result of community-level factors. Variables at the individual level were women of age 16-24 (AOR = 0.18; 95% CI: 0.11-0.29), women of age 25-34 (AOR = 0.733; 95% CI: 0.55-0.98), women with primary education level (AOR = 1.8; 95% CI: 1.23-2.57), more than one sexual accomplice (AOR = 1.33; 95% CI: 0.613-2.87), and women's age at first sexual intercourse between 25 and 34 (AOR = 0.57, 95% CI: 0.301, 1.06); these were the most significant determinants of HIV/AIDS infection. According to community-level factors, there was a lower HIV prevalence rate among rural women (AOR = 0.22; 95 percent CI: 0.13-0.36), and women in the Gambela region (AOR = 4.1; 95 percent CI: 1.99-8.34) also had higher HIV prevalence rates. The prevalence of HIV infection among sexually active women varies by region, with urban women more likely to contract the virus. Women who had more than one regular sexual partner and had their first sexual encounter at a younger age are at an increased risk of contracting HIV/AIDS. According to the study, the government should focus more support on high-risk clusters, mainly in urban areas, as well as on regions with high rates of HIV/AIDS infection.

Effects of Two Modes of Groups Counseling Approaches on HIV Voluntary Counseling and Testing Among School-going Adolescents

Aims: The study investigated the effects of cognitive behavioral and reality group therapies in fostering human immunodeficiency virus/ voluntary counseling and testing among school-going adolescents in Benin Metropolis, Edo State, Nigeria. Method: A pre- and post-test true experimental control group design was observed. While 120 school-going adolescents from three randomly selected schools were recruited and randomly assigned to two treatments (Cognitive Behavior [37] and Reality [34] Therapies) and control [38] groups, with 11 dropout accounting for 9% alteration rate. The treatment last six weeks. Two hypotheses were formulated to guide the study. The instruments used for data collection were self-administered scales with a test-retest reliability coefficient of 0.87 after an interval of three weeks. Data generated was analyzed using the inferential statistics of Analysis of Variance tested at a 0.05 level of significance. Results: The results showed that cognitive behaviour and reality therapies were significantly effective in fostering HIV/voluntary counselling and testing among school-going adolescents. That is, the two modes of group interventions improve the willingness of adolescents of these schools towards receiving counselling and performing testing for HIV. Conclusion: It was concluded that cognitive behaviour and reality therapies were found to be potent on school-going adolescents’ willingness toward HIV voluntary counselling and testing for prevention and treatment.

UPAYA PENCEGAHAN DAN PENANGGULANGAN PENYEBARAN PENYAKIT INFEKSI MENULAR SEKSUAL MASA PANDEMI COVID-19 DI KABUPATEN BATANG

With these various problems, the researchers set the research objective, namely to find out efforts to prevent and control the spread of sexually transmitted infections during the Covid-19 pandemic in Batang Regency and what factors influence it. Data collection in this qualitative descriptive study was carried out in three ways, namely observation, interviews and documentation. The results of this study indicate that efforts to prevent and control sexually transmitted infections, especially HIV/AIDS during the Covid-19 pandemic in Batang Regency are realized through several programs and activities, namely outreach programs, Voluntary Counseling and Testing (VCT), Care Support and Treatment (VCT). CST), Anti Retroviral Therapy (ART), Prevention of Mother-To-Child Transmission (PMTCT), Directly Observed Treatment, Shorourse Chemotherapy (DOTS) and Mentoring. The impact of the COVID-19 pandemic on several STI disease prevention and control programs is in the form of reducing service time even to the point of discontinuing services caused by government policies in dealing with the Covid-19 pandemic. In addition, factors that hinder and support efforts to prevent and control STIs during the COVID-19 pandemic lead to the government's policy of imposing restrictions on community activities and utilizing advances in information technology.

