scholarly journals Perspectives on HIV partner notification, partner HIV self‐testing and partner home‐based HIV testing by pregnant and postpartum women in antenatal settings: a qualitative analysis in Malawi and Zambia

2019 ◽  
Vol 22 (S3) ◽  
Author(s):  
Rebecca B Hershow ◽  
Chifundo C Zimba ◽  
Oliver Mweemba ◽  
Kasapo F Chibwe ◽  
Twambilile Phanga ◽  
...  
Keyword(s):  
Qualitative Analysis ◽  
Hiv Testing ◽  
Partner Notification ◽  
Postpartum Women ◽  
Home Based ◽  
Self Testing

scholarly journals Testing strategies for couple engagement in prevention of mother-to-child transmission of HIV and family health in Kenya: study protocol for a randomized controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Zachary Kwena ◽  
Liza Kimbo ◽  
Lynae A. Darbes ◽  
Abigail M. Hatcher ◽  
Anna Helova ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Hiv Testing ◽  
Standard Care ◽  
Family Health ◽  
Child Transmission ◽  
Home Based ◽  
Self Testing ◽  
The Cost ◽  
Mother To Child ◽  
Testing And Counseling

Abstract Background HIV-related maternal deaths and HIV infection among infants remain unacceptably high across sub-Saharan Africa despite increased antenatal care attendance and provision of antiretroviral therapy to pregnant women. In the Jamii Bora (“Better Family” in Swahili) Study, we seek to test the efficacy of an interdependence theory-based couple intervention. The intervention reaches pregnant women and male partners through home visits by male-female pairs of lay health workers. The aim is to increase access to home-based couples’ HIV testing and counseling services to improve family health. Methods This is a three-arm randomized control trial among 1080 pregnant women 15 years of age or older, living with their male partners, and who have not undergone couples’ HIV testing and counseling in Kisumu and Migori Counties in Kenya. Couples will be randomized into three groups: home-based couple visits, HIV self-testing kits for couple use, or standard care (male partner clinic invitation letters). Participants will be followed up to 18 months postpartum. The study has three aims: in aim 1, we will determine the effects of the intervention on our primary outcome of couple HIV testing, compared to HIV self-testing kits and standard care; in aim 2, we will examine the intervention impact on HIV prevention behaviors, facility delivery, and postnatal healthcare utilization, as well as secondary health outcomes of maternal viral suppression and HIV-free child survival up to 18 months for couples living with HIV; and in aim 3, we will compare the cost-effectiveness of the home-based couple intervention to the less resource-intensive strategies used in the other two study arms. Assessments with couples are conducted at baseline, late pregnancy, and at months 3, 6, 12, and 18 after birth. Discussion The results from this study will inform decision-makers about the cost-effective strategies to engage pregnant couples in the prevention of mother-to-child transmission and family health, with important downstream benefits for maternal, paternal, and infant health. Trial registration ClinicalTrials.gov NCT03547739. Registered on May 9, 2018

scholarly journals Potential interactions between the pathways to diagnosis of HIV and other STIs and HIV self-testing: insights from a qualitative study of gay, bisexual and other men who have sex with men in Singapore

2020 ◽  
pp. sextrans-2020-054623
Author(s):  
Rayner Kay Jin Tan ◽  
Yin Ying Chan ◽  
Muhamad Alif Bin Ibrahim ◽  
Lai Peng Ho ◽  
Oliver Zikai Lim ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Perceived Risk ◽  
Partner Notification ◽  
Barriers And Facilitators ◽  
Perceived Severity ◽  
Sti Testing ◽  
Self Testing ◽  
Sex With Men ◽  
Stis And Hiv ◽  
The Cost

ObjectivesThis study draws on qualitative insights on the barriers and facilitators to HIV testing, as well as perceptions of HIV self-testing (HIVST), to propose a framework to understand not only the benefits but also potential knock-on implications of introducing HIVST in the context of other STI testing.MethodsWe conducted semistructured, in-depth interviews with 30 gay, bisexual and other men who have sex with men aged 18 and 39 years old in Singapore. Interview topics included barriers and facilitators to HIV and other STI testing, as well as perceptions of HIVST. Interviews were audio-recorded, transcribed, coded and analysed using thematic analysis.ResultsFor HIV testing, participants cited the perceived risk of acquiring, susceptibility to and symptoms of HIV as internal motivators, while social influence and accessibility of HIV testing services were external motivators. For STI testing, perceived symptoms and partner notification of STI were reported as internal and external motivators, respectively. Availability of bundle tests, starting a new relationship and instances of mandatory testing motivated both simultaneous HIV and other STI testing. The fear of a positive diagnosis and lack of confidentiality were cited as internal and external barriers to HIV testing, respectively, while low perceived severity of other STI and the cost of STI tests were cited as internal and external barriers to other STI testing, respectively. We identified pathways to HIV and other STI testing and discussed how the introduction of HIVST may reduce opportunities for other STI testing.ConclusionsThe findings of this study suggest that introducing HIVST might weaken linkages to other STI testing if alternative strategies of promoting other STI testing are not simultaneously implemented. We recommend that future interventions address both the risks of HIV and other STI simultaneously, and that structural interventions promoting HIV and other STI preventions be balanced accordingly.

