scholarly journals Examining the effects of HIV self-testing compared to standard HIV testing services in the general population: A systematic review and meta-analysis

2021 ◽  
Vol 38 ◽  
pp. 100991
Author(s):  
Muhammad S. Jamil ◽  
Ingrid Eshun-Wilson ◽  
T. Charles Witzel ◽  
Nandi Siegfried ◽  
Carmen Figueroa ◽  
...  
Keyword(s):  
Systematic Review ◽  
General Population ◽  
Hiv Testing ◽  
Meta Analysis ◽  
Self Testing ◽  
Hiv Testing Services

scholarly journals The effects of HIV self-testing on the uptake of HIV testing, linkage to antiretroviral treatment and social harms among adults in Africa: A systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245498
Author(s):  
Bernard Njau ◽  
Damian J. Damian ◽  
Leila Abdullahi ◽  
Andrew Boulle ◽  
Catherine Mathews
Keyword(s):  
Systematic Review ◽  
Hiv Testing ◽  
Random Effects ◽  
Fixed Effects ◽  
Antiretroviral Treatment ◽  
Meta Analysis ◽  
Hiv Care ◽  
Controlled Trials ◽  
Self Testing ◽  
Hiv Testing Services

Introduction HIV infection is still a global public health problem. More than 75% of HIV-infected people are in Africa, and up to 54% are unaware of their HIV status, limiting access to antiretroviral treatment. Context and purpose of the study This review aimed to determine whether HIV self-testing (HIVST) increases the uptake of testing, the yield of new HIV-positive diagnoses, and the linkage to antiretroviral treatment, and social harms among adults in Africa. Methods PubMed, The Cochrane Central Register of Controlled Trials (CENTRAL), Pan African Clinical Trials Registry, The Cochrane Database of Systematic Reviews (CDSR), Databases of Abstracts of Reviews of Effectiveness (DARE), Social Sciences Citation Index, Web of Science and African Index Medicus databases were searched from 1998 to 2019 (updated in December 2019). Eligible trials employed randomized controlled trials (RCTs), before/after studies, and interrupted time series design comparing HIVST to standard HIV testing services or comparing different approaches to HIVST among adults living in Africa were systematically sought. Results After searching 2,617 citations eleven trials were identified including 59,119 participants from four (4) African countries. Meta-analysis of seven trials showed a significant increase in the uptake of HIVST compared to standard HIV testing services: Both fixed-effects (Rate Ratio (RR) = 2.64, 95% CI: 2.51 to 2.79), and random-effects (RR) = 3.10, 95% CI: 1.80 to 5.37, and a significant increase in the uptake of couples’ HIVST (RR = 2.50, 95% CI: 2.29 to 2.73 in fixed-effects models; and RR = 2.64, 95% CI: 2.01 to 3.49 in random-effects model). A decrease in linkage to care and ART was observed in HIVST compared to standard HIV testing services (RR = 0.88, 95% CI: 0.88 to 0.95 in fixed-effects models; and RR = 0.78, 95% CI: 0. 56 to 1.08 in random-effects models). Six RCTs measured social harms, with a total of ten reported cases related to HIVST. One RCT comparing two approaches to HIVST showed that offering home-based HIVST with optional home-initiation of antiretroviral treatment increased the reporting of a positive HIV test result (RR: 1.86; 95% CI: 1.16 to 2.98), and linkage to antiretroviral treatment (RR: 2.94; 95% CI: 2.10 to 4.12), compared with facility-based linkage to antiretroviral treatment. Conclusions HIVST has the potential to increase the uptake of HIV testing compared to standard HIV testing services. Offering HIVST with optional home initiation of HIV care compared to HIVST with facility-based HIV care increases HIV positivity and linkage to antiretroviral treatment. Reported incidences of intimate partner violence related to HIVST were rare. Future research should focus on the potential of HIVST to reach first-time testers, the effect of using different approaches to HIVST, and strategies for linkage to HIV services. Systematic review registration This systematic review was prospectively registered on the Prospero International Prospective Register of Systematic Review (CRD42015023935).

scholarly journals Examining the effects of HIV self-testing compared to standard HIV testing services: a systematic review and meta-analysis

2017 ◽  
Vol 20 (1) ◽  
pp. 21594 ◽  
Author(s):  
Cheryl C Johnson ◽  
Caitlin Kennedy ◽  
Virginia Fonner ◽  
Nandi Siegfried ◽  
Carmen Figueroa ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hiv Testing ◽  
Meta Analysis ◽  
Self Testing ◽  
Hiv Testing Services

scholarly journals Sexual behaviour change following HIV testing services: a systematic review and meta‐analysis

2020 ◽  
Vol 23 (11) ◽  
Author(s):  
Ruchi Tiwari ◽  
Jiayu Wang ◽  
Hannah Han ◽  
Ngozi Kalu ◽  
Lee B Sims ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hiv Testing ◽  
Behaviour Change ◽  
Sexual Behaviour ◽  
Meta Analysis ◽  
Hiv Testing Services

scholarly journals A systematic review and network meta-analyses to assess the effectiveness of HIV self-testing distribution strategies