Impact of coronavirus disease 2019 on the HIV testing and health care delivery at a university hospital in Taiwan, 2020–2021

BackgroundTo contain the coronavirus disease 2019 (Covid-19) pandemic, non-pharmacologic interventions, including lockdown and social distancing, may have adverse impact on access to HIV testing and care. This study investigated the impact of Covid-19 on HIV testing and care at a major hospital in Taiwan in 2020–2021.MethodsThe numbers of clients seeking anonymous HIV voluntary counseling and testing were compared 2 years before (2018–2019) and 2 years after Covid-19 outbreak (2020–2021). People living with HIV (PLWH) who sought care at the hospital during 2018–2021 were included to examine the status of HIV care delivery and disposition.ResultsThe annual number of HIV screening tests performed had significantly decreased from 2507 to 2794 in 2018 and 2019, respectively, to 2161 and 1737 in 2020 and 2021, respectively. The rate of discontinuation of HIV care among PLWH was 3.7% in 2019, which remained unchanged in 2020 (3.7%) and 2021 (3.8%). The respective percentage of annual plasma HIV RNA testing <2 times increased from 8.4% to 7.8% in 2018 and 2019 to 7.0% and 10.7% in 2020 and 2021, so was that of annual syphilis testing <2 times (10.1% and 8.8%–7.9% and 12.0%). The rates of plasma HIV RNA <200 copies/ml ranged from 97.0% to 98.1% in 2018–2021.ConclusionsDuring the Covid-19 pandemic, access to HIV counseling and testing was significantly limited. While the number of HIV-related testing decreased, the impact of Covid-19 on the continuity of antiretroviral therapy and viral suppression among PLWH appeared to be minimal in Taiwan.

Initial implementation of HIV pre-exposure prophylaxis for people who are incarcerated in Zambia: a cross-sectional observational study

There are over 23 000 incarcerated people in Zambia, a population which has higher HIV prevalence than the general population yet has no access to HIV prevention. To evaluate the feasibility of HIV pre-exposure prophylaxis (PrEP) implementation in Zambian criminal justice facilities, we offered PrEP services to incarcerated people and aimed to describe early implementation outcomes. In this cross-sectional observational study, we implemented a PrEP programme between Oct 1, 2020, and March 31, 2021, supporting 16 criminal justice facilities in four Zambian provinces. Before implementation, we held stakeholder engagement meetings with Zambia Correctional Service officials to discuss PrEP benefits, and trained Zambia Correctional Service health-care workers in PrEP management using the national PrEP training package. People who were incarcerated and screened positive for substantial HIV risk by use of a standardised HIV risk assessment tool were offered voluntary HIV testing and counselling. Those who tested positive were linked to antiretroviral therapy, and those who tested negative and met national HIV prevention eligibility criteria were offered PrEP. We assessed PrEP uptake and used descriptive statistics to characterise programme beneficiaries and the cascade of PrEP services. During the study period, we reached 12 367 people older than 15 years with HIV risk assessment and counselling, including 11 794 (95·4%) men and 573 (4·6%) women. Of these, 2610 people received HIV testing, with 357 (13·7%) testing HIV positive; positivity was significantly higher in women (20·6%) than men (13·2%, p=0·011). 1276 people were identified as HIV negative and PrEP eligible. Of these, 1190 (93·3%) initiated PrEP. The age group with the highest proportion reached and initiated on PrEP was those aged 25-29 years, representing 19·2% (2377 of 12 367) of all people reached and 24·1% (287 of 1190) of those who initiated PrEP. Delivery of PrEP to people who are incarcerated is feasible with adequate resourcing and support to the criminal justice health system, and can result in high uptake among eligible individuals. Further assessment is needed of PrEP persistence and adherence, and the perceptions of people who are incarcerated regarding their HIV risk and preferences for combination HIV prevention services. US President's Emergency Plan for AIDS Relief through the US Centers for Disease Control and Prevention.

