scholarly journals HIV post-test practices: an online survey examining perceived delivery of HIV test results, post-test discussion and referral in healthcare settings across the WHO European Region

Sexual Health ◽  
2016 ◽  
Vol 13 (3) ◽  
pp. 205 ◽  
Author(s):  
Stephen Bell ◽  
Jordi Casabona ◽  
Nino Tsereteli ◽  
Dorthe Raben ◽  
John de Wit
Keyword(s):  
Hiv Testing ◽  
Positive Test ◽  
European Region ◽  
Hiv Positive ◽  
Test Results ◽  
Negative Test ◽  
Hiv Test ◽  
Post Test ◽  
Test Result ◽  
Hiv Negative

Background The aim of this study was to assess perceptions of health professionals involved in HIV testing policy and practice in national settings across the WHO European Region regarding the delivery of HIV test results, post-test discussion and referral to specialist HIV services as recommended in authoritative guidelines. Methods: An online self-report survey was completed by a convenience sample of 338 respondents (response rate 34.1%) from 55 countries. Respondents worked with non-government organisations (49.4%), health services (32.8%), non-health service government agencies (6.2%) or other organisations (11.5%; e.g. prisons, education and research, international development). Results: Experts’ perceptions indicate that delivery of HIV-positive test results and related post-test discussion in their country generally corresponded to recommendations. However, results pointed to a significant gap perceived by experts between recommendations and the practice of delivering HIV-negative test results. Fewer respondents thought that suitable time is taken to deliver a negative HIV-test result (54.1%) than a positive result (73.1%). Also, fewer respondents thought there was a procedure for referral to specialist treatment, care and support services for people receiving a HIV-negative test result (34.9%) than for people receiving an HIV-positive test result (86.2%). Experts also reported low perceived use of communication technologies (i.e. telephone, email, text messaging, a secure website) for delivering HIV test results. Conclusions: This expert survey offers new insight into perceived HIV post-test practices in almost all national settings across the WHO European Region. The findings provide valuable guidance for future HIV testing guidelines for the WHO European Region.

scholarly journals Predictive Factors for Positive HIV Test Results in a Hospital Setting

2021 ◽  
Vol 16 (3) ◽  
Author(s):  
Sulmaz Ghahramani ◽  
Hassan Joulaei ◽  
Amir Human Hoveidaei ◽  
Mohammad Reza Rajabi ◽  
Kamran Bagheri Lankarani
Keyword(s):  
Risk Factors ◽  
Hospital Admission ◽  
Hiv Testing ◽  
General Hospital ◽  
Hospital Setting ◽  
Hiv Positive ◽  
Control Group ◽  
Test Results ◽  
Hiv Test ◽  
Test Result

Background: Hospital admission for any reason provides the situation for voluntary HIV testing and consultation. Identifying the predictors of positivity may lead to a cost-effective method while enhancing professionalism. Objectives: To find the predictors of HIV-positive test result in a general hospital in Shiraz compared to a control group. Methods: In this case-control study, the records of all patients who received HIV testing upon their hospitalization in a general hospital in Shiraz, south of Iran, from January 2017 to the end of December 2017 were reviewed. For each HIV-positive case, at least one control from the same ward in the hospital with negative HIV test result was randomly selected. Based on the best-fitted model of logistic regression, the probability of positive HIV test results was estimated for each participant according to the risk factors, and a receiver operating characteristic (ROC) curve was drawn. Results: Out of 7333 persons who accepted to be tested, 77 patients tested positive for HIV, of whom 55 (71.4%) were male with the mean age of 41.5 ± 9.5 years. None of the HIV-positive patients were intravenous drug users, nor had they a history of imprisonment. The odds ratio (OR) was 21 for hepatitis-positive patients (hepatitis B and/or C) compared to negative ones, which was seven times higher in opium addicts than non-opium addicts. We developed a model using age, sex, opium addiction, and HBV and HCV status to predict the probability of being positive for HIV with an AUC of 0.853 (95% confidence interval 0.797 to 0.909). Conclusions: Hospital admission could be an appropriate momentum for providing voluntary counseling and testing. Infection with HBV and HCV are important risk factors for HIV infection, and additional testing should be offered, especially to these patients.

