scholarly journals 2023 Relationship power imbalance and history of male partner HIV testing among pregnant women in central Uganda

2018 ◽  
Vol 2 (S1) ◽  
pp. 25-26
Author(s):  
Caroline Vrana ◽  
Jeffrey Korte ◽  
Angela Malek ◽  
Esther Buregyeya ◽  
Joseph Matovu ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Male Partner ◽  
Standard Of Care ◽  
Relationship Status ◽  
Power Balance ◽  
Power Imbalance ◽  
Relationship Power ◽  
Male Partners ◽  
Partner Testing ◽  
Self Testing

OBJECTIVES/SPECIFIC AIMS: We investigated the association between relationship power imbalance (which can have a negative impact on HIV prevention) and male partner HIV testing, using baseline data from a HIV self-testing trial in 3 antenatal clinics in central Uganda. METHODS/STUDY POPULATION: Pregnant women with HIV-male partners were recruited and randomized by day into standard of care or intervention (HIV self-testing kits). Analyses were performed in SAS 9.4, with χ2 tests and p<0.05 for significance. RESULTS/ANTICIPATED RESULTS: In total, 1514 women were recruited (737 standard of care, 777 intervention). Overall, 39.6% of male partners had previously tested for HIV. Among women <26, contributions to expenses differed by partner testing (overall p<0.001, 47.6% of women whose partners tested made no contribution vs. 63.2% of women whose partners did not test). Relationship status differed by partner testing (overall p=0.02, 12.4% of women whose partners tested showed a sometimes difficult relationship vs. 5.7% of women whose partners did not test). Among women 26+, decision making for family visits differed by partner testing (overall p=0.005, 52.9% of women made joint decisions with partners who tested vs. 36.5% whose partners did not test). DISCUSSION/SIGNIFICANCE OF IMPACT: Higher relationship power balance was associated with higher HIV testing among male partners when measured by contribution to expenses and decision making for family visits, but not relationship status. Relationship power balance should be considered when counseling women and men to increase HIV testing.

scholarly journals Cost-Effectiveness of Peer-Delivered HIV Self-Tests for MSM in Uganda

2021 ◽  
Vol 9 ◽  
Author(s):  
Stephen Okoboi ◽  
Barbara Castelnuovo ◽  
Jean-Pierre Van Geertruyden ◽  
Oucul Lazarus ◽  
Lung Vu ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Incremental Cost ◽  
Hiv Testing ◽  
Cost Effective ◽  
Hiv Infections ◽  
Standard Of Care ◽  
Sub Saharan Africa ◽  
High Risk Population ◽  
Self Testing ◽  
The Cost

Introduction: Distribution of HIV self-testing (HIVST) kits through MSM peer networks is a novel and effective strategy to increase HIV testing coverage in this high-risk population. No study has evaluated the cost or cost effectiveness of peer distribution of HIVST strategies among MSM in sub-Saharan Africa.Methods: From June to August 2018, we conducted a pilot study of secondary MSM peer HIVST kit distribution at The AIDS Support Organization at Entebbe and Masaka. We used an ingredients approach to estimate the cost of MSM peer HIVST kit distribution relative to standard-of-care (SOC) hotspot testing using programme expenditure data reported in US dollars. The provider perspective was used to estimate incremental cost-effective ratios per HIV infection averted using the difference in HIV annual transmission rates between MSM with HIV who knew their status and were not virologically suppressed and MSM with HIV who did not know their status.Results: We enrolled 297 participants of whom 150 received MSM peer HIVST kit distribution (intervention group) and 147 received TASO standard of care HIV testing (control group). Provider cost for the intervention was $2,276 compared with $1,827 for SOC during the 3-month study period. Overall, the intervention resulted in higher HIV positivity yield (4.9 vs. 1.4%) and averted more HIV infections per quarter (0.364 vs. 0.104) compared with SOC. The cost per person tested was higher for the intervention compared to SOC ($15.90 vs. $12.40). Importantly, the cost per new HIV diagnosis ($325 vs. $914) and cost per transmission averted ($6,253 vs. $ 17,567) were lower for the intervention approach relative to SOC. The incremental cost per HIV transmission averted by the self-testing program was $1,727. The incremental cost to providers per additional HIV-positive person identified by the intervention was $147.30.Conclusion: The intervention strategy was cost-effective, and identified more undiagnosed HIV infections than SOC hotspot testing at a cost-effectiveness threshold of US $2,129. Secondary distribution of HIVST kits through peers should further be evaluated with longer duration aimed at diagnosing 95% of all persons with HIV by 2030; the first UNAIDS 95-95-95 target.