Perceptions and Experiences of Males who have Sex with Men Regarding Sexual and Reproductive Health Services in Bulawayo, Zimbabwe

Background: Sexual and Reproductive Health services are a cornerstone for each nation to achieve Sustainable Development Goal Number 3, which challenges nations to ensure healthy lives and promote the well-being of all ages, including access to SRH services. Generally, stigma and policies against men who have sex with men have heightened the risk of getting and spreading sexually transmitted diseases in this key population. This study, therefore, sought to explore men who have sex with men's perceptions and experiences of sexual and reproductive health services offered in Bulawayo in Zimbabwe. Methods: An exploratory, descriptive qualitative study was conducted on twenty-four (24) purposively selected men who had sex with men identified through Sexual Rights Centre in Bulawayo. The study participants responded to unstructured interview questions that probed on their lived experiences and perceptions of sexual and reproductive health services offered by health facilities in the city of Bulawayo. The interviews were recorded, transcribed verbatim, coded, and thematically analyzed on MAXQDA Version 20 Pro. Results: Findings suggested that men who had sex with men sought a wider range of sexual and reproductive health services that ranged from voluntary counseling and testing, treatment of sexually transmitted infections, and obtaining pre-exposure prophylaxis tablets, among other issues. However, men who had sex with men faced discrimination, stigma, and hostile treatment by some health service providers. This scenario, in some instances, is perceived to have fueled their vulnerability and led to internalized homophobia. Conclusion: In pursuit of Sustainable Development Goal Number 3, which challenges all nations to ensure healthy lives and promote well-being at all ages, men who have sex with men are not fully accorded their rights. Therefore, there is a need to reorient health services and align policies to ensure the inclusion of this key population in accessing and utilizing sexual and reproductive health services.

PATRONAGE OF HIV/AIDS VOLUNTARY COUNSELLING AND TESTING (VCT) AMONG UNIVERSITY STUDENTS IN GHANA

Purpose: This study investigated the factors influencing patronage of HIV/AIDS Voluntary Counselling and Testing (VCT) among students in the University of Cape Coast.&#x0D; Methodology: Descriptive survey research design was adopted for the study. Referring from Krejcie and Morgan’s (1970) Sample Determination Table, a sample of 376 students was chosen using convenience sampling from a population of 18949 students. Data were collected using questionnaire adapted from the instrument of Kabiri (2016) administered online. Data were analysed using means and standard deviations.&#x0D; Findings: The study revealed that the students had high level of knowledge about HIV/AIDS VCT and its importance but had low level of knowledge about VCT centres. The study found that the respondents were willing to go to HIV/AIDS VCT Centre to check their HIV/AIDS status and knew of some friends who had gone for HIV/AIDS VCT. However, it was clear that the respondents themselves had not visited VCT centres. Additionally, it was shown in this study by the respondents that willingness, perception of risk associated with their sexual lives, positive perception about VCT, attitude of service provides and ease of access to VCT centres are factors which would influence them to patronize HIV/AIDS VCT.&#x0D; Unique Contribution to Theory, Practice and Policy: Theoretically, the study has highlighted that having awareness of VCT and its importance was not enough to make students patronize VCT services. This means that knowledge and awareness alone was not enough to influence patronage of services.It can also be said that the theory of planned behaviour reviewed in the study was confirmed because a lot of elements are involved in people deciding to engage in specific behaviours. To improve the patronage of VCT, efforts should be put into making VCT centers easily accessible to students. Policy makers are alerted on the low patronage of HIV/AIDS VCT among university students so they can streamline their policies to aid in increasing patronage of VCT by university students.

Changes in HIV testing trends in Poland during COVID-19 pandemic.