2021 ◽  
Author(s):  
Ingrid Eshun-Wilson ◽  
Muhammad S Jamil ◽  
Witzel T. Charles ◽  
Dave V Glidden ◽  
Johnson Cheryl ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hiv Testing ◽  
Meta Analysis ◽  
Sub Saharan Africa ◽  
Web Based ◽  
Standard Testing ◽  
Self Testing ◽  
Testing Uptake ◽  
Sub Saharan ◽  
Meta Analyses

Abstract Background We conducted a systematic review and network meta-analysis to identify which HIV self-testing (HIVST) distribution strategies are most effective. Methods We abstracted data from randomized controlled trials and observational studies published between June 4, 2006 and June 4, 2019. Results We included 33 studies, yielding six HIVST distribution strategies. All distribution strategies increased testing uptake compared to standard testing: in sub-Saharan Africa, partner HIVST distribution ranked highest (78% probability); in North America, Asia and the Pacific regions, web-based distribution ranked highest (93% probability), and facility based distribution ranked second in all settings. Across HIVST distribution strategies HIV positivity and linkage was similar to standard testing. Conclusion A range of HIVST distribution strategies are effective in increasing HIV testing. HIVST distribution by sexual partners, web-based distribution, as well as health facility distribution strategies should be considered for implementation to expand the reach of HIV testing services.

scholarly journals Can self-testing increase HIV testing among men who have sex with men: A systematic review and meta-analysis

PLoS ONE ◽  
2017 ◽  
Vol 12 (11) ◽  
pp. e0188890 ◽  
Author(s):  
Ci Zhang ◽  
Xianhong Li ◽  
Mary-Lynn Brecht ◽  
Deborah Koniak-Griffin
Keyword(s):  
Systematic Review ◽  
Hiv Testing ◽  
Meta Analysis ◽  
Self Testing ◽  
Sex With Men

scholarly journals Drivers and barriers to workplace-based HIV self-testing among high-risk men in Uganda: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Patience A. Muwanguzi ◽  
Robert C. Bollinger ◽  
Stuart C. Ray ◽  
LaRon E. Nelson ◽  
Noah Kiwanuka ◽  
...  
Keyword(s):  
Focus Group ◽  
Hiv Testing ◽  
Private Security ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Private Security Companies ◽  
Self Testing ◽  
Key Informant ◽  
Hiv Testing Services ◽  
Security Companies

Abstract Background Men in Sub-Saharan Africa are less engaged than women in accessing HIV testing and treatment and, consequently, experience higher HIV-related mortality. Reaching men with HIV testing services is challenging, thus, increasing the need for innovative ways to engage men with low access and those at higher risk. In this study, we explore men’s perceptions of drivers and barriers of workplace-based HIV self-testing in Uganda. Methods An exploratory study involving men working in private security companies employing more than 50 men in two districts, in central and western Uganda. Focus group discussions and key informant interviews were conducted. Data were analyzed using inductive content analysis. Results Forty-eight (48) men from eight private security companies participated in 5 focus group discussions and 17 key informant interviews. Of the 48 men, 14(29.2%) were ages 26–35 years. The majority 31(64.6%) were security guards. The drivers reported for workplace-based HIV self-testing included convenience, autonomy, positive influence from work colleagues, the need for alternative access for HIV testing services, incentives, and involvement of employers. The barriers reported were the prohibitive cost of HIV tests, stigma, lack of testing support, the fear of discrimination and isolation, and concerns around decreased work productivity in the event of a reactive self-test. Conclusions We recommend the involvement of employers in workplace-based HIV self-testing to encourage participation by employees. There is need for HIV self-testing support both during and after the testing process. Both employers and employees recommend the use of non-monetary incentives, and regular training about HIV self-testing to increase the uptake and acceptability of HIV testing services at the workplace.

scholarly journals Systematic review and meta-analysis of female lifestyle factors and risk of recurrent pregnancy loss

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ka Ying Bonnie Ng ◽  
George Cherian ◽  
Alexandra J. Kermack ◽  
Sarah Bailey ◽  
Nick Macklon ◽  
...  
Keyword(s):  
Systematic Review ◽  
General Population ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Meta Analysis ◽  
Lifestyle Factors ◽  
Caffeine Intake ◽  
Increased Risk ◽  
Secondary Outcomes

AbstractIt is known that lifestyle factors affect sporadic miscarriage, but the extent of this on RPL (recurrent pregnancy loss) is less well known. A systematic review and meta-analysis was performed to assess the associations between lifestyle factors and RPL. Studies that analysed RPL in the context of BMI, smoking, alcohol and caffeine intake were included. The primary and secondary outcomes were odds of having RPL in the general population and odds of further miscarriage, respectively. Underweight and women with BMI > 25 are at higher odds of RPL in the general population (OR 1.2, 95% CI 1.12–1.28 and OR 1.21, 95% CI 1.06–1.38, respectively). In women with RPL, having BMI > 30 and BMI > 25 has increased odds of further miscarriages (OR 1.77, 95% CI 1.25–2.50 and OR 1.35, 95% CI 1.07–1.72, respectively). The quality of the evidence for our findings was low or very low. Being underweight and BMI > 25 contributes significantly to increased risk of RPL (general population). BMI > 25 or BMI > 30 increases the risk of further miscarriages (RPL population). Larger studies addressing the effects of alcohol, cigarette smoking and caffeine on the risk of RPL with optimisation of BMI in this cohort of women are now needed.

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