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Latest & greatest articles for HIV Test
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Impact and Cost-Effectiveness of Point-Of-Care CD4 Testing on the HIV Epidemic in South Africa. Rapid diagnostic tools have been shown to improve linkage of patients to care. In the context of infectious diseases, assessing the impact and cost-effectiveness of such tools at the population level, accounting for both direct and indirect effects, is key to informing adoption of these tools. Point-of-care (POC) CD4 testing has been shown to be highly effective in increasing the proportion of HIV (...) positive patients who initiate ART. We assess the impact and cost-effectiveness of introducing POC CD4 testing at the population level in South Africa in a range of care contexts, using a dynamic compartmental model of HIV transmission, calibrated to the South African HIV epidemic. We performed a meta-analysis to quantify the differences between POC and laboratory CD4 testing on the proportion linking to care following CD4 testing. Cumulative infections averted and incremental cost-effectiveness ratios
To err is human, to correct is public health: a systematic review examining poor quality testing and misdiagnosis of HIV status. In accordance with global testing and treatment targets, many countries are seeking ways to reach the "90-90-90" goals, starting with diagnosing 90% of all people with HIV. Quality HIVtesting services are needed to enable people with HIV to be diagnosed and linked to treatment as early as possible. It is essential that opportunities to reach people with undiagnosed (...) HIV are not missed, diagnoses are correct and HIV-negative individuals are not inadvertently initiated on life-long treatment. We conducted this systematic review to assess the magnitude of misdiagnosis and to describe poor HIVtesting practices using rapid diagnostic tests.We systematically searched peer-reviewed articles, abstracts and grey literature published from 1 January 1990 to 19 April 2017. Studies were included if they used at least two rapid diagnostic tests and reported on HIV
A systematic review and meta-analysis of studies evaluating the performance and operational characteristics of dual point-of-care tests for HIV and syphilis. Mother-to-child transmission (MTCT) of syphilis and HIV continue to be important yet preventable causes of perinatal and infant morbidity and mortality.To systematically review, critically appraise and perform a meta-analysis to evaluate the operational characteristics of dual rapid diagnostic tests (RDTs) for HIV/syphilis and evaluate (...) whether they are cost effective, acceptable and easy to use.Systematic review and meta-analysis.We searched seven electronic bibliographic databases from 2012 to December 2016 with no language restrictions. Search keywords included HIV, syphilis and diagnosis.We included studies that evaluated the operational characteristics of dual HIV/syphilis RDTs. Outcomes included diagnostic test accuracy, cost effectiveness, ease of use and interpretation and acceptability. All studies were assessed against
Interventions for Increasing HIVTesting Uptake in Migrants: A Systematic Review of Evidence. Migrants have been identified as being at greater risk for late HIVtesting and diagnosis. Late diagnosis is of concern because timely diagnosis and initiation of treatment can both optimise health outcomes and reduce transmission. We reviewed and evaluated interventions that aimed to increase HIVtesting uptake in migrant populations. Of 6511 papers retrieved, 10 met the inclusion criteria and were (...) included in the review. Three types of interventions were identified (exposure to HIV prevention messages, HIV education programs, and direct offer of testing). All interventions were based on individual models of behaviour change targeting migrants or GPs. While important, interventions that also address broader health system and structural factors that contribute to late HIV-diagnosis in at-risk members of migrant populations are needed. Integrating PITC into existing primary healthcare settings
A systematic review of psychological correlates of HIVtesting intention. Undiagnosed HIV infection is associated with onward HIV transmission and delays in accessing HIV care and treatment. As a significant proportion of HIVtests are self-initiated, it is important to assess correlates of the intention to test for HIV. Psychological correlates of HIVtesting intention are more likely to be the feasible target of interventions than structural determinants. A systematic review of psychological (...) correlates of HIVtesting intention was conducted. Twenty studies were included in the review, covering a range of populations and geographical regions. The most commonly assessed variables were HIV risk perception and HIV knowledge rather than HIVtest-specific psychological factors. There was evidence that HIV risk perception and pro-testing attitudes were consistently associated with HIVtesting intention across a number of studies. There is a need for longitudinal designs, including experimental