At the beginning of COVID-19 pandemic, due to lockdown, limited mobility, as well as changes in the activity profile of some laboratories, the restriction also applied to access to various screening tests, including HIV screening tests. The aim of the study was to assess HIV testing trend during COVID-19 pandemic in laboratories in Poland and its comparison to the preceding years, with special focus on testing in the network of Voluntary Testing and Counselling (VCT) sites serving population with higher behavior risk, which increase the possibility of HIV infection. Analysis of the changes in HIV tests number was based on the results of the annual survey of HIV tests conducted among the laboratories throughout the country. The questionnaire included data on screening and positive tests by testing site type, age group and gender. In addition, we extracted data collected in comprehensive National AIDS Centre database, based on epidemiological and behavior data collected by VCT on people who come for testing. There are approximately 400,000 HIV tests annually run in general population in last years. COVID-19 pandemic, which occurred in beginning of 2020 did not have a huge impact on HIV test number among these population, because there was observed 1% decreased. Pandemic COVID-19, due to few lockdown reduced the HIV tests number among VCT clients - population with higher HIV risk infection. Tests number decreased by 44% compare to previous year, due to temporal closed of these centres. Data analysis shows that due to the pandemic, the structure of the surveyed people changed, especially in terms of age and gender, and the place where the study was performed. We confirmed low HIV testing rates in general population and low positivity rate over the studied period. The positivity rate was higher in the testing site network targeting individuals engaging in high risk behaviors. Changes observed in HIV testing trends in recent years have been affected by the COVID-19 pandemic.

Using Client Flow to Assess Effectiveness of Voluntary Counseling and Testing Service as the Gateway in the Control of HIV/AIDS in Anambra State, South-East Nigeria

Anambra State, South-East Nigeria, had high prevalence of HIV averaging 7.1% during period under study. In line with national guidelines, the State established 117 Voluntary Counseling and Testing (VCT) centers designed to function as ‘gateway’ service to other HIV/AIDS services in the State. This study assessed the effectiveness of VCT centers as ‘gateway’ to other HIV/ AIDS services in Anambra State for the period 2006 to 2011 using the client flow recorded by the VCT centers. Descriptive documentary survey was adopted. Secondary data comprising of client flows of the VCT centers were collected. The data were presented in tables as integrated annual summary reports, and analysed as percentages, comparison, and for significance using Chi-Square Test of Significance @ 0.05. It was found that average annual client flows of 1.89% at the VCT centers were not significant. Inference was drawn and conclusion made that VCT service, for the years under study, was not an effective gateway to other HIV/AIDS services in Anambra State. The study recommends a paradigm shift to Universal Counseling and Testing involving, among other features; focus on provider-initiated counseling and testing and liberalization of the location of UCT centers in other public places with high client catchment potentials such as Government Secretariats.

Deteksi HIV / AIDs Dengan Pemeriksaan Viral Load Dan Pemeriksaan Penghitungan CD4 Cell

The incidence of cases of HIV / AIDS is still increasing, including in South Kalimantan, especially Banjarmasin, which has an incidence of cases of HIV / AIDS in 2018 totaling 181 people. The HIV virus attacks white blood cells (T-helper lymphocytes "CD4 +) and results in decreased human immunity. The viral load examination is used to measure the amount of HIV virus in the blood. Examination of CD4 cell counts are used to assess the level of immunity of people with HIV / AIDS. The purpose of this study was to determine the relationship between the results of the viral load examination with the results of the examination of the number of CD4 cells in patients with HIV / AIDS. This research can provide scientific information as a reference to increase knowledge about HIV / AIDS and decrease the level of immunity of people with HIV / AIDS. This research also provides insight into how to find out initial information about the body's immunity against new sufferers. Sampling was done by purposive sampling with inclusion criteria. Samples are new outpatients, aged 20-50 years and have received VCT (Voluntary counseling and testing). Sample is an HIV / AIDS positive HIV patient by conducting an HIV rapid test. Determination of the sample was also seen from the exclusion criteria of HIV / AIDS sufferers who had received ARV drug therapy. This research was an observational analytic study with a cross-sectional approach using quantitative analysis methods. Viral load examination uses the real time reverse transcriptase method - Polymerase Chain Reaction (RT-PCR). Examination of CD4 cell numbers using the flowcytometry method with the Alere PIMA tool. Data were analyzed by Rank Spearman correlation test. The results of the Viral load in patients with HIV / AIDS in the adult age group showed 9,000 copies / ml and at the end 960,000 copies / ml. The results of the viral load test in adult patients at the end are higher than at the beginning. Examination Results of the number of CD4 cells in patients with HIV / AIDS in the adult age group showed 586 cells / ul and at the end of 11 cells / ul. Examination Results of CD4 cell counts for adult sufferers show lower end than at baseline. Indications of the results of the examination showed the higher the amount of viral load, the number of cells CD4 will be lower than patients with HIV / AIDS. The implication of this research is a recommendation of viral load examination for detection new patient. The conclusion of this study is that there is a significant relationship between the results of the examination of viral load and the results of the examination of the number of CD4 cells in patients with HIV / AIDS.

