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. Humanimmunodeficiencyvirustesting practices and interest in self-testing options among young, Black men who have sex with men in North Carolina. Sexually Transmitted Diseases. 2016;43(9):587–93. Rosales-Statkus ME, de la Fuente L, Fernandez-Balbuena S, Figueroa C, Fernandez-Lopez L, Hoyos J, et al. Approval and potential use of over-the-counter HIV self-tests: The opinion of participants in a street based HIV rapid testing program in Spain. AIDS & Behavior. 2015;19(3):472–84. Sharma A, Sullivan (...) and bisexual men. AIDS & Behavior. 2014;18(12):2485–95. Udeagu CN, Shah S, Molochevski M. Men who have sex with men seek timely humanimmunodeficiencyvirus confirmation and care after rapid humanimmunodeficiencyvirus self-test: Data from partner services program, New York City. Sexually Transmitted Diseases. 2017;44(10):608–12. Ricca AV, Hall EW, Khosropour CM, Sullivan PS. Factors associated with returning at-home specimen collection kits for HIVtesting among internet-using men who have sex with men
care, and protection from abuse (2–4). More research is needed on unintended consequences of self-testing in situations where testing is coercive and puts individuals at risk for violence if they refuse (5). The issue and why it’s important There are ethical and human rights concerns with respect to whether HIV self-testing (also known as home-testing or home-based HIVtesting) could be used in coercive ways that are harmful to vulnerable people (6). Two areas of particular concern are abusive (...) the test (e.g., losing their job, breaking up a relationship, and not having sex) (7). Alais and Venter (2014) provide their views on ethical, legal and human rights concerns raised by licensing HIV self-testing for private use and argue that HIV self-home tests are not likely to be harmful in a way that justifies restricting people’s access to them, and have plausible benefits (6). At the same time, it is important that reasonably robust protections are in place to protect against coerced testing
Effect of Universal Testing and Treatment on HIV Incidence - HPTN 071 (PopART). A universal testing and treatment strategy is a potential approach to reduce the incidence of humanimmunodeficiencyvirus (HIV) infection, yet previous trial results are inconsistent.In the HPTN 071 (PopART) community-randomized trial conducted from 2013 through 2018, we randomly assigned 21 communities in Zambia and South Africa (total population, approximately 1 million) to group A (combination prevention (...) intervention with universal antiretroviral therapy [ART]), group B (the prevention intervention with ART provided according to local guidelines [universal since 2016]), or group C (standard care). The prevention intervention included home-based HIVtesting delivered by community workers, who also supported linkage to HIV care and ART adherence. The primary outcome, HIV incidence between months 12 and 36, was measured in a population cohort of approximately 2000 randomly sampled adults (18 to 44 years
HIVTesting and Treatment with the Use of a Community Health Approach in Rural Africa. Universal antiretroviral therapy (ART) with annual population testing and a multidisease, patient-centered strategy could reduce new humanimmunodeficiencyvirus (HIV) infections and improve community health.We randomly assigned 32 rural communities in Uganda and Kenya to baseline HIV and multidisease testing and national guideline-restricted ART (control group) or to baseline testing plus annual testing (...) ). At 3 years, 47% of adults with hypertension in the intervention group and 37% in the control group had hypertension control (relative prevalence, 1.26; 95% CI, 1.15 to 1.39).Universal HIV treatment did not result in a significantly lower incidence of HIV infection than standard care, probably owing to the availability of comprehensive baseline HIVtesting and the rapid expansion of ART eligibility in the control group. (Funded by the National Institutes of Health and others; SEARCH
Universal Testing, Expanded Treatment, and Incidence of HIV Infection in Botswana. The feasibility of reducing the population-level incidence of humanimmunodeficiencyvirus (HIV) infection by increasing community coverage of antiretroviral therapy (ART) and male circumcision is unknown.We conducted a pair-matched, community-randomized trial in 30 rural or periurban communities in Botswana from 2013 to 2018. Participants in 15 villages in the intervention group received HIVtesting (...) and counseling, linkage to care, ART (started at a higher CD4 count than in standard care), and increased access to male circumcision services. The standard-care group also consisted of 15 villages. Universal ART became available in both groups in mid-2016. We enrolled a random sample of participants from approximately 20% of households in each community and measured the incidence of HIV infection through testing performed approximately once per year. The prespecified primary analysis was a permutation test
