HIV testing of pregnant women—what is needed to protect positive women's needs and rights?

Sexual Health ◽  
2005 ◽  
Vol 2 (3) ◽  
pp. 143 ◽  
Author(s):  
Maria de Bruyn ◽  
Susan Paxton
Keyword(s):  
Pregnant Women ◽  
Hiv Testing ◽  
Perinatal Transmission ◽  
Hiv Positive ◽  
Physical Assault ◽  
People Living With Hiv ◽  
Women's Lives ◽  
Living With Hiv ◽  
Voluntary Counselling And Testing ◽  
The Impact

With increased availability of antiretroviral therapy, there is an escalating global trend to test all pregnant women for HIV in order to stop perinatal transmission. However, insufficient consideration is given to the impact this may have on the lives of these women and their families. Many women feel pressured into HIV testing during pregnancy, do not receive adequate pre-test counselling or do not give truly informed consent. Some women who test positive experience significantly more discrimination from their partners, families and community members than HIV-positive men do. As a consequence, large numbers of women diagnosed during pregnancy do not tell their husband their status because they fear blame, abandonment or abuse, including physical assault. Women who do disclose their HIV status may face dramatic negative repercussions on their own and their children’s wellbeing. Consequently, it is unfair to test women during pregnancy solely or mainly to help prevent perinatal transmission if there are no available support services to protect the women’s rights, enable them to live healthily after an HIV-positive diagnosis and engage them in the policies and programmes that affect women’s lives. We need to create a climate that encourages HIV testing before pregnancy so that women can make informed reproductive choices. Men must be brought into the testing process through couple counselling before pregnancy and scaling up of voluntary counselling and testing programmes outside the antenatal care setting. In addition, people living with HIV have unique expertise and are very effective as peer counsellors. They have been under-utilised in the health care sector to provide support to newly-diagnosed people and to help eliminate AIDS-related shame and stigma.

scholarly journals Disclosure of HIV seropositivity to sexual partner in Ethiopia: A systematic review

2021 ◽  
Vol 17 ◽  
pp. 174550652110630
Author(s):  
Aklilu Endalamaw ◽  
Yibeltal Assefa ◽  
Demeke Geremew ◽  
Habte Belete ◽  
Berihun Assefa Dachew ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Sexual Partners ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Hiv Status ◽  
Living With Hiv ◽  
Status Disclosure ◽  
The Impact

Introduction: In Ethiopia, the burden of HIV/AIDS is a public health issue that requires significant control of transmission. Once an infection has been established, determinants influence people living with HIV to disclose or not their HIV-positive status to sexual partners. This study assessed the proportion and associated factors of people living with HIV’s disclosure status to sexual partners. Methods: CRD42020149092 is the protocol’s registration number in the PROSPERO database. We searched PubMed, Scopus, African Journals Online, and Google Scholar databases. For the subjective and objective assessment of publication bias, we used a funnel plot and Egger’s regression test, respectively. The I2 statistic was used to assess variation across studies. Meta-analysis of weighted inverse variance random-effects model was used to estimate the pooled proportion. We conducted subgroup and sensitivity analyses to investigate the cause of heterogeneity and the impact of outliers on the overall estimation, respectively. A trend analysis was also performed to show the presence of time variation. Results: The percentage of people living with HIV who disclosed their HIV-positive status to sexual partners was 76.03% (95% confidence interval: 68.78, 83.27). Being on antiretroviral therapy (adjusted odds ratio = 6.19; 95% confidence interval: 2.92, 9.49), cohabiting with partner (adjusted odds ratio = 4.48; 95% confidence interval: 1.24, 7.72), receiving HIV counseling (adjusted odds ratio = 3.94; 95% confidence interval: 2.08, 5.80), having discussion prior to HIV testing (adjusted odds ratio = 4.40; 95% confidence interval: 2.11, 6.69), being aware of partner’s HIV status (adjusted odds ratio = 6.08; 95% confidence interval: 3.05, 9.10), positive relationship with partner (adjusted odds ratio = 4.44; 95% confidence interval:1.28, 7.61), and being member of HIV association (adjusted odds ratio = 3.70; 95% confidence interval: 2.20, 5.20) had positive association with HIV status disclosure. Conclusion: In Ethiopia, more than one-fourth of adults living with HIV did not disclose their HIV-positive status to sexual partners. HIV-positive status disclosure was influenced by psychosocial factors. A multidimensional approach is required to increase seropositive disclosure in Ethiopia.