High Incidence, Reinfections, and Active Syphilis in Populations Attending a Specialized HIV Clinic in Mexico, a Dynamic Cohort Study

Syphilis, a sexually transmitted infection, has reemerged in many vulnerable groups around the world. The objective of the current study was to determine the prevalence and incidence of syphilis among people who attended a specialized HIV clinic in Mexico from 2011 to 2015. Databases from the laboratory were analyzed, and the following four groups were formed: people seeking HIV-1 voluntary counseling and testing (VCT), people in prison (PPr), people living with HIV (PLWH), and patients from primary care clinics (others). The diagnosis of syphilis was made using the reverse algorithm; antibody titers were examined to determine the stage of infection. Baseline data were analyzed and, with follow-up information, a retrospective dynamic cohort was formed. Factors associated with the seroprevalence of syphilis and active syphilis were evaluated by the chi-square test. Moreover, risk factors for the incidence of syphilis were described. A total of 81,863 baseline individuals were analyzed. The seroprevalence of syphilis was 9.9% in the VCT group, 8.2% in the PPr group, 37.0% in the PLWH group, and 8.7% in the others group; the prevalence of active syphilis was 1.7–13.1%. A total of 11,124 people were followed up. The incidence (cases per 100 person-years) was 3.5 among the VCT group, 16.0 among the PLWH group, and < 0.1 among both the PPr and others groups, respectively; moreover, the frequency of reinfections was 11.1–24.4%. The high prevalence and incidence of syphilis, active syphilis, and reinfections among men, transgender people, individuals aged 20–39 years, and people with a history of HIV or hepatitis B suggest that it is critical to improve prevention, diagnosis, and treatment measures to stop the reemergence of syphilis. There are also new factors such as methamphetamine use, group sex, or contacting partners over the internet that are associated with syphilis. In addition, HIV preexposure prophylaxis could contribute to the increased incidence of syphilis by providing false security in the prevention of STIs, thereby increasing risky sexual behaviors.

Willingness to Test for Human Immunodeficiency Virus (HIV) Infection among First-Year Students of a Public University in the Volta Region of Ghana

Voluntary counselling and testing (VCT) is key in HIV prevention. Young people aged 15–24 years carry a significant burden of new infections globally, but VCT uptake is low in this population. The study assessed university freshmen’s willingness to test for HIV now, among others, in a cross-sectional study as university campuses are places of risky sexual behaviour. Structured questionnaires were used to collect data on age, sex, marital status, HIV/AIDS knowledge, previous history of testing, willingness to test now, and others. Summary statistics were reported while chi-square and logistic regression methods were used to assess the association between dependent and independent variables with p-values &lt; 0.05 held significant. About 90% (374/412) of respondents had good HIV/AIDS knowledge based on criteria defined by the study, but only 23.3% (96/412) had ever tested and 66.3% (266/401) were willing to test now for HIV. Respondents’ sex, previous sexual intercourse, and whether respondents’ educational support was from parents or non-parents influenced willingness to test for HIV now. The study highlights what appears to be personal beliefs that can potentially hinder HIV testing and control efforts. Relevant stakeholders must address these gaps to improve testing. Further qualitative investigation will improve understanding of the dynamics informing willingness to test for HIV among young people generally.