Strategies to link people with undiagnosed HIV infection to HIVtesting, care, and prevention services Strategies to link people with undiagnosed HIV infection to HIVtesting, care, and prevention services | The Ontario HIV Treatment Network The Ontario HIV Treatment Network Strategies to link people with undiagnosed HIV infection to HIVtesting, care, and prevention services Strategies to link people with undiagnosed HIV infection to HIVtesting, care, and prevention services , , , , Questions (...) What strategies have been successful at linking people with undiagnosed HIV infection to HIVtesting, care, and prevention services? Key take-home messages A variety of strategies have shown promise for identifying individuals with undiagnosed HIV and engaging them with HIVtesting using clinical, community-based, network-based, and self-directed approaches. Various service delivery models for implementing rapid initiation of antiretroviral treatment have demonstrated benefits for linking the newly
for HIVtesting of adults, adolescents, and pregnant women in health-care settings. Available from: . Morbidity and Mortality Weekly Report: Recommendations and Reports. 2006;55(14):1–17. Accessed April 24, 2019. Austin T, Traversy GP, Ha S, Timmerman K. Canadian and international recommendations on the frequency of HIV screening and testing: A systematic review. Canada Communicable Disease Report. 2016;42(8):161–8. Public Health Agency of Canada (PHAC). Humanimmunodeficiencyvirus – HIV screening (...) and testing guide. 2014. Available from: . Accessed April 24, 2019. Institut national de santé publique du Québec, Sous-comité Optimiser le dépistage du VIH, Comité sur les infections transmissibles sexuellement et par le sang (ITSS). Optimiser le dépistage et le diagnostic de l’infection par le virus de l’immunodéficience humaine. 2011. Available from: . Accessed April 24, 2019. Gustafson R, Ogilvie G, Moore D, Kendall P. New HIVtesting guidelines in BC. Available from: . BC Medical Journal. 2014;56(4
HIV self-testing alone or with additional interventions, including financial incentives, and linkage to care or prevention among male partners of antenatal care clinic attendees in Malawi: An adaptive multi-arm, multi-stage cluster randomised trial Conventional HIVtesting services have been less comprehensive in reaching men than in reaching women globally, but HIV self-testing (HIVST) appears to be an acceptable alternative. Measurement of linkage to post-test services following HIVST remains (...) HIVST kits for their partners; the second and third arms provided 2 HIVST kits along with a conditional fixed financial incentive of $3 or $10; the fourth arm provided 2 HIVST kits and a 10% chance of receiving $30 in a lottery; and the fifth arm provided 2 HIVST kits and a phone call reminder for the women's partners. The primary outcome was the proportion of male partners who were reported to have tested for HIV and linked into care or prevention within 28 days, with referral for antiretroviral
Self-testing kits increase overall HIVtesting uptake in men who have sex with men Self-testing kits increase overall HIVtesting uptake in men who have sex with men Discover Portal Discover Portal Self-testing kits increase overall HIVtesting uptake in men who have sex with men Published on 6 February 2018 doi: Frequency of HIVtesting in men who have sex with men may be increased by one additional test in a six month period when self-testing kits are used. Self-testing kits allow people (...) and support following an HIV diagnosis are of great importance and should include partner notification. Self-testing kits are available in the UK online from and are recommended by Public Health England. Share your views on the research. Why was this study needed? An estimated 89,400 people in the UK are living with HIV according to 2016 figures. The annual rate of new diagnoses is starting to decline, falling from 6,286 in 2015 to 5,164 in 2016. Over half of cases are in men who have sex with men (MSM
