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101. HIV testing in Europe: Evaluating the impact, added value, relevance and usability of the European Centre for Disease Prevention and Control (ECDC)'s 2010 HIV testing guidance. (PubMed)

HIV testing in Europe: Evaluating the impact, added value, relevance and usability of the European Centre for Disease Prevention and Control (ECDC)'s 2010 HIV testing guidance. An evaluation of the 2010 ECDC guidance on HIV testing, conducted in October 2015-January 2016, assessed its impact, added value, relevance and usability and the need for updated guidance.Data sources were two surveys: one for the primary target audience (health policymakers and decision makers, national programme (...) respondents indicated the guidance was the most relevant when compared with other international guidance. Primary target audience respondents in 11 of 23 countries reported that they had used the guidance in development, monitoring and/or evaluation of their national HIV testing policy, guidelines, programme and/or strategy, and 29 of 51 of the broader target audience respondents reported having used the guidance in their work. Both the primary and broader target audience considered it important or very

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2017 Euro Surveillance

102. HIV testing week 2015: lowering barriers for HIV testing among high-risk groups in Amsterdam. (PubMed)

HIV testing week 2015: lowering barriers for HIV testing among high-risk groups in Amsterdam. Evaluation of the HIV Testing Week (HTW) 2015 in Amsterdam: the number of (positive) tested persons, characteristics and testing history of the tested population, the differences in attendance per location and the healthcare workers' experiences and opinions concerning the HTW.The HTW took place from 28 November till 4 December 2015. Anonymous HIV rapid testing (INSTI™ HIV1/HIV2 Ab test or Determine™ (...) HIV-1/2 Ag/Ab test) was offered free of charge at four hospitals, 12 general practitioner (GP) clinics, a sexually transmitted infections (STI) clinic, a laboratory, sites of a community-based organisation, and at outreach locations. Home-based testing (OraQuick® In-Home HIV Test) was offered online. The focus was to motivate two groups to test: men who have sex with men (MSM) and non-Western migrants. Questionnaires regarding participant's characteristics and HIV testing history were collected

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2017 BMC Infectious Diseases

103. Examining the effects of HIV self-testing compared to standard HIV testing services: a systematic review and meta-analysis. (PubMed)

Examining the effects of HIV self-testing compared to standard HIV testing services: a systematic review and meta-analysis. HIV self-testing (HIVST) is a discreet and convenient way to reach people with HIV who do not know their status, including many who may not otherwise test. To inform World Health Organization (WHO) guidance, we assessed the effect of HIVST on uptake and frequency of testing, as well as identification of HIV-positive persons, linkage to care, social harm, and risk (...) behaviour.We systematically searched for studies comparing HIVST to standard HIV testing until 1 June 2016. Meta-analyses of studies reporting comparable outcomes were conducted using a random-effects model for relative risks (RR) and 95% confidence intervals. The quality of evidence was evaluated using GRADE.After screening 638 citations, we identified five randomized controlled trials (RCTs) comparing HIVST to standard HIV testing services among 4,145 total participants from four countries. All offered

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2017 Journal of the International AIDS Society

104. Zambian Peer Educators for HIV Self-Testing (ZEST) study: rationale and design of a cluster randomised trial of HIV self-testing among female sex workers in Zambia. (PubMed)

Zambian Peer Educators for HIV Self-Testing (ZEST) study: rationale and design of a cluster randomised trial of HIV self-testing among female sex workers in Zambia. HIV testing and knowledge of status are starting points for HIV treatment and prevention interventions. Among female sex workers (FSWs), HIV testing and status knowledge remain far from universal. HIV self-testing (HIVST) is an alternative to existing testing services for FSWs, but little evidence exists how it can be effectively (...) and safely implemented. Here, we describe the rationale and design of a cluster randomised trial designed to inform implementation and scale-up of HIVST programmes for FSWs in Zambia.The Zambian Peer Educators for HIV Self-Testing (ZEST) study is a 3-arm cluster randomised trial taking place in 3 towns in Zambia. Participants (N=900) are eligible if they are women who have exchanged sex for money or goods in the previous 1 month, are HIV negative or status unknown, have not tested for HIV in the previous