Costs and cost-effectiveness of HIV counselling and testing modalities in Southern Mozambique

ObjectiveDespite the high HIV associated burden, Mozambique lacks data on HIV counselling and testing (HCT) costs. To help guide national HIV/AIDS programs, we estimated the cost per test for voluntary counselling and testing (VCT) from the patient’s perspective and the costs per person tested and per HIV-positive individual linked to care to the healthcare provider for VCT, provider-initiated counselling and testing (PICT) and home-based testing (HBT). We also assessed the cost-effectiveness of these strategies for linking patients to care.MethodsData from a cohort study conducted in the Manhiça District were used to derive costs and linkage-to-care outcomes of the three HCT strategies. A decision tree was used to model HCT costs according to the likelihood of HCT linking individuals to care and to obtain the incremental cost-effectiveness ratios (ICERs) of PICT and HBT with VCT as the comparator. Sensitivity analyses were performed to assess robustness of base-case findings.FindingsBased on costs and valuations in 2015, average and median VCT costs to the patient per individual tested were US$1.34 and US$1.08, respectively. Costs per individual tested were greatest for HBT (US$11.07), followed by VCT (US$7.79), and PICT (US$7.14). The costs per HIV-positive individual linked to care followed a similar trend. PICT was not cost-effective in comparison with VCT at a willingness-to-accept threshold of US$4.53, but only marginally given a corresponding base-case ICER of US$4.15, while HBT was dominated, with higher costs and lower impact than VCT. Base-case results for the comparison between PICT and VCT presented great uncertainty, whereas findings for HBT were robust.ConclusionPICT and VCT are likely equally cost-effective in Manhiça. We recommend that VCT be offered as the predominant HCT strategy in Mozambique, but expansion of PICT could be considered in limited-resource areas. HBT without facilitated linkage or reduced costs is unlikely to be cost-effective.

중년기에 진로를 전환한 여성 상담사들의 은퇴 후 삶에 대한 현상학적 연구

Objectives This study attempted to clarify the meaning and nature of volunteer counseling by female retirement counselors who changed their careers in middle age. Methods 12 participants were selected by mixing standard sampling and snowball samplidhldpng. The data were constructed by conducting in-depth interviews with participants. The in-depth interview period was from November 2021 to January 2022. The data were carried out in accordance with the seven-step data analysis procedure presented by Colaizzi. Results As a result of the study, 24 topics were derived, which were aggregated into 12 topics. It was found that social reduction of talent, cracking in ageism, the sense of resignation of juniors, the realization of altruism that was reserved, and aging well are aging together. Conclusions Counseling activities of female counselors who changed their careers in middle age continued even after retirement, and volunteer counseling after retirement is always a process of making a new history of their lives. Based on the results of the study, the researchers discussed participants' independent life plans and challenges, subjective life reorganization, and overcoming ageism and made specific suggestions for counselors to support quality of life and counseling after retirement.

Determinant Factors of Sexual and Reproductive Health Service Utilization among In-School Adolescents with Disability in Jimma Zone, Southwest Ethiopia