scholarly journals Accuracy of self-reported HIV testing history and awareness of HIV-positive status among people living with HIV in four Sub-Saharan African countries

AIDS ◽  
2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Yiqing Xia ◽  
Rachael M. Milwid ◽  
Arnaud Godin ◽  
Marie-Claude Boily ◽  
Leigh F. Johnson ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
African Countries ◽  
Sub Saharan ◽  
Living With Hiv

scholarly journals The Impact of Migration on HIV Infection Situation (Analytical Review)

2019 ◽  
Vol 74 (2) ◽  
pp. 88-97
Author(s):  
Anastasia V. Pokrovskaya ◽  
Valeriy V. Yumaguzin ◽  
Dmitry E. Kireev ◽  
Maria V. Vinnik ◽  
Vadim V. Pokrovskiy
Keyword(s):  
Hiv Infection ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Negative Effects ◽  
State Budget ◽  
Global Epidemic ◽  
Legal Norms ◽  
The World ◽  
Living With Hiv ◽  
The Impact

Today, the unstable political and economic situation in the world has led to an intensified migration and changes in their directions. The legal norms regarding the status of migrants, including people living with HIV, are also changing. Over the past 10 years laws restricting the entry and residence of HIV-infected foreign citizens have been repealed in many countries, but in Russia the deportation and prohibition of long-term stay of HIV positive international migrants are still in effect. This review presents the main aspects of the impact of migration on the spread of HIV in the world and Russia, as well as the possible positive and negative effects of decriminalization of migrants living with HIV in terms of epidemic situation, socio-demographic and economic processes. The argument for retaining the deportation is due to the potential risk of the spread of the disease by foreigners and the unresolved organization of medical care and treatment of HIV infection for foreign migrants, which are provided for Russian citizens from the state budget. On the other hand, the deportation law touches upon ethical aspects, violating freedom of movement, the right to privacy and freedom from discrimination. Despite the presence or absence of restrictive measures against HIV-positive migrants, HIV has spread throughout all countries and led to a global epidemic. Prevention of HIV infection among general population of the country, regardless of their migration status, is a priority on the way to stop the spread of infection. 

scholarly journals Improving uptake of prevention of mother-to-child HIV transmission services in Benue State, Nigeria through a faith-based congregational strategy

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0260694
Author(s):  
Michele Montandon ◽  
Timothy Efuntoye ◽  
Ijeoma U. Itanyi ◽  
Chima A. Onoka ◽  
Chukwudi Onwuchekwa ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Hiv Testing ◽  
Hiv Transmission ◽  
Male Partner ◽  
Hiv Positive ◽  
Linkage Data ◽  
Hiv Status ◽  
Faith Based ◽  
Hiv Test ◽  
The Impact

Background Nigeria has low antiretroviral therapy (ART) coverage among HIV-positive pregnant women. In a previous cluster-randomized trial in Nigeria, Baby Shower events resulted in higher HIV testing coverage and linkage of pregnant women to ART; here, we assess outcomes of Baby Shower events in a non-research setting. Methods Baby Shower events, including a prayer ceremony, group education, music, gifting of a “mama pack” with safe delivery supplies, and HIV testing with ART linkage support for HIV-positive pregnant women, were conducted in eighty sites in Benue State, Nigeria. Client questionnaires (including demographics, ANC attendance, and HIV testing history), HIV test results, and reported linkage to ART were analyzed. Descriptive data on HIV testing and ART linkage data for facility-based care at ANC clinics in Benue State were also analyzed for comparison. Results Between July 2016 and October 2017, 10,056 pregnant women and 6,187 male partners participated in Baby Shower events; 61.5% of women attended with a male partner. Nearly half of female participants (n = 4515, 44.9%) were not enrolled in ANC for the current pregnancy, and 22.3% (n = 2,241) of female and 24.8% (n = 1,532) of male participants reported they had never been tested for HIV. Over 99% (n = 16,240) of participants had their HIV status ascertained, with 7.2% of females (n = 724) and 4.0% of males (n = 249) testing HIV-positive, and 2.9% of females (n = 274) and 2.3% of males (n = 138) receiving new HIV-positive diagnoses. The majority of HIV-positive pregnant women (93.0%, 673/724) were linked to ART. By comparison, at health facilities in Benue State during a similar time period, 99.7% of pregnant women had HIV status ascertained, 8.4% had a HIV-positive status, 2.1% were newly diagnosed HIV-positive, and 100% were linked to ART. Conclusion Community-based programs such as the faith-based Baby Shower intervention complement facility-based approaches and can reach individuals who would not otherwise access facility-based care. Future Baby Showers implementation should incorporate enhanced support for ART linkage and retention to maximize the impact of this intervention on vertical HIV transmission.