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2017 BMJ open

105. Effect of availability of HIV self-testing on HIV testing frequency in gay and bisexual men at high risk of infection (FORTH): a waiting-list randomised controlled trial. (PubMed)

Effect of availability of HIV self-testing on HIV testing frequency in gay and bisexual men at high risk of infection (FORTH): a waiting-list randomised controlled trial. Frequent testing of individuals at high risk of HIV is central to current prevention strategies. We aimed to determine if HIV self-testing would increase frequency of testing in high-risk gay and bisexual men, with a particular focus on men who delayed testing or had never been tested before.In this randomised trial, HIV (...) -negative high-risk gay and bisexual men who reported condomless anal intercourse or more than five male sexual partners in the past 3 months were recruited at three clinical and two community-based sites in Australia. Enrolled participants were randomly assigned (1:1) to the intervention (free HIV self-testing plus facility-based testing) or standard care (facility-based testing only). Participants completed a brief online questionnaire every 3 months, which collected the number of self-tests used

2017 The lancet. HIV

106. Linkage into care among newly diagnosed HIV-positive individuals tested through outreach and facility-based HIV testing models in Mbeya, Tanzania: a prospective mixed-method cohort study. (PubMed)

Linkage into care among newly diagnosed HIV-positive individuals tested through outreach and facility-based HIV testing models in Mbeya, Tanzania: a prospective mixed-method cohort study. Linkage to care is the bridge between HIV testing and HIV treatment, care and support. In Tanzania, mobile testing aims to address historically low testing rates. Linkage to care was reported at 14% in 2009 and 28% in 2014. The study compares linkage to care of HIV-positive individuals tested at mobile (...) /outreach versus public health facility-based services within the first 6 months of HIV diagnosis.Rural communities in four districts of Mbeya Region, Tanzania.A total of 1012 newly diagnosed HIV-positive adults from 16 testing facilities were enrolled into a two-armed cohort and followed for 6 months between August 2014 and July 2015. 840 (83%) participants completed the study.We compared the ratios and time variance in linkage to care using the Kaplan-Meier estimator and Log rank tests. Cox

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2017 BMJ open

107. What drives ‘first-time testers’ to test for HIV at community-based HIV testing services? (PubMed)

What drives ‘first-time testers’ to test for HIV at community-based HIV testing services? Drivers of and barriers to testing are not well understood for those who have never been tested previously and now self-initiate at a community-based human immuno-deficiency virus (HIV) testing service (CB-HTS). This descriptive study enrolled 229 first-time testers. Participants completed an electronic questionnaire. The majority reported fear and (non) accessibility of HTS as barriers to testing (40 (...) % and 24%, respectively). Wanting 'to know my status' and the immediate opportunity to test were reported as drivers of testing (41% and 35%, respectively). Addressing fear of testing and providing an easily accessible opportunity to test may go some way to encouraging those previously untested individuals to test.

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2017 Public health action

108. Secondary Distribution of HIV Self-tests: an Innovative Strategy for Promoting Partner Testing and Reducing HIV Risk

Secondary Distribution of HIV Self-tests: an Innovative Strategy for Promoting Partner Testing and Reducing HIV Risk Secondary Distribution of HIV Self-tests: an Innovative Strategy for Promoting Partner Testing and Reducing HIV Risk - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number (...) of saved studies (100). Please remove one or more studies before adding more. Secondary Distribution of HIV Self-tests: an Innovative Strategy for Promoting Partner Testing and Reducing HIV Risk The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT03135067 Recruitment Status : Active, not recruiting First

2017 Clinical Trials

109. Reactions to Testing HIV Negative: Measurement and Associations with Sexual Risk Behavior among Young MSM Who Recently Tested HIV Negative (PubMed)