Association of Implementation of a Universal Testing and Treatment Intervention With HIV Diagnosis, Receipt of Antiretroviral Therapy, and Viral Suppression in East Africa. Antiretroviral treatment (ART) is now recommended for all HIV-positive persons. UNAIDS has set global targets to diagnose 90% of HIV-positive individuals, treat 90% of diagnosed individuals with ART, and suppress viral replication among 90% of treated individuals, for a population-level target of 73% of all HIV-positive (...) persons with HIV viral suppression.To describe changes in the proportions of HIV-positive individuals with HIV viral suppression, HIV-positive individuals who had received a diagnosis, diagnosed individuals treated with ART, and treated individuals with HIV viral suppression, following implementation of a community-based testing and treatment program in rural East Africa.Observational analysis based on interim data from 16 rural Kenyan (n = 6) and Ugandan (n = 10) intervention communities
Examining the effects of HIV self-testing compared to standard HIVtesting 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 HIVtesting 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 HIVtesting services among 4,145 total participants from four countries. All offered
Linkage to HIV care after home-based HIV counselling and testing in sub-Saharan Africa: A systematic review. Home-based HIV counselling and testing (HBHCT) has the potential to increase HIVtesting uptake in sub-Saharan Africa (SSA), but data on linkage to HIV care after HBHCT are scarce. We conducted a systematic review of linkage to care after HBHCT in SSA.Five databases were searched for studies published between 1st January 2000 and 19th August 2016 that reported on linkage to care among (...) adults newly identified with HIV infection through HBHCT. Eligible studies were reviewed, assessed for risk of bias and findings summarised using the PRISMA guidelines.A total of 14 studies from six countries met the eligibility criteria; nine used specific strategies (point-of-care CD4 count testing, follow-up counselling, provision of transport funds to clinic and counsellor facilitation of HIV clinic visit) in addition to routine referral to facilitate linkage to care. Time intervals
Should trained lay providers perform HIVtesting? A systematic review to inform World Health Organization guidelines. New strategies for HIVtesting services (HTS) are needed to achieve UN 90-90-90 targets, including diagnosis of 90% of people living with HIV. Task-sharing HTS to trained lay providers may alleviate health worker shortages and better reach target groups. We conducted a systematic review of studies evaluating HTS by lay providers using rapid diagnostic tests (RDTs). Peer-reviewed (...) and specificity (≥98%). Values and preferences studies generally found support for lay providers conducting HTS, particularly in non-hypothetical scenarios. Based on evidence supporting using trained lay providers, a WHO expert panel recommended lay providers be allowed to conduct HTS using HIV RDTs. Uptake of this recommendation could expand HIVtesting to more people globally.
Factors associated with HIVtesting and HIV treatment adherence: a systematic review. The impact of the global economic crisis on HIV-related access and care remains unclear. The objective of this systematic review of the literature was to evaluate the association between socioeconomic factors and HIV diagnosis, and adherence to treatment, following the 2008 global economic crisis.A systematic search of PubMed and Scopus for studies published between January 2008 and October 2016 was conducted (...) . Studies providing data on social, demographic, economic and cultural barriers associated with HIV diagnosis and treatment were included.Of 33 studies included, 22 evaluated HIVtesting and 11 evaluated treatment adherence. Medical history of a sexually transmitted disease, knowledge of HIV-related risks, and age, were significantly associated with HIVtesting in most of the included studies. Absence of social support, and alcohol or substance use, were the most common factors associated with adherence
of acquiring a humanimmunodeficiencyvirus (HIV) infection. Guidance relating to both HIV infection prevention, in general, and individual-level behaviour change interventions, in particular, is very limited. The objective of this review was to conduct an evidence synthesis of the clinical effectiveness of behaviour change interventions to reduce risky sexual behaviour among MSM after a negative HIV infection test. To identify effective components within interventions in reducing HIV risk-related (...) The clinical effectiveness of individual behaviour change interventions to reduce risky sexual behaviour after a negative humanimmunodeficiencyvirustest in men who have sex with men: systematic and realist reviews and intervention development The clinical effectiveness of individual behaviour change interventions to reduce risky sexual behaviour after a negative humanimmunodeficiencyvirustest in men who have sex with men: systematic and realist reviews and intervention development
. 2015;29(11):617-24. Hurt CB, Soni K, Miller WC, Hightow-Weidman LB. 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. Witzel TC, Rodger AJ, Burns FM, Rhodes T, Weatherburn P. HIV self-testing among men who have sex with men (MSM) in the UK: A qualitative study of barriers and facilitators, intervention preferences and perceived impacts. PLoS ONE. 2016;11(9 (...) with early antiretroviral therapy. New England Journal of Medicine,. 2011;365(6):493-505. Public Health Agency of Canada. Humanimmunodeficiencyvirus: HIV screening and testing guide. (accessed December 1, 2016). 2012. Traversy GP, Austin T, Ha S, Timmerman K, Gale-Row M. An overview of recent evidence on barriers and facilitators to HIVtesting. Canada Communicable Disease Report. 2015;41(12). Figueroa C, Johnson C, Verster A, Baggaley R. Attitudes and acceptability on HIV self-testing among key