Black Women’s Approaches to Encourage a Male Partner to Test for HIV: Preliminary Adaptation and a Factor Analysis Study of the HIV Testing Approach Scale

2018 ◽  
Vol 26 (1) ◽  
pp. 76-89 ◽  
Author(s):  
Kerry Nolte ◽  
Barbara Guthrie ◽  
John Griffith ◽  
Tiffany Kim
Keyword(s):  
Black Women ◽  
Hiv Testing ◽  
Factor Model ◽  
Male Partner ◽  
Measurement Instrument ◽  
Partner Testing ◽  
Reliable Instrument ◽  
Components Analysis ◽  
Testing Approach ◽  
Adequate Reliability

Background and Purpose:Black women are disproportionately affected by HIV. Increasing status awareness through partner testing can improve status awareness and reduce transmission. Varying approaches to encourage HIV testing are described but a measurement instrument is lacking. The AIDS Discussion Strategy Scale (ADSS) was adapted into the HIV Testing Approach Scale (HTAS) to measure Black women's approaches to encourage partners to test for HIV.Methods:Preliminary adaptation included five steps to ensure validity. Participants comprised 158 sexually active 18–29-year-old Black women. The HTAS was analyzed with principal components analysis (PCA).Results:PCA indicated a four-factor model explaining 67% of variance. Four distinct approaches were Active Persuasion, Decisive Collaboration, Ultimatum, and Sweet Talking. The HTAS approaches demonstrated adequate reliability.Conclusion:The HTAS may serve as a valid and reliable instrument for research. HIV prevention should encourage testing discussion to increase status awareness.

scholarly journals Stakeholders’ recommendations for implementing HIV self-testing and secondary distribution of HIV self-testing for male partners of Option B+ clients in Haiti as an assisted partner service strategy: a qualitative study

2019 ◽  
Author(s):  
Donaldson Fadael Conserve ◽  
Jacob Michel ◽  
Joseph Emmanuel Adrien Demes ◽  
Jean Marxcime Chéry ◽  
Jean-Gabriel Balan ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Community Health ◽  
Health Workers ◽  
Public Information ◽  
Linkage To Care ◽  
Hiv Care ◽  
Small Scale ◽  
Male Partners ◽  
Self Testing ◽  
Secondary Distribution

Abstract Background Despite significant public health efforts, HIV testing remains low among men in Haiti. HIV self-testing (HIVST), which allows people to test in private, is an effective strategy for increasing HIV testing among men. Secondary distribution of HIVST to male partners of women living with HIV (WLWH) is one promising assisted partner services strategy to address the low HIV testing rate among men in Haiti. However, little research has been conducted on how to implement HIVST in the Caribbean. The purpose of this study was to assess stakeholders’ perspectives towards HIVST and to obtain their recommendations for how to implementing HIVST in Haiti to reach male partners of Option B+ clients. Methods Sixteen key informant interviews and nine focus groups with 44 healthcare workers (HCWs), 31 Option B+ clients, and 13 men were carried out in Haiti. Key informants were representatives of the Ministry of Health and of a non-governmental agency involved in HIV partner services. HCWs included program leads and staff members from the HIV care and treatment program, the Option B+ program, the community health service program, and the HIV counseling and testing services from 2 hospitals. Results Perceived HIVST advantages included an increase in the number of people who would learn their HIV status and start treatment. Perceived disadvantages were lack of support to ensure self-testers initiate treatment, uncertainty about male partner’s reaction, risk of violence towards a woman by a man after having received an HIVST kit from her, and the inability of a woman to counsel a man in case his self-test result is positive. Recommendations for implementing HIVST and secondary distribution of HIVST included coupling HIVST distribution with public information, education, and communication through media and social marketing; relying on community health workers to mediate the use of HIVST and ensure linkage to care; and piloting HIVST programs on a small scale. Conclusions HIVST is an appropriate and feasible HIV prevention strategy for men and women. Our findings indicate that more research is needed to determine and pilot how best to implement HIVST and secondary distribution of HIVST by Option B+ clients in Haiti.