Reactions to Testing HIV Negative: Measurement and Associations with Sexual Risk Behavior among Young MSM Who Recently Tested HIV Negative Receiving an HIV-positive test result is associated with reduced condomless anal sex (CAS), but little is known about negative test results. The recent development of the Inventory of Reactions to Testing HIV Negative confirmed that there are diverse reactions to receiving a negative test result, which have implications for risk behaviour. The goals (...) of the current study were to validate the measure in a sample of young men who have sex with men who recently tested HIV-negative (N = 1113) and to examine its associations with CAS. Factor analysis identified four factors, three of which were the same as the original factors (Reinforced Safety, Luck, and Invulnerability) and one that was novel (Reinforced Risk). Construct validity was demonstrated with associations between subscales and constructs from the IMB model of HIV prevention. Lower Reinforced

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2017 AIDS and behavior

110. HIV testing experiences and their implications for patient engagement with HIV care and treatment on the eve of ‘test and treat’: findings from a multicountry qualitative study (PubMed)

HIV testing experiences and their implications for patient engagement with HIV care and treatment on the eve of ‘test and treat’: findings from a multicountry qualitative study In view of expanding 'test and treat' initiatives, we sought to elicit how the experience of HIV testing influenced subsequent engagement in HIV care among people diagnosed with HIV.As part of a multisite qualitative study, we conducted in-depth interviews in Uganda, South Africa, Tanzania, Kenya, Malawi and Zimbabwe (...) with 5-10 health workers and 28-59 people living with HIV, per country. Topic guides covered patient and provider experiences of HIV testing and treatment services. Themes were derived through deductive and inductive coding.Various practices and techniques were employed by health workers to increase HIV testing uptake in line with national policies, some of which affected patients' subsequent engagement with HIV services. Provider-initiated testing was generally appreciated, but rarely considered

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2017 Sexually transmitted infections

111. What prevents Central Asian migrant workers from accessing HIV testing? Implications for increasing HIV testing uptake in Kazakhstan (PubMed)

What prevents Central Asian migrant workers from accessing HIV testing? Implications for increasing HIV testing uptake in Kazakhstan Several barriers prevent key populations, such as migrant workers, from accessing HIV testing. Using data from a cross-sectional study among Central Asian migrant workers (n = 623) in Kazakhstan, we examined factors associated with HIV testing. Overall, 48% of participants had ever received an HIV test. Having temporary registration (AOR 1.69; (95% CI [1.12-2.56 (...) ]), having an employment contract (AOR 2.59; (95% CI [1.58-4.23]), being able to afford health care services (AOR 3.61; (95% CI [1.86-7.03]) having a medical check-up in the past 12 months (AOR 1.85; 95% CI [1.18-2.89]), and having a regular doctor (AOR 2.37; 95% CI [1.20-4.70]) were associated with having an HIV test. HIV testing uptake among migrants in Kazakhstan falls far short of UNAIDS 90-90-90 goals. Intervention strategies to increase HIV testing among this population may include initiatives

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2017 AIDS and behavior

112. Factors Associated with Patients Who Prefer HIV Self-Testing over Health Professional Testing in an Emergency Department-Based Rapid HIV Screening Program (PubMed)

Factors Associated with Patients Who Prefer HIV Self-Testing over Health Professional Testing in an Emergency Department-Based Rapid HIV Screening Program Kiosk-facilitated HIV self-testing has been shown to be accurate and well accepted by emergency department (ED) patients. We investigated factors associated with patients who preferred self-testing over testing performed by health professionals in an ED-based HIV screening program. This opt-in program evaluation studied 332 patients (...) in an inner-city academic ED from February 2012 to April 2012, when a kiosk-based HIV self-testing program was standard of care. The first kiosk in the 2-stage system registered patients and assessed their interest in screening, while the second kiosk gathered demographic and risk factor information and also provided self-testing instructions. Patients who declined to self-test were offered testing by staff. Broad eligibility included patients aged 18-64 years who were not critically ill, English-speaking

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2017 International journal of STD & AIDS