scholarly journals Accuracy of self-reported HIV testing history and awareness of HIV-positive status among people living with HIV in four Sub-Saharan African countries

2020 ◽  
Author(s):  
Yiqing Xia ◽  
Rachael M. Milwid ◽  
Arnaud Godin ◽  
Mare-Claude Boily ◽  
Leigh F. Johnson ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Latent Class ◽  
Latent Class Models ◽  
Sub Saharan Africa ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Hiv Status ◽  
African Countries ◽  
Sub Saharan ◽  
Living With Hiv

Background: In many countries in Sub-Saharan Africa, self-reported HIV testing history and awareness of HIV-positive status from household surveys are used to estimate the percentage of people living with HIV (PLHIV) who know their HIV status. Despite widespread use, there is limited empirical information on the sensitivity of those self-reports, which can be affected by non-disclosure. Methods: Bayesian latent class models were used to estimate the sensitivity of self-reported HIV testing history and awareness of HIV-positive status in four Population-based HIV Impact Assessment surveys in Eswatini, Malawi, Tanzania, and Zambia. Antiretroviral (ARV) metabolites biomarkers were used to identify persons on treatment who did not accurately report their status. For those without ARV biomarkers, the pooled estimate of non-disclosure among untreated persons was 1.48 higher than those on treatment. Results: Among PLHIV, the sensitivity of self-reported HIV testing history ranged 96% to 99% across surveys. Sensitivity of self-reported awareness of HIV status varied from 91% to 97%. Non-disclosure was generally higher among men and those aged 15-24 years. Adjustments for imperfect sensitivity did not substantially influence estimates of of PLHIV ever tested (difference <4%) but the proportion of PLHIV aware of their HIV-positive status was higher than the unadjusted proportion (difference <8%). Conclusions: Self-reported HIV testing histories in four Eastern and Southern African countries are generally robust although adjustment for non-disclosure increases estimated awareness of status. These findings can contribute to further refinements in methods for monitoring progress along the HIV testing and treatment cascade.

Increasing awareness and prompting HIV testing: Contributions of Amsterdam HIV Testing Week 2016

2018 ◽  
Vol 29 (11) ◽  
pp. 1057-1065 ◽  
Author(s):  
C den Daas ◽  
EM Meddens ◽  
JEAM van Bergen ◽  
GJ de Bree ◽  
AA Hogewoning ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Key Populations ◽  
Raising Awareness ◽  
Western Migration ◽  
Sex With Men ◽  
Living With Hiv ◽  
Anonymous Hiv Testing ◽  
Hiv Negative

We evaluated Amsterdam HIV Testing Week (HTW) 2016 regarding its primary goals of raising awareness and prompting HIV testing. Participating services offered free, anonymous HIV testing, with a focus on reaching men who have sex with men (MSM) and people with a non-western migration background. Sociodemographic characteristics, HIV testing history, intention to test regularly, beliefs about personal risk and severity of HIV, and perceived social norms regarding HIV testing and people living with HIV were assessed among all who tested. A community quick scan assessed awareness of Amsterdam HTW 2016 and attitudes and intentions regarding HIV testing. Of 806 people tested, 59.6% (405/679) belonged to key populations. None tested HIV-positive and 37.6% intended to test regularly in the future. The community quick scan found moderate awareness of Amsterdam HTW 2016. Awareness was highest among recent testers and HIV-positive MSM and not associated with HIV testing attitudes and intentions. People tested during Amsterdam HTW 2016 were from key populations and/or were not (adequately) reached via traditional testing approaches. The contribution of the Amsterdam HTW approach to raising awareness and prompting HIV testing in key populations may benefit from focusing on HIV-negative individuals who have not been tested recently.