Correlates of perceived difficulty in potentially disclosing HIV-positive test results: a study of low-income women attending an urban clinic

Sexual Health ◽  
2005 ◽  
Vol 2 (2) ◽  
pp. 103 ◽  
Author(s):  
Richard Crosby ◽  
Elizabeth A. Bonney ◽  
Lydia Odenat
Keyword(s):  
Hiv Testing ◽  
African American Women ◽  
Low Income ◽  
Contextual Factors ◽  
Urgent Care ◽  
Positive Test ◽  
Hiv Positive ◽  
Test Results ◽  
Intrapersonal Factors ◽  
Hiv Test

Background: The study identified correlates of women’s perception that testing positive for HIV would be very difficult to communicate to friends, family members and sex partners. We also determined whether perceived disclosure difficulty was associated with HIV-testing intent. Methods: Face-to-face interviews were conducted with 143 women attending an urgent care centre in Atlanta, Georgia. The centre served primarily low-income or indigent African–American women. A three-item scale (α = 0.81) assessed disclosure difficulty. Assessed correlates included selected social/contextual factors and intrapersonal factors. Results: In controlled multivariate analyses, only the social/contextual factors were associated with HIV disclosure difficulty. Women perceiving an inability to cope with positive results were more likely to report high disclosure difficulty (P = 0.01). Women perceiving an inadequate support system and those believing that HIV would substantially complicate their lives were more likely to anticipate high disclosure difficulty (P = 0.006 and P = 0.03, respectively). Disclosure difficulty was not associated with intent for HIV-testing ‘today’ (P = 0.50) or within the next 12 months (P = 0.27). Conclusion: Findings provide initial evidence suggesting that selected social/contextual factors rather than intrapersonal factors are associated with anticipated disclosure difficulty of HIV-positive test results among low-income minority women, residing in the urban south. High levels of anticipated disclosure difficulty may not preclude HIV test acceptance.

Sexually transmitted disease rates before and after HIV testing

1998 ◽  
Vol 9 (5) ◽  
pp. 291-293 ◽  
Author(s):  
Nigel George ◽  
John Green ◽  
Siobhan Murphy
Keyword(s):  
Hiv Testing ◽  
Sexually Transmitted Disease ◽  
Transmitted Disease ◽  
Hiv Positive ◽  
Negative Test ◽  
Negative Test Result ◽  
Sexually Transmitted ◽  
Hiv Test ◽  
Before And After ◽  
Test Result

Summary: The aim of the study was to evaluate the effect of having an HIV-positive or negative test result on sexual risk behaviour before and after the test. Longitudinal retrospective case-note survey identifying new episodes of sexually transmitted disease (STD) infections in 114 subjects testing HIV positive and 114 matched negatives were examined at the Genitourinary Medicine Department, St Mary's Hospital, Paddington, London. Across the whole sample in the year after HIV testing the number of cases of new STD infections was 40% of the number of cases in the year prior to HIV testing. There was no association between serostatus and incidence of STD infections before and after HIV testing. Of those testing negative, 5.3% were identified as having a new infection in the year after the HIV test, while amongst those testing positive there was a rate of new STDs of 2.6%. In conclusion, there was no evidence that having a negative test result increased the risk of acquisition of new STDs. Rates of new STD infections amongst seropositives in the year after HIV testing were low.

scholarly journals HIV pre-test practices: an online survey examining perceptions of informed consent and pre-test information delivery in health care settings across the WHO European Region

2016 ◽  
Vol 28 (6) ◽  
pp. 558-563 ◽  
Author(s):  
Stephen Bell ◽  
Jordi Casabona ◽  
Nino Tsereteli ◽  
Dorthe Raben ◽  
John de Wit
Keyword(s):  
Informed Consent ◽  
Hiv Testing ◽  
Positive Test ◽  
European Region ◽  
Positive Test Result ◽  
Test Information ◽  
Social Risks ◽  
Hiv Test ◽  
Written Informed Consent ◽  
Test Result