Methods, system errors, and demographic differences in participant errors using daily text message-based short message service computer-assisted self-interview (SMS-CASI) to measure sexual risk behavior in a RCT of HIV self-test use. Assessment of sexual risk behavior is crucial to HIV prevention trials. Currently, there are no biomarkers or objective measures to detect and characterize sexual risk behavior; therefore, we must rely on self-reports. Self-report accuracy may be improved (...) by collecting data in real-time. Our objective was to demonstrate how a text message-based short message service computer-assisted self-interview (SMS-CASI) system can collect daily sexual risk behavior data.During the course of a 2-arm randomized controlled trial, confidential daily SMS-CASI was used to assess sexual risk behavior over three months for participants using only condoms in the control condition and using condoms and HIV self-tests to test themselves and their non-monogamous sexual partner
Variations in Testing for HIV and Other Sexually Transmitted Infections Across Gender Identity Among Transgender Youth. Purpose: Transgender youth are at high risk for humanimmunodeficiencyvirus (HIV) and other sexually transmitted infections (STIs), but their rates of screening are unknown. This study sought to quantify HIV and other STI testing levels and to examine variations in testing levels across three categories of gender identity: transgender men, transgender women, and nonbinary (...) individuals. Methods: Between June 2017 and June 2018, 186 transgender youth aged 15-24 years were recruited into a randomized trial of home HIVtesting supplemented with telehealth-based counseling. Information on sociodemographics, health care utilization, sexual activity, stress and resilience, and history of HIV and other STI testing was obtained. Multivariable logistic regression models were formulated to identify variations in testing for HIV and other STIs across gender identities. Results: Twenty
/EEA European Union/European Economic Area GP General practitioner HA-REACT Joint Action on HIV and Co-Infection Prevention and Harm Reduction HBV Hepatitis B virus HBsAg Hepatitis B surface antigen HCV Hepatitis C virusHIVHumanimmunodeficiencyvirus IC Indicator condition IFN Interferon INTEGRATE Joint Action on Integrating Prevention, Testing and Linkage to Care Strategies Across HIV, Viral Hepatitis, TB and STIs in Europe IUSTI International Union Against Sexually Transmitted Infections MSM (...) health guidance on HIV, hepatitis B and C testing in the EU/EEA – An integrated approach 1 Executive summary Reaching and testing those at risk of infection with humanimmunodeficiencyvirus (HIV), hepatitis B virus (HBV) or hepatitis C virus (HCV) is still a public health challenge across Europe. One in two people currently living with HIV is diagnosed late in the course of their infection and an even larger proportion of the estimated 9 million Europeans living with chronic hepatitis B or C
to include HIVST. Workplaces must implement HIVST within the context of human rights principles as set forth in the ILO Recommendation concerning HIV and AIDS and the world of work, 2010 (Recommendation 200) 7 – which apply to any HIVtesting. They include: Consent: HIVtesting must be genuinely voluntary and free of any coercion. It is the workers’ choice to accept a test kit or not, after receiving information or offer of the test. Also, workers should be free to choose the place and time to test (...) a better price with the manufacturer due to larger procurement volumes. Resource considerations Adequate human and financial resources are essential to operationalize HIVST at the workplace. Resource needs will depend on the scale and nature of the programme and the models adopted for delivering HIVST. Human resource and infrastructure: Staffing needs should be considered: Will enough staff be available to cope with the likely increase in demand for HIVtesting? In workplaces with on-site health-care
External quality assessment for HIV rapid tests: challenges and opportunities in Haiti HIV rapid diagnostic tests (RDTs) are instrumental in scaling-up HIVtesting services (HTS) in low-income and middle-income countries (LMICs). HIV misdiagnosis is a growing concern in the era of expanded and decentralised access to HTS. External quality assurance (EQA) programme including proficiency testing (PT) for HIV RDTs is a priority to guarantee the accuracy and reliability of the patients' result (...) in PT programs. In more than half of the lab enrolled in the PT programme in Haiti, the panels are always tested by the most experienced technician, defying the purpose of the program which is to evaluate the performance of the technician performing the test daily. EQA programme in Haiti and other LMICs are usually not tailored to address community HIVtesting challenges. With decreased funding and absence of government financial commitment to HIV RDTs EQA programmes, more innovative and cost
