'I think they might just go to the doctor': qualitatively examining the (un)acceptability of newer HIV testing approaches among Vietnamese-born migrants in greater-Brisbane, Queensland, Australia

Sexual Health ◽  
2021 ◽  
Vol 18 (1) ◽  
pp. 50 ◽  
Author(s):  
Sarah J. Blondell ◽  
Joseph Debattista ◽  
Mark P. Griffin ◽  
Jo Durham
Keyword(s):  
Hiv Testing ◽  
Emotional Support ◽  
Community Setting ◽  
Host Population ◽  
Medical Setting ◽  
Rapid Testing ◽  
Structured Interviews ◽  
Self Testing ◽  
Hiv Rapid Testing ◽  
Hiv Rt

Background In high-income countries (HICs), migrants often have higher rates of late diagnosis of HIV than the host population. Timely HIV testing has significant implications for HIV prevention and management. Newer HIV testing approaches, namely provider-initiated testing and counselling (PITC), HIV rapid testing (HIV RT) and HIV self-testing (HIV ST), aim to reach those populations most at risk and, particularly, those who have not previously tested for HIV. Methods: This study used semi-structured interviews to examine the (un)acceptability, barriers and facilitators to newer HIV testing approaches (i.e. PITC, HIV RT and HIV ST) among Vietnamese-born migrants (n = 10) in greater-Brisbane, Queensland, Australia. Results: Vietnamese-born migrants had mixed perspectives on the (un)acceptability of newer HIV testing approaches. PITC was largely viewed by participants as a facilitator to HIV testing for Vietnamese-born migrants. Likewise, HIV RT (undertaken by a doctor in a medical setting, as opposed to a trained community member in a community setting) was generally considered to facilitate HIV testing. HIV ST was largely not considered acceptable to Vietnamese-born migrants and they would prefer to go to a doctor for HIV testing. Several factors were identified that either facilitate or act as barriers to newer HIV testing approaches, including privacy; cost of (accessing) HIV testing; comfort and convenience; healthcare provider relationship; risk perception; symptoms; and technical and emotional support. Conclusions: There is a need to understand migrants’ HIV testing preferences if poorer HIV-related outcomes are to be overcome. The findings from this study show a preference for doctor-centred HIV testing, due to enhanced privacy, accuracy and support.

scholarly journals Evaluation of Rapid Testing Algorithms for Venue-based Anonymous HIV Testing among Non-HIV-Positive Men Who Have Sex with Men, National HIV Behavioral Surveillance (NHBS), 2017

2020 ◽  
Vol 45 (6) ◽  
pp. 1228-1235
Author(s):  
Shamaya Whitby ◽  
◽  
Amanda Smith ◽  
Rebecca Rossetti ◽  
Johanna Chapin-Bardales ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Confirmatory Test ◽  
Test Results ◽  
Rapid Testing ◽  
Behavioral Surveillance ◽  
National Hiv Behavioral Surveillance ◽  
Hiv Test ◽  
Hiv Rapid Testing ◽  
Testing Algorithms ◽  
Sex With Men

Abstract HIV rapid testing algorithms (RTAs) using any two orthogonal rapid tests (RTs) allow for on-site confirmation of infection. RTs vary in performance characteristics therefore the selection of RTs in an algorithm may affect identification of infection, particularly if acute. National HIV Behavioral Surveillance (NHBS) assessed RTAs among men who have sex with men recruited using anonymous venue-based sampling. Different algorithms were evaluated among participants who self-reported never having received a positive HIV test result prior to the interview. NHBS project areas performed sequential or parallel RTs using whole blood. Participants with at least one reactive RT were offered anonymous linkage to care and provided a dried blood spot (DBS) for testing at CDC. Discordant results (RT-1 reactive/RT-2 non-reactive) were tested at CDC with lab protocols modified for DBS. DBS were also tested for HIV-1 RNA (VL) and antiretroviral (ARV) drug levels. Of 6500 RTAs, 238 were RT-1 reactive; of those, 97.1% (231/238) had concordant results (RT-1/RT-2 reactive) and 2.9% (7/238) had discordant results. Five DBS associated with discordant results were available for confirmation at CDC. Four had non-reactive confirmatory test results that implied RT-1 false reactivity; one had ambiguous confirmatory test results which was non-reactive in further testing. Regardless of order and type of RT used, RTAs demonstrated high concordant results in the population surveyed. Additional laboratory testing on DBS following discordant results confirmed no infection. Implementing RTAs in the context of anonymous venue-based HIV testing could be an option when laboratory follow-up is not practicable.