The objective of this study was to gather health professionals’ perceptions about gaining informed consent and delivering HIV pre-test information. An online self-report survey was completed by 338 respondents involved in HIV testing in 55 countries in the WHO European Region. Nearly two thirds (61.5%) of respondents thought that HIV testing guidelines used in their country of work included recommendations about pre-test information; 83% thought they included recommendations regarding obtaining informed consent. One third (34%) of respondents thought that written informed consent was required; respondents from Eastern Europe and Central Asia were more likely to perceive this as required. Respondents from Western Europe thought pre-test information about the following aspects was significantly less likely to be addressed than respondents in other regions: the right to decline a test; services available after a positive test; laws/regulations impacting someone being tested and receiving a positive test result; potential risks for a client taking an HIV test; the possible need for partner notification after a positive test result. Results offer insight into perceived HIV pre-test practices in all but two national settings across the WHO European Region, and can be used in the development and evaluation of future HIV testing guidelines in the WHO European Region. Findings highlight that practices of obtaining written informed consent depart from current guidelines in some HIV testing settings. Furthermore, findings underscore that it is uncommon for pre-test information to address legal and social risks and harms that people testing HIV-positive may incur. This differs from the most recent global WHO guidelines emphasising the importance of such information, and raises important questions regarding the implications and appropriateness of the currently dominant focus of recommendations on streamlining the HIV testing process.

scholarly journals Repeat HIV testing of individuals with discrepant HIV self-test results in Central Uganda

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Rose Kisa ◽  
Joseph K. B. Matovu ◽  
Esther Buregyeya ◽  
William Musoke ◽  
Caroline J. Vrana-Diaz ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Hiv Positive ◽  
Test Results ◽  
Hiv Status ◽  
Weak Band ◽  
Rapid Hiv Testing ◽  
Hiv Test ◽  
Self Test ◽  
Dna Pcr ◽  
Hiv Negative

Abstract Background According to the user instructions from the manufacturer of OraQuick HIV self-test (HIVST) kits, individuals whose kits show one red band should be considered to be HIV-negative, no matter how weak the band is. However, recent reports show potential for a second false weak band after storage, thereby creating confusion in the interpretation of results. In this study, we re-tested individuals whose results were initially non-reactive but changed to weak reactive results to determine their true HIV status. Methods This study was nested within a large, cluster-randomized HIVST trial implemented among pregnant women attending antenatal care and their male partners in central Uganda between July 2016 and February 2017. Ninety-five initially HIV-negative respondents were enrolled into this study, including 52 whose kits developed a second weak band while in storage and 43 whose kits were interpreted as HIV-positive by interviewers at the next follow-up interview. Respondents were invited to return for repeat HIVST which was performed under the observation of a trained nurse counsellor. After HIVST, respondents underwent blood-based rapid HIV testing as per the national HIV testing algorithm (Determine (Abbot Laboratories), STAT-PAK (Chembio Diagnostic Systems Inc.) and Unigold (Trinity Biotech plc.) and dry blood spots were obtained for DNA/PCR testing. DNA/PCR was considered as the gold-standard HIV testing method. Results After repeat HIVST, 90 (94.7%) tested HIV-negative; 2 (2.1%) tested HIV-positive; and 3 (3.2%) had missing HIV test results. When respondents were subjected to blood-based rapid HIV testing, 97.9% (93/95) tested HIV-negative while 2.1% (2/95) tested HIV-positive. Finally, when the respondents were subjected to DNA/PCR, 99% (94/95) tested HIV-negative while 1.1% (1/95) tested HIV-positive. Conclusions Nearly all initially HIV-negative individuals whose HIVST kits developed a second weak band while in storage or were interpreted as HIV-positive by interviewers were found to be HIV-negative after confirmatory DNA/PCR HIV testing. These findings suggest a need for HIV-negative individuals whose HIVST results change to false positive while under storage or under other sub-optimal conditions to be provided with an option for repeat testing to determine their true HIV status.

scholarly journals Return of test results in Vietnam HIV sentinel surveillance: Implementation and preliminary results