scholarly journals Web-based multifaceted approach in community-based screening in HIV self-testing: protocol for randomized community trial among female sex workers in Indonesia (Preprint)

2021 ◽  
Author(s):  
Jessie Olivia Yunus ◽  
Anak Agung Sagung Sawitri ◽  
Dewa Nyoman Wirawan ◽  
I Gusti Agung Agus Mahendra ◽  
Dewi Susanti ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Standard Of Care ◽  
Community Based ◽  
Web Based ◽  
Female Sex ◽  
Self Testing ◽  
High Satisfaction ◽  
Fluid Test

BACKGROUND The HIV epidemic in Indonesia continues to be concentrated among key populations including female sex workers (FSW). However, increasing HIV testing among this sub-population continues to be a challenge, necessitating exploration into alternatives testing modalities. OBJECTIVE The objective of this study was to test whether the addition of oral fluid test as an alternative testing modality will increase the number of FSW who receive HIV testing. METHODS We undertook a community-randomized trial in 23 national priority districts with existing package of HIV community outreach services. The trial consisted of 15 intervention districts and 8 control districts. In the control districts, implementing units of HIV program administered the standard of care while in the intervention districts, an additional HIV self-testing option using oral fluid test was given as a community-based screening. Participants with reactive screening results will be encouraged to undergo HIV testing at a health facility to confirm their diagnosis and subsequent antiretroviral treatment. Multiple means of recruitment were deployed including through outreach workers and social media campaign. Due in large part to the COVID-19 pandemic, most research activities were conducted online. RESULTS 17,962 FSWs were reached in the intervention sites, 45.5% (n=8,176/17,962) accepted testing, 18.9% of whom accepted OFT (n= 1,545/8,176). A total of 1.3% (n=106/8,176) participants were confirmed HIV positive. In the control districts, 7,653 FSWs were reached, 45.4% (n=3,471/7.653) received testing, 0.8% (n=29/3,471) were confirmed HIV positive. Post-test surveys for participants receiving OFT indicated overall high satisfaction and intention to use. Through the social media campaign, there were also people who registered independently for OFT but did not identify as FSW. They were eventually not eligible to participate but their interest point to the possibility of implementing HIV self-testing to general population. CONCLUSIONS The addition of HIV self-testing to standard of care supported by a web-based data collection system was able to result in higher HIV testing and higher case finding among female sex workers in Indonesia. High satisfaction of OFT users and the interest of general population towards this alternative testing modality are promising for scaling up this strategy nationally. CLINICALTRIAL ClinicalTrials.gov, number NCT04578145

scholarly journals Male partner involvement in HIV testing and counseling among partners of pregnant women in the Delanta District, Ethiopia

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248436
Author(s):  
Haile Chanyalew ◽  
Eshetu Girma ◽  
Tesfaye Birhane ◽  
Muluken Genetu Chanie
Keyword(s):  
Pregnant Women ◽  
Hiv Testing ◽  
Male Partner ◽  
Local Health ◽  
Northern Ethiopia ◽  
Male Partners ◽  
Male Partner Involvement ◽  
Hiv Testing And Counseling ◽  
Partner Involvement ◽  
Testing And Counseling

Background Only screening a pregnant mother is not satisfactory to prevent mother-to-child transmission of HIV (PMTCT). A male partner’s involvement in HIV testing and counseling is also critical for PMTCT, however, it is one of the biggest challenges in Ethiopia. This study aimed to assess a male partner’s involvement in HIV testing and counseling and associated factors among partners of pregnant women in the Delanta District, Northern Ethiopia. Methods A community-based cross-sectional study design was conducted in the Delanta District from March 15 to May 10, 2018. During the study period, 609 male partners were involved. A binary and multiple logistic regression model was used to examine the association between variables. Results Out of all, 325 (53.7% at 95% CI: 49.6 to 57.5) of male partners were involved in HIV testing and counseling in the District. Male partners who were living together, ever heard about HIV from health professionals, pregnant women’s antenatal care (ANC) visit, partner visited the PMTCT clinic with wife, and partner and wife discussion before HIV testing and counseling were factors associated with male partner involvement. Conclusion The proportion of male partner involvement was found to be low as compared to the national standards. Local health authorities and health care workers need to develop and conduct interventions that help partners with their wife to live together, improve their awareness about HIV and testing, ANC visit by pregnant women, and encourage having home discussion before HIV testing through counseling, by so doing finally raise the level of male partner involvement in HIV testing and counseling.

