The Impact of HIV Self-Efficacy on Attitudes Toward Routine HIV Testing Among Sexually Active Adolescents

225 Background: HIV is a cancer-associated virus classically associated with KS, NHL, and cervical cancer, but more recently with anal cancer, lung, and head and neck cancers. HIV testing and treatment are important for cancer patients for three reasons: 1) HIV treatment is associated with reduced transmission of a cancer-associated virus. 2) HIV treatment is associated with improved outcomes of cancer therapy in many cancers. 3) HIV testing optimizes quality of care, since testing is recommended by the Centers for Disease Control and Prevention (CDC) and the US Preventive Services Task Force (USPSTF)(A level recommendation) for patients between the ages of 15 and 65 years of age. Since emergency centers (EC’s) commonly provide immunizations and other preventive care, we implemented HIV testing at our cancer center EC. Methods: In our 44 bed cancer center EC with approximately 25,000 annual visits, routine implementation by physician order was implemented in July 2014. EC information technology (IT) assisted in modification of the order sets and facilitated documentation of specific consent for HIV. Educational materials were disseminated to patients and EC providers. A new consent form with integration of HIV consent, including a check box to refuse HIV testing, was implemented on June 19, 2015. Testing results are described through August 2015. Results: HIV testing increased significantly from July 2014 and August 2015. The impact on institutional testing was considerable, increasing from 1.2% of all HIV testing in 2013 to 15.1% to date in 2015. Between July 2014 and August 2015, 1.4% (0.4% incident) of 852 patients screened positive for HIV. Notably, 83% of patients agreed to HIV testing, but less than 20% of patients were actually tested. The highest refusal rate (18.8%) was in patients over age 70 and lowest (9.9%) in those 21-29 years of age. Conclusions: Routine HIV testing is feasible in a comprehensive cancer center ED, but increased awareness is necessary to optimize testing, given the high acceptance rate. Seroprevalence of HIV is comparable to non-cancer center EC’s (0.5-1.2%). These results demonstrate the acceptance by patients of testing for HIV, with implications in reduction of transmission of this cancer-associated virus.

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Correlates of Sexual Risky Behaviours, HIV Testing, and HIV Testing Intention among Sexually Active Youths in Northern Tanzania

East African Health Research Journal ◽

10.24248/eahrj.v5i2.666 ◽

2021 ◽

Vol 5 (2) ◽

pp. 151-158

Author(s):

Bernard Njau ◽

Grace Mhando ◽

Damian Jeremiah ◽

Declare Mushi

Keyword(s):

Hiv Testing ◽

Self Efficacy ◽

Casual Sex ◽

Perceived Barriers ◽

Sexually Active ◽

Social Approval ◽

Testing Procedures ◽

Northern Tanzania ◽

Risky Behaviours ◽

Hiv Testing Services

Background: HIV testing services are important entry-point into the HIV cascade to care and treatment in order to slow down the spread of HIV infection. Over half of all new HIV infections in Sub-Saharan Africa occur among young people under the age of 25, particularly women. The study aimed to determine factors influencing young people’s decision to undergo HIV testing services in Northern Tanzania. Methods: A total of 536 sexually active participants aged 15 to 24 years old completed a semi-structured questionnaire based on the Health Belief Model (HBM) and the Theory of Planned Behaviour (TPB). Results: Males compared to female participants were significantly younger at first age of sexual intercourse (15.4 vs. 16.7 years; p = .001). Out of 536 participants, 418(78%) reported inconsistent condom use, and 203/303(67%) were those practicing casual sex. Only, 189/536(35.3%) of the participants reported to have had an HIV-test. Age, socioeconomic status, perceived HIV severity, attitudes and social approval regarding testing and beliefs about testing procedures and perceived barriers to testing were significant predictors of HIV testing (R2 =.22). Age, unsafe casual sex, perceived severity, HIV-testing attitudes, self-efficacy, social approval, cues for actions and perceived quality of testing procedures were significant and positively related to HIV-testing intentions, while perceived barriers to testing were negatively related (R2 = .36). Conclusion: The integrated constructs of HBM and TPB provides a framework for identifying correlates of HIV testing behaviours and HIV testing intentions among sexually active youths. Future behaviour change interventions should focus on reduction of sexually risky behaviours, increasing perceived HIV severity, enhance positive attitudes and social approvals on testing, reduce misconceptions about testing procedures, alleviation of perceived barriers to testing and improve testing self-efficacy among sexually active youths in this setting.