scholarly journals To achieve 95-95-95 targets we must reach men and youth: High level of knowledge of HIV status, ART coverage, and viral suppression in the Botswana Combination Prevention Project through universal test and treat approach

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255227
Author(s):  
Refeletswe Lebelonyane ◽  
Pamela Bachanas ◽  
Lisa Block ◽  
Faith Ussery ◽  
Mary Grace Alwano ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Viral Suppression ◽  
Population Level ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Hiv Incidence ◽  
Combination Prevention ◽  
Universal Test And Treat ◽  
Prevention Project ◽  
The Impact

Background Increasing HIV treatment coverage is crucial to reducing population-level HIV incidence. Methods The Botswana Combination Prevention Project (BCPP) was a community randomized trial examining the impact of multiple prevention interventions on population-level HIV incidence and was conducted from October 2013 through June 2017. Home and mobile campaigns offered HIV testing to all individuals ≥ age 16. All identified HIV-positive persons who were not on antiretroviral therapy (ART) were referred to treatment and tracked to determine linkage to care, ART status, retention in treatment, and viral suppression Results Of an estimated total of 14,270 people living with HIV (PLHIV) residing in the 15 intervention communities, BCPP identified 13,328 HIV-positive persons (93%). At study start, 10,703 (80%) of estimated PLHIV knew their status; 2,625 (20%) learned their status during BCPP, a 25% increase with the greatest increases occurring among men (37%) and youth (77%). At study start, 9,258 (65%) of estimated PLHIV were on ART. An additional 3,001 persons started ART through the study. By study end, 12,259 had initiated and were retained on ART, increasing coverage to 93%. A greater increase in ART coverage was achieved among men (40%) compared to women (29%). Of the 11,954 persons who had viral load (VL) test results, 11,687 (98%) were virally suppressed (HIV-1 RNA ≤400 copies/mL). Overall, 82% had documented VL suppression by study end. Conclusions Knowledge of HIV-positive status and ART coverage increased towards 95–95 targets with universal testing, linkage interventions, and ART. The increases in HIV testing and ART use among men and youth were essential to reaching these targets. Clinical trial number NCT01965470.

scholarly journals Monitoring progress towards the first UNAIDS target: understanding the impact of people living with HIV who re-test during HIV-testing campaigns in rural Mozambique

2018 ◽  
Vol 21 (4) ◽  
pp. e25095 ◽  
Author(s):  
Laura Fuente-Soro ◽  
Elisa Lopez-Varela ◽  
Orvalho Augusto ◽  
Charfudin Sacoor ◽  
Ariel Nhacolo ◽  
...  
Keyword(s):  
Hiv Testing ◽  
People Living With Hiv ◽  
Living With Hiv ◽  
The Impact ◽  
Monitoring Progress

The Bio/Necropolitics of ACTG 076: Lessons from Pregnant Women of Colour Living with HIV for Treatment for Prevention in the Twenty-first Century

Somatechnics ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. 233-253
Author(s):  
Eli Manning
Keyword(s):  
Hiv Transmission ◽  
Ethical Dilemmas ◽  
Hiv Treatment ◽  
First Century ◽  
Hiv Positive ◽  
Treatment As Prevention ◽  
People Living With Hiv ◽  
Hiv Positive Women ◽  
Aids Clinical Trials ◽  
Living With Hiv

Since the pharmaceutical turn, using HIV treatment to prevent transmission is increasingly common. Treatment as Prevention®, or TasP, has relied on HIV treatment to prevent HIV transmission, targeting people living with HIV. However, TasP is predicated on troublesome heterosexist, classist, and racist medical practices borrowed from various times and spaces that enact biopolitical and necropolitical relations. This paper discusses the debate surrounding the first clinical trial that used HIV treatment to prevent transmission from woman-to-foetus. The 1994 landmark AIDS Clinical Trials Group 076 study laid the groundwork for using HIV treatment to prevent HIV transmission, the essential precursor to TasP. By examining the concerns of HIV positive women of colour and other AIDS activists, we are able to understand the ethical dilemmas and practical consequences that still haunt today's game-changing uses of HIV treatment for prevention and to see how biopolitics and necropolitics persist in TasP.

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