scholarly journals Barriers to HIV Testing and Opportunities for Expansion Using Home-Based HIV Self-Testing: Results of a National Study of Higher HIV Risk Young Men Who Have Sex With Men

SAGE Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 215824402110168
Author(s):  
Sarah J. Marks ◽  
Roland C. Merchant ◽  
Melissa A. Clark ◽  
Tao Liu ◽  
Joshua G. Rosenberger ◽  
...  
Keyword(s):  
Hiv Testing ◽  
The United States ◽  
National Study ◽  
National Guidelines ◽  
The Past ◽  
Home Based ◽  
Self Testing ◽  
Hiv Test ◽  
Condomless Anal Intercourse ◽  
Sex With Men

HIV incidence among young adult men-who-have-sex-with-men (YMSM) is among the highest in the United States (US), yet YMSM have lower rates of HIV testing than most other MSM. Among 1,835 U.S. Black, Hispanic, and White YMSM who reported condomless anal intercourse (CAI) in the prior year, 30% (95% confidence interval [CI]: [28%, 32%]) had not been tested for HIV in the past year as recommended by national guidelines, and 19% (95% CI: [17%, 21%]) had never been tested. Factors associated with not being tested in the past year included not having a primary care provider (PCP)) (odds ratio [OR]: 2.00, 95% CI: [1.53, 2.60]), discomfort with asking a PCP for an HIV test (OR: 2.66, 95% CI: [2.05, 3.44]), living in a smaller community (OR: 1.71, 95% CI: [1.35, 2.18]), younger age (OR: 2.00, 95% CI: [1.53, 2.60]), and greater self-perception of having an undiagnosed HIV infection (OR: 1.46, 95% CI: [1.07, 1.99]). YMSM who had not been tested in the prior year were less likely to know where to get tested, yet were interested in trying home-based HIV self-testing. This study shows that knowledge, clinician-relationship, geographic, and perceptional barriers must be overcome to improve HIV testing among YMSM. Home-based HIV self-testing may address some of these barriers, particularly for YMSM living in smaller communities.

scholarly journals HOSENG trial – Effect of the provision of oral self-testing for absent and refusing individuals during a door-to-door HIV testing campaign on testing coverage: protocol of a cluster randomized clinical trial in rural Lesotho

2019 ◽  
Author(s):  
Alain Amstutz ◽  
Thabo Ishmael Lejone ◽  
Lefu Khesa ◽  
Josephine Muhairwe ◽  
Bienvenu Lengo Nsakala ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Health Facility ◽  
World Health ◽  
Eligibility Criteria ◽  
High Coverage ◽  
Home Based ◽  
Self Testing ◽  
Household Members ◽  
Cluster Randomized ◽  
Testing Coverage

Abstract BACKGROUND HIV testing coverage remains below the targeted 90% despite efforts and resources invested. Home-based HIV testing is a key approach endorsed by the World Health Organization (WHO), especially to reach individuals who might not seek testing otherwise. Although acceptance of test-ing during such campaigns is high, coverage remains low due to absent household members. This cluster-randomized trial aims to assess increase in testing coverage using oral HIV self-testing (HIVST) among individuals who are absent or decline testing during home-based HIV testing. METHODS The HOSENG (HOme-based SElf-testiNG) trial is a cluster-randomized, parallel group, superiority trial in two districts of Lesotho, Southern Africa. Clusters are stratified by district, village size, and village access to the nearest health facility. Cluster eligibility criteria include: village is in catchment area of one of the study facilities, village authority provides consent, and village has a registered, capable and consenting village health worker (VHW). In intervention clusters, HIV self-tests are provided for eligible household members who are absent or decline HIV testing in presence of the campaign team. In control clusters, standard of care for absent and refusing individuals applies, i.e. referral to health facility. The primary outcome is HIV testing coverage among individuals 12 years and older within 120 days after enrolment. Secondary objectives include HIV testing coverage among other age groups, and uptake of the different testing modalities. Statistical analyses will be conducted and reported in line with CONSORT guidelines. HOSENG trial is linked to VIBRA (Village-Based Refill of ART) trial. Together, they constitute the GET ON (GETting tOwards Ninety) research project. DISCUSSION The HOSENG trial tests if oral HIVST may be an add-on during door-to-door testing campaigns towards achieving optimal testing coverage. The provision of oral self-test kits, followed up by VHWs, requires little additional human resources, finances and logistics. If cost-effective, this approach will inform home-based HIV testing policies not only in Lesotho, but in similar high-prevalence settings. TRIAL REGISTRATION This trial has been registered at clinicaltrials.gov (NCT03598686) on July 25, 2018. More information under www.getonproject.wordpress.com.