Introduction Adolescents with disability are often presumed erroneously to be sexually inactive. Though they have the same need for sexual and reproductive health (SRH) services as nondisabled people, they are often overlooked by sexual and reproductive health programs, interventions, and studies. Objective To assess determinant factors of sexual and reproductive health service utilization among in-school adolescents with disability in Jimma zone, southwest Ethiopia. Method Institution-based cross-sectional study design was employed among in-school adolescents with disability in Jimma zone, Ethiopia, from September 21 to November 30, 2021. A total of 454 participants were included in the study by using the multistage sampling technique. Data were collected by using a structured questionnaire through face-to-face interviews. Data were entered into Epi-data version 4.2 and analyzed by using SPSS version 23. Bivariate and multivariable logistic regression analyses at a 95% confidence interval were performed, and a P value < 0.05 was considered statistically significant. Result 454 study participants were included in this study with a respondent rate of 97.4%. Only 38 (8.4%, 95% CI: 5.7-10.8%) of in-school adolescents utilized SRH information and education service. The majority (265, 49%) of adolescents with disability knew family planning as sexual and reproductive health services which were followed by voluntary counselling and testing for HIV/AIDS (116, 21.4%). Seventy-eight (17.2%, 95% CI: 13.7-20.5%) of in-school adolescents with disability visited nearby health facilities for VCT services. Male sex (AOR = 2.32, 95% CI: 1.18-4.57), favourable attitude (AOR = 3.11, 95% CI: 1.59-6.07), and history of sexual intercourse (AOR = 5.34, 95% CI: 2.05–13.92) were significantly associated with SRH service utilization. Conclusion The overall sexual and reproductive health service utilization of in-school adolescents with disability was low when compared with other studies. Physical impairment, male sex, ever had sexual intercourse, good knowledge, and favourable attitudes were determinant factors of SRH service utilization among in-school adolescents with disabilities. So, it is recommended that the Jimma zone administration, government, and NGOs should give attention to SRH services.

Assessment of HIV/AIDS Service Quality Using SERVQUAL Model in Iran: A Cross-sectional Study

Background: This study aimed to evaluate the quality of services provided in Voluntary Counseling and Testing (VCT) centers from the perspective of clients. Methods: This cross-sectional study was conducted on people living with human immunodeficiency virus (PLWH) in Shiraz, Iran, in 2019. The data were collected using a SERVQUAL questionnaire. Results: The mean scores of expected and perceived service qualities were 4.81 (95% CI: 4.741 - 4.864) and 3.96 (95% CI: 3.901 - 4.019) in male subjects and 4.85 (95% CI: 4.80 - 4.89) and 4.09 (95% CI: 4.01 - 4.135) in female subjects, respectively. There was a significant difference between the expectations and perceptions of clients in all dimensions of service quality in VCT centers. The gaps in the dimensions of responsiveness and empathy were greater than all other dimensions. Conclusions: Due to the high dissatisfaction of PLWH with the quality of services in the responsiveness, accessibility, and empathy dimensions, priority should be given to these dimensions in any improvement effort. The low education level of this group should be taken into account for any educational programs to be successful.

HIV Voluntary Counseling and Testing (VCT-HIV) effectiveness for sexual risk-reduction among key populations: A systematic review and meta-analysis.

SummaryBackgroundHIV disproportionately affects people who inject drugs, transgender people, sex workers, men who have sex with men, and incarcerated people. Recognized as key populations (KP), these groups face increased impact of HIV infection and reduced access to health assistance. In 1990, the Center for Disease Control and Prevention organized technical guidance on HIV Voluntary Counseling and Testing (VCT-HIV), with subsequent trials comparing intervention methodologies, no longer recommending this strategy. However, KP needs have not been explicitly considered.MethodsWe assessed VCT-HIV effectiveness for sexual risk-reduction among KP (PROSPERO 2020 CRD42020088816). We searched Pubmed, EMBASE, Global Health, Scopus, PsycINFO, and Web of Science for peer-reviewed, controlled trials from February, 2020, to April, 2022. We screened the references list and contacted the main authors, extracted data through Covidence, applied the Cochrane Risk-of-Bias tool, and performed the meta-analysis using Review Manager.FindingsWe identified 17 eligible trials, including 10,916 participants and evaluated HIV risk behaviors. When compared to baseline, VCT-HIV reduced unsafe sex frequency (Z=5.40; p<0.00001, I²=0%).InterpretationWhile our meta-analysis identified VCT-HIV as protective for sexual risk behaviors for among KP, the results are limited to MSM and PWID, demonstrating the paucity of data on the other KP. Also, it highlights the importance of applying a clear VCT-HIV guideline as well as properly training the counselors.FundingResearch funded by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPQ/MS-DIAHV N° 24/2019), and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior.