scholarly journals Effectiveness of a Novel HIV Self-Testing Service with Online Real-Time Counseling Support (HIVST-Online) in Increasing HIV Testing Rate and Repeated HIV Testing among Men Who Have Sex with Men in Hong Kong: Results of a Pilot Implementation Project

2021 ◽  
Vol 18 (2) ◽  
pp. 729
Author(s):  
Paul Shing-fong Chan ◽  
Andrew Chidgey ◽  
Jason Lau ◽  
Mary Ip ◽  
Joseph T.F. Lau ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Real Time ◽  
Linkage To Care ◽  
Standard Of Care ◽  
Multiple Sources ◽  
Self Testing ◽  
Post Test ◽  
Pilot Implementation ◽  
Sex With Men ◽  
Testing Coverage

HIV self-testing (HIVST) with online real-time counseling (HIVST-online) is an evidence-based intervention to increase HIV testing coverage and to ensure linkage to care for men who have sex with men (MSM). A community-based organization (CBO) recruited 122 MSM who had ever used HIVST-online (ever-users) and another 228 new-users from multiple sources and promoted HIVST-online. A free oral fluid-based HIVST kit was sent to all the participants by mail. Experienced HIVST administrators implemented HIVST-online by providing real-time instruction, standard-of-care pre-test and post-test counseling via live-chat application. The number of HIVST-online sessions performed was documented by the administrators. The post-test evaluation was conducted 6 months after the pre-test survey. At month 6, 63.1% of ever-users and 40.4% of new-users received HIVST-online. Taking other types of HIV testing into account, 79.4% of ever-users and 58.6% of new-users being followed up at month 6 received any HIV testing during the project period. Ever-users were more likely to receive HIVST-online and any HIV testing as compared to new-users. Four HIVST-online users were screened to be HIV positive and linked to the treatment. The process evaluation of HIVST-online was positive. Implementation of HIVST-online was helpful to improve HIV testing coverage and repeated HIV testing among Chinese MSM. A larger scale implementation should be considered.

scholarly journals Pregnant women, their male partners and health care providers’ perceptions of HIV self-testing in Kampala, Uganda: Implications for integration in prevention of mother-to-child transmission programs and scale-up

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253616
Author(s):  
Joseph Rujumba ◽  
Jaco Homsy ◽  
Femke Bannink Mbazzi ◽  
Zikulah Namukwaya ◽  
Alexander Amone ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Health Care Providers ◽  
Health Workers ◽  
Scale Up ◽  
Care Providers ◽  
Male Partners ◽  
Hiv Status ◽  
Lactating Women ◽  
Self Testing ◽  
Study Participants

Background HIV status awareness is critical for HIV prevention and care but HIV testing rates remain low in Uganda, especially among men. One suggested approach to increase access and utilisation of HIV testing services is HIV self-testing. We explored perceptions of pregnant and lactating women and their male partners who attended antenatal care, and health care providers in a government hospital in Kampala, Uganda, about HIV self-testing for initial or repeat testing for women and their partners during pregnancy and postpartum We draw implications for scaling-up this new testing approach in Uganda. Methods This was a qualitative study conducted at Mulago National Referral Hospital, Kampala, Uganda, between April and December 2017. We conducted in-depth interviews with five pregnant or lactating women and their five male partners; five focus group discussions (two with women, two with health workers and one with male partners of women attending antenatal care) and five key informant interviews with health workers providing prevention of mother-to-child HIV transmission (PMTCT) services. Data were analysed using content thematic approach. Results There was limited awareness about HIV self-testing especially among pregnant or lactating women and their male partners. Study participants mentioned that HIV self-testing would enable people to know their HIV status faster, they thought the approach would be cost- and time-saving compared to health facility-based HIV testing, improve confidentiality and reduce stigma for those who test HIV positive. They expressed however, a general fear that HIV self-testing would lead to harm to self and others in case one tested HIV positive, including suicide, violence among couples, intentional transmission of HIV, and limited linkage to care due to lack of counselling. The likely misinterpretation of HIV test results especially among those with no or limited education, and possible coercion exerted by male partners on their wives were other potential concerns raised about the use of HIV self-testing. Conclusions There was limited knowledge about HIV self-testing among pregnant and lactating women, their partners and health workers. While the self-testing modality was perceived to be critical for helping people, especially those in casual and distant relationships, to know their HIV status and that of their partners, most study participants believed that HIV self-testing could potentially result in a multitude of negative outcomes in the absence of pre- and post-test counselling. Successful scale-up and integration of self-testing in HIV programs requires community education, provision of information materials and making self-test kits accessible and affordable, especially in rural areas.