Antiretroviral resistance testing in HIV-positive people. Resistance to antiretroviral therapy (ART) among people living with humanimmunodeficiencyvirus (HIV) compromises treatment effectiveness, often leading to virological failure and mortality. Antiretroviral drug resistance tests may be used at the time of initiation of therapy, or when treatment failure occurs, to inform the choice of ART regimen. Resistance tests (genotypic or phenotypic) are widely used in high-income countries (...) , but not in resource-limited settings. This systematic review summarizes the relative merits of resistance testing in treatment-naive and treatment-exposed people living with HIV.To evaluate the effectiveness of antiretroviral resistance testing (genotypic or phenotypic) in reducing mortality and morbidity in HIV-positive people.We attempted to identify all relevant studies, regardless of language or publication status, through searches of electronic databases and conference proceedings up to 26 January 2018. We
Prenatal and Perinatal HumanImmunodeficiencyVirusTesting - Expanded Recommendations Prenatal and Perinatal HumanImmunodeficiencyVirusTesting - Expanded Recommendations - ACOG Menu ▼ Prenatal and Perinatal HumanImmunodeficiencyVirusTesting - Expanded Recommendations Page Navigation ▼ INTERIM UPDATE Number 752 (Replaces Committee Opinion No. 635, June 2015) Committee on Obstetric Practice HIV Expert Work Group This Committee Opinion was developed by the American College of Obstetricians (...) be performed after women have been notified that HIV screening is recommended for all pregnant patients and that they will receive an HIVtest as part of the routine panel of prenatal tests unless they decline (opt-out screening). Humanimmunodeficiencyvirustesting using the opt-out approach, which is currently permitted in every jurisdiction in the United States, should be a routine component of care for women during prepregnancy and as early in pregnancy as possible. Repeat HIVtesting in the third
Health care usersâ€™ knowledge, attitudes and perceptions of HIV self-testing at selected gateway clinics at eThekwini district, KwaZulu-Natal province, South Africa Progress in promoting knowledge of HIV status has been made globally, but half of all people living with HIV are still unaware of their HIV status. It is argued the new innovative HIV self-testing strategy could increase the uptake of HIVtesting among the people. The aim of the study was to assess outpatients' health care user's (...) knowledge, attitudes and perceptions towards HIV self-testing (HIVST) at selected Gateway clinics at eThekwini District, KwaZulu-Natal Province, South Africa. The objectives of the study were to determine health care users' knowledge of HIVST, assess health care users' attitudes and perceptions towards HIVST and establish if there is any relationship between knowledge, attitudes and perceptions of health care users towards HIVST. A quantitative, non-experimental descriptive design was used to determine
Effect of Offering Same-Day ART vs Usual Health Facility Referral During Home-Based HIVTesting on Linkage to Care and Viral Suppression Among Adults With HIV in Lesotho: The CASCADE Randomized Clinical Trial. Home-based HIVtesting is a frequently used strategy to increase awareness of HIV status in sub-Saharan Africa. However, with referral to health facilities, less than half of those who testHIV positive link to care and initiate antiretroviral therapy (ART).To determine whether offering (...) same-day home-based ART to patients with HIV improves linkage to care and viral suppression in a rural, high-prevalence setting in sub-Saharan Africa.Open-label, 2-group, randomized clinical trial (February 22, 2016-September 17, 2017), involving 6 health care facilities in northern Lesotho. During home-based HIVtesting in 6655 households from 60 rural villages and 17 urban areas, 278 individuals aged 18 years or older who testedHIV positive and were ART naive from 268 households consented
Occupational exposure, attitude to HIV-positive patients and uptake of HIV counselling and testing among health care workers in a tertiary hospital in Nigeria Health care workers (HCWs) are at risk of occupational exposure to HIV. Their attitude to HIV-positive patients influences patients' willingness and ability to access quality care. HIV counselling and testing (HCT) services are available to inform HCWs and patients about their status. There is little information about HCT uptake (...) age <40 years OR = 1.6, 95% CI (1.1-2.4), having worked for >5 years OR = 1.5, 95% CI (1.03-2.2) and working in medical department OR = 1.7, 95% CI (1.1-2.8). Respondents in nursing departments were more likely to require routine HIVtest for all patients, OR = 3.9, 95% CI (2.4-6.2). HCWs in the laboratory departments were more likely to believe that HIV patients should be on separate wards, OR = 3.6, 95% CI (1.9-7.0). HCWs should be protected and encouraged to access HCT services in order