HIV testing in an urgent-care clinic

Sexual Health ◽  
2005 ◽  
Vol 2 (4) ◽  
pp. 245 ◽  
Author(s):  
Keith Murphy ◽  
Oscar Grusky ◽  
Kathleen Johnston Roberts ◽  
Aimee-Noelle Swanson
Keyword(s):  
Hiv Prevention ◽  
Hiv Testing ◽  
Urgent Care ◽  
Medical Setting ◽  
Structured Interviews ◽  
Care Clinic ◽  
Health Maintenance ◽  
Hiv Test ◽  
Study Results ◽  
Urgent Care Clinic

Background: Early detection of HIV is increasingly important in light of advances in HIV research and treatment. Although treatment advances offer the potential to curtail HIV incidence and seroprevalence, the full benefits remain unrealised because many infected individuals remain unaware of their serostatus. An intensive observational study of HIV testing and counselling was undertaken in a large health maintenance organisation’s urgent-care clinic (UCC) for non-threatening illnesses and non-traumatic injuries in order to better understand the HIV testing process in a medical setting. Methods: Multiple data collection strategies, including observation, semi-structured interviews and document and policy analyses, were used in order to identify key factors influencing HIV testing. The study examined physicians’, nurses’ and physician’s assistants’ relationships with patients in the UCC. Results: It was found that HIV testing in the UCC is highly variable because some patients are asked about their sexual risk histories and given HIV prevention education materials and others are not. Moreover, for those patients who do receive these components of testing, the content of both the risk assessments and HIV prevention counselling varies from patient to patient. Findings also highlight the problematic nature of providing HIV test results in an UCC. Conclusions: A number of implementation issues were found to be relevant to the new US Centers for Disease Control and Prevention (CDC) policy of making HIV testing a routine feature of medical care. The study results suggest the need for organisationally fine-tuned interventions designed to improve the process of testing patients for HIV in medical settings.

scholarly journals Evaluation of antenatal rapid human immunodeficiency virus testing in rural South Africa

2018 ◽  
Vol 19 (1) ◽  
Author(s):  
Tivani P. Mashamba-Thompson ◽  
Pravi Moodley ◽  
Benn Sartorius ◽  
Paul K. Drain
Keyword(s):  
Pregnant Women ◽  
Hiv Testing ◽  
Rapid Test ◽  
Test Results ◽  
Rapid Testing ◽  
Hiv Test ◽  
Hiv Rapid Testing ◽  
Immunodeficiency Virus ◽  
Rapid Tests ◽  
Testing Algorithm

Introduction: South African guidelines recommend two rapid tests for diagnosing human immunodeficiency virus (HIV) using the serial HIV testing algorithm, but the accuracy and compliance to this algorithm is unknown in rural clinics. We evaluated the accuracy of HIV rapid testing and the time to receiving test results among pregnant women in rural KwaZulu-Natal (KZN).Method: We observed the accuracy of rapid HIV testing algorithms for 208 consenting antenatal patients accessing voluntary HIV testing services in nine rural primary healthcare (PHC) clinics in KZN. A PHC-based HIV counsellor obtained finger-prick whole blood from each participant to perform rapid testing using the Advanced Quality™ One Step anti-HIV (1&2) and/or ABON™ HIV 1/2/O Tri-Line HIV test. A research nurse obtained venous blood for an enzyme-linked immunosorbent assay (ELISA) HIV test, which is the gold standard diagnostic test. We recorded the time of receipt of HIV test results for each test.Results: Among 208 pregnant women with a mean age of 26 years, 72 women from nine rural PHC clinics were identified as HIV-positive by two rapid tests with an HIV-prevalence of 35% (95% Bayesian credibility intervals [BCI]: 28% – 41%). Of the 208 patients, 135 patients from six clinics were tested with the serial HIV testing algorithm. The estimated sensitivity and specificity for the 135 participants were 100% (95% confidence interval [CI]: 93% – 100%) and 99% (CI: 95% – 100%), respectively. The positive predictive value and negative predictive value were estimated at 98% (CI: 94% – 100%) and 95% (CI: 88% – 99%), respectively. All women received their HIV rapid test results within 20 min of testing. Test stock-out resulted in poor test availability at point-of-care, preventing performance of a second HIV test in three out of nine PHC clinics in rural KZN.Conclusion: Despite the poor compliance with national guidelines for HIV rapid testing services, HIV rapid test results provided to pregnant women in rural PHC clinics in KZN were generally accurate and timely. Test stock-out was shown to be one of the barriers to test availability in rural PHC clinics, resulting in poor compliance with guidelines. We recommend a compulsory confirmation HIV rapid test for all HIV-negative test results obtained from pregnant patients in rural and resource-limited settings.