Conducting meta-analyses of HIV prevention literatures from a theory-testing perspective. Using illustrations from HIV prevention research, the current article advocates approaching meta-analysis as a theory-testing scientific method rather than as merely a set of rules for quantitative analysis. Like other scientific methods, meta-analysis has central concerns with internal, external, and construct validity. The focus of a meta-analysis should only rarely be merely describing the effects (...) of health promotion, but rather should be on understanding and explaining phenomena and the processes underlying them. The methodological decisions meta-analysts make in conducting reviews should be guided by a consideration of the underlying goals of the review (e.g., simply effect size estimation or, preferably theory testing). From the advocated perspective that a health behavior meta-analyst should test theory, the authors present a number of issues to be considered during the conduct of meta
Effectiveness of peer-led interventions to increase HIVtesting among men who have sex with men: a systematic review and meta-analysis. HIVtesting constitutes a key step along the continuum of HIV care. Men who have sex with men (MSM) have low HIVtesting rates and delayed diagnosis, especially in low-resource settings. Peer-led interventions offer a strategy to increase testing rates in this population. This systematic review and meta-analysis summarizes evidence on the effectiveness of peer (...) -led interventions to increase the uptake of HIVtesting among MSM. Using a systematic review protocol that was developed a priori, we searched PubMed, PsycINFO and CINAHL for articles reporting original results of randomized or non-randomized controlled trials (RCTs), quasi-experimental interventions, and pre- and post-intervention studies. Studies were eligible if they targeted MSM and utilized peers to increase HIVtesting. We included studies published in or after 1996 to focus on HIVtesting
Evidence for optimal HIVtesting intervals in HIV-negative individuals from various risk groups: a systematic review protocol Evidence-based recommendations for HIVtesting are essential for health care providers. However, it is unclear whether there is sufficient evidence to support recommendations for HIVtesting frequencies in a variety of HIV risk groups.The aim of this document is to outline the methodological protocol of a systematic review that would gather evidence for the optimal (...) frequency of HIVtesting among individuals in various HIV risk groups with respect to personal and public health outcomes and cost-effectiveness.This protocol adheres to the PRISMA-P reporting items, and the review is registered with PROSPERO. The target population includes individuals who may have undiagnosed HIV infection. Different frequencies of HIVtesting will be compared and outcomes to do with personal and public health, patient values/preferences and costs will be examined. The search strategy
The clinical effectiveness of individual behaviour change interventions to reduce risky sexual behaviour after a negative humanimmunodeficiencyvirustest in men who have sex with men: systematic and realist reviews and intervention development. Men who have sex with men (MSM) experience significant inequalities in health and well-being. They are the group in the UK at the highest risk of acquiring a humanimmunodeficiencyvirus (HIV) infection. Guidance relating to both HIV infection (...) prevention, in general, and individual-level behaviour change interventions, in particular, is very limited.To conduct an evidence synthesis of the clinical effectiveness of behaviour change interventions to reduce risky sexual behaviour among MSM after a negative HIV infection test. To identify effective components within interventions in reducing HIV risk-related behaviours and develop a candidate intervention. To host expert events addressing the implementation and optimisation of a candidate
Returning for HIVTest Results: A Systematic Review of Barriers and Facilitators. This systematic review aims to identify factors that facilitate or hinder the return for HIVtest results. Four electronic databases were searched. Two independent reviewers selected eligible publications based on inclusion/exclusion criteria. Quantitative studies published since 1985 were included. Thirty-six studies were included in the final review. Individual level barriers included sociodemographic (...) characteristics, such as being a male, of young age and low education level, risk behaviours such as injecting drugs, having multiple sexual partners, and psychosocial factors. Older age, higher education level, being a woman, having high self-esteem, having coping skills, and holding insurance coverage were identified as facilitators. Interpersonal barriers and facilitators were linked to risk behaviours of sexual partners. Contextual barriers included essentially the HIVtesting center and its