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Impact of Patient Navigators in Linkage to Care for HIV-Positive Patients in an Urban Emergency Department in Newark, NJ

Open Forum Infectious Diseases ◽

10.1093/ofid/ofx163.1054 ◽

2017 ◽

Vol 4 (suppl_1) ◽

pp. S420-S420

Author(s):

Samuel Maldonado ◽

Gregory Sugalski ◽

Garry Closeil ◽

Shobha Swaminathan

Keyword(s):

Risk Factors ◽

Emergency Department ◽

Hiv Testing ◽

Hiv Risk ◽

Linkage To Care ◽

Patient Navigators ◽

Hiv Test ◽

Routine Hiv Testing ◽

The Impact ◽

White Patients

Abstract Background Despite CDC recommendations, areas with high HIV prevalence have not implemented routine HIV testing, stating among other concerns, inability to effectively link them to care. We implemented a routine HIV testing program in the Emergency Department (ED) at University Hospital in Newark, NJ that had 46,164 visits from July 2015 to November 2016 and looked at the impact of patient navigators (PN) on linkage to care (LTC) rates. Methods This was a retrospective study of all patients newly diagnosed (ND) with HIV or previously positive (PP) but lost to follow-up (LTFU) in select areas of the ED from July 2015 to November 2016. We collected information on demographics, HIV risk factor, and looked at the impact of PN on LTC by comparing months the PN was able to make personal contact compared with months when the PN was unavailable for substantial periods of time. Results A total of 9,511 individuals were screened, and 151 (1.6%) had a positive HIV test; 8 died and 2 were incarcerated. Of the remaining 141, 102 (72%) were LTC. The mean age was 49, 57% Male, 77% Black, 14% Hispanic, and 6% White. The reported HIV risk factors were 67% Heterosexual, 9% MSM, 6% IV drug use (IDU) and 18% Other. Of the patients with a positive HIV test, 60 (43%) were ND and 81 (57%) were PP. Only 52% ND patients were LTC, while 88% PP patients were LTC. Black and Hispanic patients tended to be PP (60% of both groups), while White patients tended to be ND (75% of white patients were ND). The risk factors for ND were 44% Heterosexual, 39% MSM, and 25% IDU. Average LTC while the PN was unavailable decreased from 78% to 56%. There were no demographic differences in the LTC group compared with the LTFU group. IDU had the highest rate of being LTFU at 37% followed by MSM and Heterosexual at approximately 23% each. The primary reason for LTFU was incorrect contact information in the medical record such as wrong address or phone number. PN would make 3 phone calls, send 2 letters and 1 outreach attempt. If all of those failed, the PN notified the state health department. Conclusion PN have a positive impact on LTC even in busy ED settings. Given limitations of staffing a busy ED 24/7, we need to develop strategies to link patients even if the PN is not present. To address this limitation, we plan on looking at the impact of involving medical residents to help with linkage to care after business hours. Disclosures S. Swaminathan, Gilead Sciences: Grant Investigator and Scientific Advisor, Consulting fee and Research grant

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Adolescents and Young Adults: The Pediatrician’s Role in HIV Testing and Pre- and Postexposure HIV Prophylaxis

PEDIATRICS ◽

10.1542/peds.2021-055207 ◽

2021 ◽

Author(s):

Katherine K Hsu ◽

Natella Yurievna Rakhmanina

Keyword(s):