113. Can trained lay providers perform HIV testing services? A review of national HIV testing policies (PubMed)

Can trained lay providers perform HIV testing services? A review of national HIV testing policies Only an estimated 54% of people living with HIV are aware of their status. Despite progress scaling up HIV testing services (HTS), a testing gap remains. Delivery of HTS by lay providers may help close this testing gap, while also increasing uptake and acceptability of HIV testing among key populations and other priority groups.50 National HIV testing policies were collated from WHO country (...) intelligence databases, contacts and testing program websites. Data regarding lay provider use for HTS was extracted and collated. Our search had no geographical or language restrictions. This data was then compared with reported data from the Global AIDS Response Progress Reporting (GARPR) from July 2015.Forty-two percent of countries permit lay providers to perform HIV testing and 56% permit lay providers to administer pre-and post-test counseling. Comparative analysis with GARPR found that less than

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2017 BMC research notes

114. Gender, HIV testing and stigma: The association of HIV testing behaviors and community-level and individual-level stigma in rural South Africa differ for men and women (PubMed)

Gender, HIV testing and stigma: The association of HIV testing behaviors and community-level and individual-level stigma in rural South Africa differ for men and women Stigma remains a significant barrier to HIV testing in South Africa. Despite being a social construct, most HIV-stigma research focuses on individuals; further the intersection of gender, testing and stigma is yet to be fully explored. We examined the relationship between anticipated stigma at individual and community levels (...) and recent testing using a population-based sample (n = 1126) in Mpumalanga, South Africa. We used multi-level regression to estimate the potential effect of reducing community-level stigma on testing uptake using the g-computation algorithm. Men tested less frequently (OR 0.22, 95% CI 0.14-0.33) and reported more anticipated stigma (OR 5.1, 95% CI 2.6-10.1) than women. For men only, testing was higher among those reporting no stigma versus some (OR 1.40, 95% CI 0.97-2.03; p = 0.07). For women only, each

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2017 AIDS and behavior

115. Xpert® HIV-1 Point of Care Test for neonatal diagnosis of HIV in the birth testing programme of a maternity hospital – a field evaluation study (PubMed)

Xpert® HIV-1 Point of Care Test for neonatal diagnosis of HIV in the birth testing programme of a maternity hospital – a field evaluation study Point-of-care testing (POCT) among HIV-exposed infants might improve linkage to care relative to laboratory-based testing (LABT). We evaluated HIV-1 POCT at birth in the context of universal LABT in a maternity hospital and describe our implementation experience.We did a field evaluation study between Oct 1, 2014, and April 30, 2016, at the urban (...) Rahima Moosa Mother and Child Hospital (RMMCH), Johannesburg, South Africa. We aimed to sample consecutive neonates at birth with POCT (Cepheid Xpert HIV-1 Qualitative test) and compared results with those of LABT (Roche COBAS TaqMan HIV-1 Qualitative test) with respect to performance in terms of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and Cohen's κ coefficient, result return, antiretroviral treatment (ART) initiation, and coverage.18 268 women

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2017 The lancet. HIV

116. Reliability of HIV rapid diagnostic tests for self-testing compared with testing by health-care workers: a systematic review and meta-analysis (PubMed)

Reliability of HIV rapid diagnostic tests for self-testing compared with testing by health-care workers: a systematic review and meta-analysis The ability of individuals to use HIV self-tests correctly is debated. To inform the 2016 WHO recommendation on HIV self-testing, we assessed the reliability and performance of HIV rapid diagnostic tests when used by self-testers.In this systematic review and meta-analysis, we searched PubMed, PopLine, and Embase, conference abstracts, and additional (...) grey literature between Jan 1, 1995, and April 30, 2016, for observational and experimental studies reporting on HIV self-testing performance. We excluded studies evaluating home specimen collection because patients did not interpret their own test results. We extracted data independently, using standardised extraction forms. Outcomes of interest were agreement between self-testers and health-care workers, sensitivity, and specificity. We calculated κ to establish the level of agreement and pooled