Non-disclosed men who have sex with men within local MSM HIV-1 genetic transmission networks in Guangyuan, China.

BackgroundMost men who have sex with men (MSM), especially those with HIV infection, do not disclose their same-sex behaviors in China due to Chinese family values and fear of stigmatization, rejection, or prejudice. However, disclosure of same-sex behaviors to healthcare providers (HCPs) can be beneficial for reducing viral transmission and promoting their physical and mental health. In this study, by combining phylogenetic analysis with traditional epidemiological approaches, we tried to identify the MSM who do not disclose to HCPs in transmission networks and explored the factors related to the non-disclosed behaviors.MethodPhylogenetic analysis was conducted using HIV pol sequences obtained from the drug-resistant surveillance program, which was collected as part of routine clinical care since 2012. Sequences were linked to the demographic data collected in the Chinese HIV/AIDS Comprehensive Response Information Management System (CRIMS). First, male patients in whom genetic sequences were within the molecular transmission clusters involving self-reported MSM were identified as potential MSM (pMSM). Then, a cross-sectional survey was conducted to supplement behavioral information and attitudes toward MSM.ResultsOur sample consisted of 190 pMSM patients. In total, 43.16% of the patients were likely to conceal same-sex behaviors during the first-self-report, and 14.73% of patients might continue to conceal a history of same-sex behaviors even after receiving medical care. The pMSM who concealed their same-sex behaviors were reluctant to accept medical services such as Voluntary Counseling and Testing (VCT) and had a lower likelihood of condom use. In addition, the related factors for non-disclosed behavior were associated with current address, income before diagnosis, and attitudes toward MSM.ConclusionNon-disclosure of same-sex behaviors to HCPs may be a major obstacle for certain medical services for MSM who exhibit risky sexual behaviors. The pMSM from developing areas, with high monthly income, and with neutral or un-supportive attitudes toward MSM may represent non-disclosure of their same-sex behaviors. Thus, policies facilitating MSM to disclose their same-sex behaviors are recommended, such as legislations protecting homosexual rights on employment, education, marriage, and so on.

PENCEGAHAN HIV DAN AIDS MELALUI KURSUS PRA NIKAH DALAM PERSPEKTIF ISLAM DAN SAINS

The HIV epidemic has been present in Indonesia for the past twenty years, despite various prevention efforts. However, the trend is very concerning, so it is critical to innovate in the prevention of HIV-AIDS, particularly through sexual transmission, as the rate of increase is very rapid. One way to avoid it is to raise a sakinah family, which instills a sense of mutual loyalty to a partner. Pre-marital courses can help to start the development of a sakinah family. The purpose of the pre-wedding course is to provide young people of marriageable age and brides-to-be with knowledge, understanding, skills, and awareness-raising about domestic and family life. This pre-wedding course is a three-day, 24-hour briefing (shot course) for teenagers of marriageable age or prospective brides. Teaching and learning facilities for organizing pre-marital courses include syllabus, modules, and other teaching materials required for learning. The syllabus and modules prepared by the Ministry of Religion for pre-marital course organizers can be correlated with material on HIV and the importance of Counseling and Testing on Health Officer Initiation (KTIP) and Voluntary Counseling and Testing (KTS), both of which are critical components in efforts to prevent HIV transmission. Furthermore, it can deepen material that synergizes with the purpose of marriage, namely forming a sakinah family and avoiding HIV, namely option B (Be Faithful), meaning being mutually loyal to one sex partner, and if the test result is positive, you can still get married then use option C (Condom).