United States ◽

Hiv Testing ◽

Injection Drug Users ◽

Drug Users ◽

The United States ◽

Clinical Report ◽

Hiv Screening ◽

Sexually Active ◽

Routine Hiv Screening ◽

Routine Hiv Testing

Most sexually active youth in the United States do not believe that they are at risk for contracting HIV and have never been tested. Creating safe environments that promote confidentiality and respect, obtaining an accurate sexual and reproductive health assessment, and providing nonstigmatizing risk counseling are key components of any youth encounters. Pediatricians can play a key role in preventing and controlling HIV infection by promoting risk-reduction counseling and offering routine HIV testing and prophylaxis to adolescent and young adult (youth) patients. In light of persistently high numbers of people living with HIV in the United States and documented missed opportunities for HIV testing, the Centers for Disease Control and Prevention and the US Preventive Services Task Force recommend universal and routine HIV screening among US populations, including youth. Recent advances in HIV diagnostics, treatment, and prevention help support this recommendation. This clinical report reviews epidemiological data and recommends that routine HIV screening be offered to all youth 15 years or older, at least once, in health care settings. After initial screening, youth at increased risk, including those who are sexually active, should be rescreened at least annually, and potentially as frequently as every 3 to 6 months if at high risk (male youth reporting male sexual contact, active injection drug users, transgender youth; youth having sexual partners who are HIV-infected, of both genders, or injection drug users; youth exchanging sex for drugs or money; or youth who have had a diagnosis of or have requested testing for other sexually transmitted infections). Youth at substantial risk for HIV acquisition should be routinely offered HIV preexposure prophylaxis, and HIV postexposure prophylaxis is also indicated after high-risk exposures. This clinical report also addresses consent, confidentiality, and coverage issues that pediatricians face in promoting routine HIV testing and HIV prophylaxis for their patients.

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The impact of routine HIV testing on HIV-related stigma and discrimination in Africa

International Journal of Discrimination and the Law ◽

10.1177/1358229111435735 ◽

2011 ◽

Vol 11 (4) ◽

pp. 187-200 ◽

Cited By ~ 2

Author(s):

Ebenezer Durojaye

Keyword(s):

Human Rights ◽

Hiv Testing ◽

Fundamental Rights ◽

Testing Methods ◽

African Countries ◽

Hiv Epidemic ◽

Immunodeficiency Virus ◽

Related Stigma ◽

Routine Hiv Testing ◽

The Impact

This paper discusses different methods of human immunodeficiency virus (HIV) testing, particularly routine and voluntary HIV testing methods, which have been adopted in response to the HIV epidemic in Africa. It then examines the importance of HIV testing as a tool for the prevention and treatment of infected and affected persons. The paper argues that although routine HIV testing is important in scaling up HIV testing in Africa, it may not necessarily address HIV-related stigma as contended by some commentators. Rather, it is argued that routine HIV testing, as practised in many African countries, may fuel HIV-related stigma and violate individuals’ fundamental rights guaranteed in numerous human rights instruments. In conclusion, the paper cautions that any attempt at adopting routine HIV testing in Africa should be tempered with respect for people’s human rights.

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Experience in the USA

International Journal of STD & AIDS ◽

10.1258/ijsa.2008.08s201 ◽

2009 ◽

Vol 20 (1_suppl) ◽

pp. 2-6

Author(s):

K H Mayer

Keyword(s):

Hiv Testing ◽

Hiv Transmission ◽

Cost Effective ◽

The United States ◽

Healthcare Settings ◽

Control And Prevention ◽

The Usa ◽

New Guidelines ◽

Routine Hiv Testing ◽

The Impact

In November 2006, the United States Centers for Disease Control and Prevention updated their recommendations for HIV-testing in healthcare settings in the USA. The new guidelines recommended routine HIV-testing not based on patient risk, opt-out testing, no separate consent for HIV-testing and no requirement for pretest counselling. Three cardinal points underlie the changes: risk-based testing has not identified all HIV-infected individuals in the USA, opportunities for diagnosis and management of HIV are being missed and routine HIV screening is cost-effective. Routine screening for HIV is desirable and should be achievable, but challenges still remain in introducing it in the USA. State-by-State changes in laws have had to be made, the impact on providers and payers must be considered and proactive screening programmes must be supported by faith and cultural leaders in the highly affected communities. Furthermore, non-specialist clinicians must be trained to deal with all aspects of HIV-testing in an appropriate and professional manner. Despite fears that the public would not accept the new approach, many Americans believe that HIV-testing is an appropriate part of a medical check-up. With the public's support, newly diagnosed HIV-infected individuals will benefit from treatment, and society will benefit because of reduced HIV transmission.

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