HIV test and knowledge of U=U: insights from MSM living in Portugal and participating in EMIS 2017

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J P Costa ◽  
P Meireles ◽  
A Aguiar ◽  
A J Schmidt ◽  
H Barros
Keyword(s):  
Hiv Testing ◽  
Community Setting ◽  
Undetectable Viral Load ◽  
City Size ◽  
Medical Setting ◽  
Logistic Regression Models ◽  
Hiv Test ◽  
Big City ◽  
Hiv Testing And Counselling ◽  
Hiv Negative

Abstract Recently, it became clear that undetectable equals untransmittable (U=U), stressing the importance of engaging in medical care and adhering to antiretroviral therapy. HIV testing and counselling (HTC) are offered in different settings and can be an opportunity to inform people. We aimed to understand if HIV testing history, including recency, place and, result, was associated with U=U knowledge. We used data from 2242 MSM living in Portugal participating in EMIS 2017 that answered if they already knew that “A person with HIV who is on effective treatment (called 'undetectable viral load') cannot pass their virus to someone else during sex”, opting of 5 possible answers, dichotomized in “I already knew” vs. any other option. Regarding HIV testing history, participants were categorized as follows:1. HIV positive; 2. HIV negative and last test ≤12 months in a community setting; 3. HIV negative and last test ≤12 months in a medical setting, and 4. never tested for HIV or last test >12 months or tested in other settings (reference). Logistic regression models were fitted to estimate crude and city size and education-adjusted associations. The median (P25; P75) age of participants was 34 (25; 43) years. No significant statistical association was found with age or current occupation. Those with more years of education and living in a big or very big city were more likely to know that U=U (aOR:1.55; 95%CI:1.20-1.99 and aOR:1.26; 95%CI:1.04-1.53, respectively). Considering HIV testing history and diagnosis, men with diagnosed HIV (aOR:6.33; 95%CI:4.50-8.90), those who had the last test in community setting (aOR:2.44; 95%CI:1.87-3.17) and those who had the last test in a medical setting (aOR: 1.57; 95%CI:1.26-1.95) were more aware of U=U than those not tested in the last 12 months. Our results suggest that there is a gradient of U=U knowledge associated with HIV testing history among MSM. Efforts should focus on improving counselling about U=U at all HIV testing settings. Key messages The knowledge of U=U seems to be associated with the place, recency and result of the last HIV test. Counselling should focus on the best evidence available at all HIV testing settings, to inform and empower the individuals.

scholarly journals Comprehensive approach to HIV/AIDS testing and linkage to treatment among men who have sex with men in Curitiba, Brazil

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0249877
Author(s):  
Marly Marques da Cruz ◽  
Vanda Lúcia Cota ◽  
Nena Lentini ◽  
Trista Bingham ◽  
Gregory Parent ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Statistical Tests ◽  
Hiv Positive ◽  
Cross Sectional ◽  
Self Testing ◽  
Hiv Test ◽  
Test Kit ◽  
Hiv Rapid Testing ◽  
Sex With Men ◽  
Hiv Aids

Introduction The Curitiba (Brazil)-based Project, A Hora é Agora (AHA), evaluated a comprehensive HIV control strategy among men who have sex with men (MSM) aimed at expanding access to HIV rapid testing and linking HIV-positive MSM to health services and treatment. AHA’s approach included rapid HIV Testing Services (HTC) in one mobile testing unit (MTU); a local, gay-led, non-governmental organization (NGO); an existing government-run health facility (COA); and Internet-based HIV self-testing. The objectives of the paper were to compare a) number of MSM tested in each strategy, its positivity and linkage; b) social, demographic and behavioral characteristics of MSM accessing the different HTC and linkage services; and c) the costs of the individual strategies to diagnose and link MSM to services. Methods We used data for 2,681 MSM tested at COA, MTU and NGO from March 2015 to March 2017. This is a cross sectional comparison of the demographics and behavioral factors (age group, race/ethnicity, education, sexually transmitted diseases, knowledge of AHA services and previous HIV test). Absolute frequencies, percentage distributions and confidence intervals for the percentages were used, as well as unilateral statistical tests. Results and discussion AHA performed 2,681 HIV tests among MSM across three in-person strategies: MTU, NGO, and COA; and distributed 4,752 HIV oral fluid tests through the self-testing platform. MTU, NGO and COA reported 365 (13.6%) HIV positive diagnoses among MSM, including 28 users with previous HIV diagnosis or on antiretroviral treatment for HIV. Of these, 89% of MSM were eligible for linkage-to-care services. Linkage support was accepted by 86% of positive MSM, of which 66.7% were linked to services in less than 90 days. The MTU resulted in the lowest cost per MSM tested ($137 per test), followed by self-testing ($247). Conclusions AHA offered MSM access to HTC through innovative strategies operating in alternative sites and schedules. It presented the Curitiba HIV/AIDS community the opportunity to monitor HIV-positive MSM from diagnosis to treatment uptake. Self-testing emerged as a feasible strategy to increase MSM access to HIV-testing through virtual tools and anonymous test kit delivery and pick-up. Cost per test findings in both the MTU and self-testing support expansion to other regions with similar epidemiological contexts.