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Giang T. Le ◽  
Duc H. Bui ◽  
Diep T. Vu ◽  
Duong C. Thanh ◽  
Nghia V. Khuu ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Sentinel Surveillance ◽  
Confirmatory Test ◽  
Hiv Positive ◽  
Test Results ◽  
Hiv Surveillance ◽  
Hiv Test ◽  
Hiv Serostatus ◽  
To Receive ◽  
Test Result

ObjectiveTo describe the implementation and preliminary results of returning HIV test results to participants in Vietnam HIV sentinel surveillance.IntroductionKnowledge of one’s HIV serostatus helps improve quality of life for those who test positive and decreases the risk of HIV transmission. WHO recommends that all participants in HIV prevalence surveys be provided access to their test results, especially those who test HIV positive [1]. Anonymous Vietnam HIV sentinel surveillance (HSS), implemented since 1994, focuses on people who inject drugs (PWID), female sex workers (FSW), and men who have sex with men (MSM) [2]. According to national guidelines, the HIV testing algorithm for surveillance purposes was based on two tests whereas the diagnostic algorithm for individuals was based on three tests. Thus, surveillance test results could not be returned to participants [3] who were instead encouraged to learn their HIV serostatus by testing at public confirmatory testing sites.In 2015, a three-test strategy was applied as part of HSS so that test results could be returned to participants.MethodsIn 2015, return of HIV test results was implemented as a pilot in 16 HSS provinces. HSS participants were asked to identify which of the designated HIV testing and counselling centers (HTC) in the province was most convenient for them. Participants were then given appointment cards with an assigned survey ID to receive their test results at the chosen venue at a specific date and time. Specimens, with assigned survey IDs, were transferred to the respective HIV laboratory at the Province AIDS Center (PAC) for confirmatory testing. The same three-test algorithm was used for surveillance purposes as well as to return confirmatory test results to participants [3]. Final test results were classified as “positive”, “negative” or “indeterminate”. HIV confirmatory test results were made available at all designated HTC in the provinces within 10 days after blood collection; thus, if a participant presented at a location, date or time that differed from the appointment card, s/he could still receive the test result. In some settings in which provinces integrated HSS with either static or mobile HTC, three rapid tests were used at point-of-care so that same-day test results were available. In this case, participants received test results at the end of the specified time regardless of their infection status.At the HTC, individuals showed their appointment cards. The IDs were used to identify the correct test results which were then given verbally to participants by HTC counsellors. Test results were not returned by phone or email. Individuals who tested positive were immediately referred to HIV treatment and other available health/social services in the province.The proportion of participants who received their test results was calculated for each survey group and province.ResultsThe number of provinces that reported returning of HIV test results in 2015 and 2016 were 14 and 15, respectively. Overall, among 15,530 persons tested through HSS in 2015 and 2016, 7,354 persons returned to receive their test results. The proportion of participants who returned for test results varied by province and survey population (table 1). In some provinces where HSS was integrated with HTC, such as Hai Phong and Dong Thap, 100% of participants received their test results within a day [4].ConclusionsReturning HIV test results to HIV surveillance participants is feasible and beneficial in low-income countries like Vietnam. This enhancement facilitates participants learning their serostatus and contributes toward Vietnam’s achievement of HIV control [4]. Based on the pilot experiences, Vietnam Ministry of Health decided to extend test result notifications to all 20 HSS provinces in 2017.Key factors that contributed to the success of the activity were fast turnaround time, roles and level of commitment of PAC, and coordination between the survey and HTC. The returning rate in HSS 2015 and 2016 are promising but these could be improved further. Better coordination and commitment between the survey and HIV testing service are needed to further increase return rates so that HIV-positive individuals can learn their serostatus and be better linked to care and treatment services.References1. WHO, Guidelines for second generation HIV surveillance: An update: Know your epidemic, 2013.2. VAAC, Guidance for epidemiological surveillance of HIV/AIDS & sexually transmitted infections, 2012.3. MOH, National guideline on HIV serology testing, in Decision 1098/QD-BYT, 2013.4. VAAC, Primarily results of HSS, 2016. 