scholarly journals Reaching hard-to-reach men through home-based couple HIV testing among pregnant women and their male partners in Western Kenya: A qualitative study

2020 ◽  
Author(s):  
Daisy Krakowiak ◽  
Pamela Makabong’o ◽  
Marielle Goyette ◽  
John Kinuthia ◽  
Alfred Onyango Osoti ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Pregnant Women ◽  
Hiv Testing ◽  
Health Workers ◽  
Partner Notification ◽  
Sub Saharan Africa ◽  
Male Partners ◽  
Home Based ◽  
Couple Testing ◽  
Couple Hiv Testing

Abstract Background Globally only 79% of adults living with HIV (human immunodeficiency virus) know their status and men in sub-Saharan Africa are considered a particularly hard-to-reach population for HIV testing. Home-based HIV couple testing during the antenatal period is a safe and effective method that has been used to test male partners of pregnant women. The goal of this qualitative study was to identify elements that made couple testing successful and describe important characteristics of this home-based intervention from couples’ perspectives. Methods Couples who received scheduled home-based couple testing during pregnancy in Kisumu, Kenya, were purposively sampled based on HIV status from January to May 2015. An interviewer administered all of the in-depth interviews and two coders were directly involved in the data analysis and reconciled codes several times in the process. Results Twenty-one couples were enrolled: 9 concordant HIV-negative couples, 8 HIV discordant couples, 3 HIV concordant HIV-positive couples, and 1 whose concordance status was unknown. Median age at the time of home-based couple testing was 24 and 28 years for women and men, respectively. Median relationship duration was 3 years and couples had a median of two pregnancies. The major themes that emerged were that home-based couple testing 1) removed the female burden of requesting couple testing, 2) overcame logistical barriers associated with clinic-based testing, 3) encouraged participants to overcome their fear of testing and disclosure, 4) provided privacy in the home, and 5) provided quality time with the health advisors. Importantly, some women appreciated individual testing at the clinic before couple testing and some couples preferred skilled, anonymous health advisors delivering the intervention rather than known community health workers. Conclusions The results of this qualitative study suggest that home-based couple testing during pregnancy overcame many of the barriers that limit men’s access to and uptake of clinic-based testing. It encouraged participants to overcome their fear of testing and disclosure through a setting that afforded privacy and quality time with skilled health advisors. These qualitative results may help design effective partner and couple HIV testing programs in the antenatal setting and alongside or within other assisted partner notification services. Trial Registration: Clinicaltrials.gov registry: NCT01784783. Registered prospectively on June 15, 2012.

Home-based oral self-testing for absent and declining individuals during a door-to-door HIV testing campaign in rural Lesotho (HOSENG): a cluster-randomised trial

2020 ◽  
Vol 7 (11) ◽  
pp. e752-e761 ◽  
Author(s):  
Alain Amstutz ◽  
Thabo Ishmael Lejone ◽  
Lefu Khesa ◽  
Josephine Muhairwe ◽  
Moniek Bresser ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Randomised Trial ◽  
Cluster Randomised Trial ◽  
Cluster Randomised ◽  
Home Based ◽  
Self Testing

scholarly journals South African HIV self-testing policy and guidance considerations

2017 ◽  
Vol 18 (1) ◽  
Author(s):  
Francois Venter ◽  
Mohammed Majam ◽  
Lauren Jankelowitz ◽  
Siraaj Adams ◽  
Michelle Moorhouse ◽  
...  
Keyword(s):  
Hiv Testing ◽  
South African ◽  
Healthcare Providers ◽  
Partner Notification ◽  
World Health ◽  
Sexually Transmitted ◽  
Self Testing ◽  
Private And Public ◽  
Hiv Testing Services ◽  
Health Organization

The gap in HIV testing remains significant and new modalities such as HIV self-testing (HIVST) have been recommended to reach key and under-tested populations. In December 2016, the World Health Organization (WHO) released the Guidelines on HIV Self-Testing and Partner Notification: A Supplement to the Consolidated Guidelines on HIV Testing Services (HTS) and urged member countries to develop HIVST policy and regulatory frameworks. In South Africa, HIVST was included as a supplementary strategy in the National HIV Testing Services Policy in 2016, and recently, guidelines for HIVST were included in the South African National Strategic Plan for HIV, sexually transmitted infections and tuberculosis 2017–2022. This document serves as an additional guidance for the National HIV Testing Services Policy 2016, with specific focus on HIVST. It is intended for policy advocates, clinical and non-clinical HTS providers, health facility managers and healthcare providers in private and public health facilities, non-governmental, community-based and faith-based organisations involved in HTS and outreach, device manufacturers, workplace programmes and institutes of higher education.

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