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2018 The lancet. HIV

117. ‘If I had not taken it [HIVST kit] home, my husband would not have come to the facility to test for HIV’: HIV self-testing perceptions, delivery strategies, and post-test experiences among pregnant women and their male partners in Central Uganda (PubMed)

‘If I had not taken it [HIVST kit] home, my husband would not have come to the facility to test for HIV’: HIV self-testing perceptions, delivery strategies, and post-test experiences among pregnant women and their male partners in Central Uganda HIV self-testing (HIVST) can improve HIV-testing rates in 'hard-to-reach' populations, including men. We explored HIVST perceptions, delivery strategies, and post-test experiences among pregnant women and their male partners in Central Uganda.This (...) that would arouse male partners' inquisitiveness or waited for 'opportune' moments when their husbands were likely to be more receptive. A few (three) women lied about the purpose of the test kit (testing for syphilis and other illnesses) while one woman stealthily took a mucosal swab from the husband. Most men initially doubted the ability of oral HIVST kits to test for HIV, but this did not stop them from using them. Both men and women perceived HIVST as an opportunity to learn about each other's HIV

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2018 Global health action

118. HIV Testing After a First Positive Rapid Diagnostic Test: A Role for Nucleic Acid Testing? (PubMed)

HIV Testing After a First Positive Rapid Diagnostic Test: A Role for Nucleic Acid Testing? We developed an open-access, Excel-based model simulating currently recommended and alternative algorithms for adult HIV testing as a preliminary investigation of trade-offs between accuracy and costs. Despite higher costs, simpler HIV testing algorithms incorporating point of care nucleic acid testing may improve outcomes and thus merit additional research and field testing.

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2018 Open forum infectious diseases

119. HIV Self-Testing in Lusaka Province, Zambia: Acceptability, Comprehension of Testing Instructions, and Individual Preferences for Self-Test Kit Distribution in a Population-Based Sample of Adolescents and Adults (PubMed)

HIV Self-Testing in Lusaka Province, Zambia: Acceptability, Comprehension of Testing Instructions, and Individual Preferences for Self-Test Kit Distribution in a Population-Based Sample of Adolescents and Adults We assessed attitudes and preferences toward HIV self-testing (HIVST) among Zambian adolescents and adults. We conducted a population-based survey of individuals aged 16-49 years old in Lusaka Province, Zambia. HIVST was shown to participants through a short video on oral fluid-based (...) self-testing. In addition to demographics, HIV risk perceptions, and HIV testing history, we assessed participants' acceptability and concerns regarding HIVST. Using a discrete choice experiment, we investigated preferences for the location of self-test pickup, availability of counseling, and cost. After reviewing an instructional sheet or an additional video, we assessed participants' understanding of self-test performance. Among 1617 participants, 647 (40.0%) were male, 269 (16.6%) were

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2018 AIDS research and human retroviruses

120. Guidelines on HIV self-testing and partner notification

Guidelines on HIV self-testing and partner notification SUPPLEMENT GUIDELINES ON HIV TESTING SERVICES DECEMBER 2016 HIV SELF-TESTING AND PARTNER NOTIFICATION SUPPLEMENT TO CONSOLIDATED GUIDELINES ON HIV TESTING SERVICES#Test4HIV SUPPLEMENT GUIDELINES ON DECEMBER 2016 HIV SELF-TESTING AND PARTNER NOTIFICATION SUPPLEMENT TO CONSOLIDATED GUIDELINES ON HIV TESTING SERVICESWHO Library Cataloguing-in-Publication Data Guidelines on HIV self-testing and partner notification: supplement to consolidated (...) guidelines on HIV testing services I.World Health Organization. ISBN 978 92 4 154986 8 Subject headings are available from WHO institutional repository © World Health Organization 2016 All rights reserved. Publications of the World Health Organization are available on the WHO website (www.who.int) or can be purchased from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: bookorders@who.int). Requests for permission

2016 World Health Organisation HIV Guidelines

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