Barriers to contraception among HIV-positive women in a periurban district of Uganda

2012 ◽  
Vol 23 (9) ◽  
pp. 661-666 ◽  
Author(s):  
A K Mbonye ◽  
K S Hansen ◽  
F Wamono ◽  
P Magnussen
Keyword(s):  
Hiv Testing ◽  
Household Survey ◽  
Hiv Positive ◽  
Care Seeking ◽  
Test Results ◽  
Group Discussions ◽  
Effective Interventions ◽  
Hiv Positive Women ◽  
Hiv Test ◽  
Negative Perceptions

This study explored perceptions and care-seeking practices for HIV testing and contraception in order to obtain data for designing effective interventions to increase contraception among HIV-positive women. A triangulation of methods (household survey, focus group discussions and key informant interviews) were conducted in Wakiso district, central Uganda from January to April 2009. Results show that a majority of women, 2062/2896 (71.2%) would like to have an HIV test, while access to antiretroviral therapy (ART) was low at 237/879 (27%). Of the women who were on ART, 133/266 (50.0%) could not use contraception due to negative perceptions that a combination of ART and contraceptives would weaken them, as these drugs were perceived to be ‘strong’. Fear of side-effects for contraceptives and resistance from spouses were other main reasons. Constraints to HIV testing included fear of clients knowing their own HIV status and fear of their spouses’ reactions to the test results. Private midwives were identified as a potential outlet for delivering contraception to HIV-positive women.

scholarly journals Utilization of HIV Testing and Counselling Services By Women With Disabilities During Antenatal Care in Uganda: Analysis of 2016 Demographic and Health Survey

2021 ◽  
Author(s):  
Hussaini Zandam ◽  
Ilhom Akobirshoev ◽  
Allyala Nandakumar ◽  
Monika Mitra
Keyword(s):  
Antenatal Care ◽  
Hiv Testing ◽  
Health Survey ◽  
Women With Disabilities ◽  
Counselling Services ◽  
Hiv Test ◽  
Post Test ◽  
Hiv Testing And Counselling ◽  
To Receive ◽  
Test Result

Abstract Background: HIV testing and counselling during antenatal care (ANC) is critical for eliminating mother-to-child transmission of HIV. We investigated disparity in utilization of HIV testing and counselling services (HTC) between women with and without disabilities in Uganda.Methods: We conducted a retrospective study using the nationally representative 2016 Uganda Demographic and Health Survey. The study sampled 10,073 women between age 15-49 who had a live birth in the last 5 years. We estimated unadjusted and adjusted odds ratio for receiving pre-test HIV counselling, obtaining an HIV test result, and post-test HIV counselling by disability status using logistic regressions.Results: We found that women with disabilities were less likely to receive pre-test HIV counselling (59.6 vs 52.4), obtain an HIV test result (68.2 vs 61.4), receive post-test HIV counselling (55.5 vs 51.6), and all HTC services (49.2 vs 43.5). From the regression analysis, women with disabilities were less likely to receive pre-test counselling [AOR = 0.83; CI = 0.74, 0.93] and obtain an HIV test result [AOR = 0.88; CI = 0.78, 0.99].Conclusions: Our findings revealed that women with disabilities are less likely to receive HTC service during ANC and highlighted the need for disability-inclusive HIV and reproductive health services. Government, non-governmental organizations, and other stakeholders should consider funding inclusive campaigns and identifying other mechanisms for disseminating health information and behavioral interventions to women with disabilities.

scholarly journals Receipt of infant HIV DNA PCR test results is associated with a reduction in retention of HIV-exposed infants in integrated HIV care and healthcare services: a quantitative sub-study nested within a cluster randomised trial in rural Malawi

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Elasma Milanzi ◽  
Victor Mwapasa ◽  
Jessica Joseph ◽  
Aurelie Jousset ◽  
Timothy Tchereni ◽  
...  
Keyword(s):  
Randomised Trial ◽  
Hiv Positive ◽  
Healthcare Facilities ◽  
Hiv Exposed Infants ◽  
Hiv Test ◽  
Hiv Exposed ◽  
Infant Study ◽  
Test Result ◽  
Hiv Negative