scholarly journals The Utility of SMS to Report Male Partner HIV Self-testing Outcomes Among Women Seeking Reproductive Health Services in Kenya: Cohort Study (Preprint)

2019 ◽  
Author(s):  
Alison L Drake ◽  
Emily Begnel ◽  
Jillian Pintye ◽  
John Kinuthia ◽  
Anjuli D Wagner ◽  
...  
Keyword(s):  
Male Partner ◽  
Outcome Data ◽  
Sensitive Information ◽  
Male Partners ◽  
Reproductive Health Services ◽  
Coverage Bias ◽  
Self Testing ◽  
Prep Implementation ◽  
Exposure Prophylaxis

BACKGROUND Use of SMS for data collection is expanding, but coverage, bias, and logistical constraints are poorly described. OBJECTIVE The aim of this study is to assess the use of SMS to capture clinical outcomes that occur at home and identify potential biases in reporting compared to in-person ascertainment. METHODS In the PrEP Implementation in Young Women and Adolescents program, which integrated pre-exposure prophylaxis (PrEP) into antenatal care, postnatal care, and family planning facilities in Kisumu County, Kenya, HIV-negative women 14 years of age or older were offered oral HIV self-tests (HIVSTs) to take home to male partners. Women that brought a phone with a Safaricom SIM to the clinic were offered registration in an automated SMS system (mSurvey) to collect information on HIVST outcomes. Women were asked if they offered the test to their male partners, and asked about the test process and results. HIVST outcomes were collected via SMS (sent 2.5 weeks later), in-person (if women returned for a follow-up scheduled 1 month later), or using both methods (if women initiated PrEP, they also had scheduled follow-up visits). The SMS prompted women to reply at no charge. HIVST outcomes were compared between women with scheduled follow-up visits and those without (follow-up visits were only scheduled for women who initiated PrEP). HIVST outcomes were also compared between women reporting via SMS and in-person. RESULTS Among 2123 women offered HIVSTs and mSurvey registration, 486 (23.89%) accepted HIVSTs, of whom 359 (73.87%) were eligible for mSurvey. Additionally, 76/170 (44.7%) women with scheduled follow-up visits and 146/189 (77.3%) without scheduled follow-up visits registered in mSurvey. Among the 76 women with scheduled follow-ups, 62 (82%) had HIVST outcomes collected: 19 (31%) in-person, 20 (32%) by SMS, and 23 (37%) using both methods. Among the 146 women without scheduled visits, 87 (59.6%) had HIVST outcomes collected: 3 (3%) in-person, 82 (94%) by SMS, and 2 (2%) using both methods. SMS increased the collection of HIVST outcomes substantially for women with scheduled follow-up visits (1.48-fold), and captured 82 additional reports from women without scheduled follow-up visits. Among 222 women with reported HIVST outcomes, frequencies of offering partners the HIVST (85/95, 89% in-person vs 96/102, 94% SMS; <i>P</i>=.31), partners using the HIVST (83/85, 98% vs 92/96, 96%; <i>P</i>=.50), women using HIVST with partners (82/83, 99% vs 91/92, 99%; <i>P</i>=.94), and seeing partner’s HIVST results (82/83, 99% vs 89/92, 97%; <i>P</i>=.56) were similar between women reporting in-person only versus by SMS only. However, frequency of reports of experiencing harm or negative reactions from partners was more commonly reported in the SMS group (17/102, 16.7% vs 2/85, 2%; <i>P</i>=.003). Barriers to the SMS system registration included not having a Safaricom SIM or a functioning phone. CONCLUSIONS Our results suggest that the use of SMS substantially improves completeness of outcome data, does not bias reporting of nonsensitive information, and may increase reporting of sensitive information.  

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