scholarly journals HIV rapid testing as a key strategy for prevention of mother-to-child transmission in Brazil

2010 ◽  
Vol 44 (5) ◽  
pp. 803-811 ◽  
Author(s):  
Valdiléa G Veloso ◽  
Francisco I Bastos ◽  
Margareth Crisóstomo Portela ◽  
Beatriz Grinsztejn ◽  
Esau Custodio João ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Hiv Testing ◽  
Rio De Janeiro ◽  
Rapid Test ◽  
Rapid Testing ◽  
Child Transmission ◽  
Porto Alegre ◽  
Hiv Rapid Testing ◽  
Maternity Hospitals ◽  
Mother To Child

OBJECTIVE: To assess the feasibility of HIV rapid testing for pregnant women at maternity hospital admission and of subsequent interventions to reduce perinatal HIV transmission. METHODS: Study based on a convenience sample of women unaware of their HIV serostatus when they were admitted to delivery in public maternity hospitals in Rio de Janeiro and Porto Alegre, Brazil, between March 2000 and April 2002. Women were counseled and tested using the Determine HIV1/2 Rapid Test. HIV infection was confirmed using the Brazilian algorithm for HIV infection diagnosis. In utero transmission of HIV was determined using HIV-DNA-PCR. There were performed descriptive analyses of sociodemographic data, number of previous pregnancies and abortions, number of prenatal care visits, timing of HIV testing, HIV rapid test result, neonatal and mother-to-child transmission interventions, by city studied. RESULTS: HIV prevalence in women was 6.5% (N=1,439) in Porto Alegre and 1.3% (N=3.778) in Rio de Janeiro. In Porto Alegre most of women were tested during labor (88.7%), while in Rio de Janeiro most were tested in the postpartum (67.5%). One hundred and forty-four infants were born to 143 HIV-infected women. All newborns but one in each city received at least prophylaxis with oral zidovudine. It was possible to completely avoid newborn exposure to breast milk in 96.8% and 51.1% of the cases in Porto Alegre and Rio de Janeiro, respectively. Injectable intravenous zidovudine was administered during labor to 68.8% and 27.7% newborns in Porto Alegre and Rio de Janeiro, respectively. Among those from whom blood samples were collected within 48 hours of birth, in utero transmission of HIV was confirmed in 4 cases in Rio de Janeiro (4/47) and 6 cases in Porto Alegre (6/79). CONCLUSIONS: The strategy proved feasible in maternity hospitals in Rio de Janeiro and Porto Alegre. Efforts must be taken to maximize HIV testing during labor. There is a need of strong social support to provide this population access to health care services after hospital discharge.

Development of a Community-Based Participatory Research Effort to Evaluate Conventional HIV Testing (CHT) and HIV Rapid Testing (HRT)

2006 ◽  
Vol 5 (3-4) ◽  
pp. 201-219
Author(s):  
Julie Gleason-Comstock ◽  
Alicia Streater ◽  
Cindy Bolden Calhoun ◽  
Harry L. Simpson ◽  
Rosalind Rolack ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Participatory Research ◽  
Research Effort ◽  
Community Based Participatory Research ◽  
Rapid Testing ◽  
Community Based ◽  
Hiv Rapid Testing

Implementation of an HIV Rapid Testing/Linkage to Care Project Among Homeless Individuals

2014 ◽  
Author(s):  
Henry Anaya ◽  
Herschel Knapp ◽  
Magdalena Esquivel ◽  
Sophia F. Rumanes ◽  
Jaimi N. Butler ◽  
...  
Keyword(s):  
Linkage To Care ◽  
Rapid Testing ◽  
Hiv Rapid Testing ◽  
Care Project
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