Abstract Background Retention of HIV-infected mothers in integrated HIV and healthcare facilities is effective at reducing mother-to-child-transmission (MTCT) of HIV. In the context of Option B+, we examined maternal and HIV-exposed infant retention across three study arms to 18 months postpartum: mother-and-infant clinics (MIP), MIP with short-messaging service (MIP + SMS) and standard of care (SOC). In particular, we focused on the impact of mothers receiving an infant’s HIV PCR test result on maternal and infant study retention. Methods A quantitative sub-study nested within a cluster randomised trial undertaken between May 2013 and August 2016 across 30 healthcare facilities in rural Malawi enrolling HIV-infected pregnant mothers and HIV-exposed infants on delivery, was performed. Survival probabilities of maternal and HIV-exposed infant study retention was estimated using Kaplan-Meier curves. Associations between mother’s receiving an infant’s HIV test result and in particular, an infant’s HIV-positive result on maternal and infant study retention were modelled using time-varying multivariate Cox regression. Results Four hundred sixty-one, 493, and 396 HIV-infected women and 386, 399, and 300 HIV-exposed infants were enrolled across study arms; MIP, MIP + SMS and SOC, respectively. A total of 47.5% of mothers received their infant’s HIV test results < 5 months postpartum. Receiving an infant’s HIV result by mothers was associated with a 70% increase in infant non-retention in the study compared with not receiving an infant’s result (HR = 1.70; P-value< 0.001). Receiving a HIV-positive result was associated with 3.12 times reduced infant retention compared with a HIV-negative result (P-value< 0.001). Of the infants with a HIV-negative test result, 87% were breastfed at their final study follow-up. Conclusions Receiving an infant’s HIV test result was a driving factor for reduced infant study retention, especially an infant’s HIV-positive test result. As most HIV-negative infants were still breastfed at their last follow-up, this indicates a large proportion of HIV-exposed infants were potentially at future risk of MTCT of HIV via breastfeeding but were unlikely to undergo follow-up HIV testing after breastfeeding cessation. Future studies to identify and address underlying factors associated with infant HIV testing and reduced infant retention could potentially improve infant retention in HIV/healthcare facilities. Trial registration Pan African Clinical Trial Registry: PACTR201312000678196.

Impact of BRCA1/BRCA2 Mutation Testing on Psychologic Distress in a Clinic-Based Sample

2002 ◽  
Vol 20 (2) ◽  
pp. 514-520 ◽  
Author(s):  
Marc D. Schwartz ◽  
Beth N. Peshkin ◽  
Chanita Hughes ◽  
David Main ◽  
Claudine Isaacs ◽  
...  
Keyword(s):  
Genetic Testing ◽  
Perceived Risk ◽  
Brca2 Mutation ◽  
Positive Test ◽  
Test Results ◽  
Brca1 And Brca2 ◽  
Negative Test ◽  
Psychologic Distress ◽  
The Impact ◽  
Test Result

PURPOSE: Despite the increasingly widespread availability of BRCA1 and BRCA2 genetic testing, little is known about the psychologic impact of such testing in the clinical setting. The objective of this study was to examine the long-term psychologic impact of receiving BRCA1/2 test results within a clinic-based testing program. PATIENTS AND METHODS: The participants were 279 high-risk women who underwent genetic counseling and testing for alterations in the BRCA1/2 genes. At baseline (before genetic testing) and at 6 months after the disclosure of mutation status, we measured perceived risk for breast and ovarian cancer, cancer-specific distress, and general distress. We examined the impact of the test result on each of these outcomes at the 6-month follow-up. Analyses were conducted separately for probands and their relatives who were unaffected with cancer. RESULTS: We found no effect of test result among affected probands. Among unaffected relatives, we found that participants who received definitive negative test results exhibited significant reductions in perceived risk and distress compared with participants who received positive test results. Importantly, relatives who received positive test results did not exhibit increased distress or perceived risk. CONCLUSION: These results suggest that clinic-based BRCA1/2 testing can lead to psychologic benefits for individuals who receive negative test results. At 6 months after disclosure, those who receive positive or uninformative test results do not exhibit increased psychologic distress or perceived risk.

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