The impact of stigma, experience, and group referent on HIV risk assessments and HIV testing intentions in Namibia

2006 ◽  
Vol 63 (10) ◽  
pp. 2649-2660 ◽  
Author(s):  
Rachel A. Smith ◽  
Daniel Morrison
Keyword(s):  
Hiv Testing ◽  
Hiv Risk ◽  
Risk Assessments ◽  
The Impact

scholarly journals Substance use and HIV stage at entry into care among people with HIV

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Canada Parrish ◽  
Bridget M. Whitney ◽  
Robin M. Nance ◽  
Nancy Puttkammer ◽  
Paul Fishman ◽  
...  
Keyword(s):  
Substance Use ◽  
Hiv Testing ◽  
Hiv Risk ◽  
Regression Models ◽  
Hiv Care ◽  
Hiv Disease ◽  
Methamphetamine Use ◽  
Early Entry ◽  
Timing Of Entry ◽  
The Impact

Abstract Background Information regarding the impact of substance use on the timing of entry into HIV care is lacking. Better understanding of this relationship can help guide approaches and policies to improve HIV testing and linkage. Methods We examined the effect of specific substances on stage of HIV disease at entry into care in over 5000 persons with HIV (PWH) newly enrolling in care. Substance use was obtained from the AUDIT-C and ASSIST instruments. We examined the association between early entry into care and substance use (high-risk alcohol, methamphetamine, cocaine/crack, illicit opioids, marijuana) using logistic and relative risk regression models adjusting for demographic factors, mental health symptoms and diagnoses, and clinical site. Results We found that current methamphetamine use, past and current cocaine and marijuana use was associated with earlier entry into care compared with individuals who reported no use of these substances. Conclusion Early entry into care among those with substance use suggests that HIV testing may be differentially offered to people with known HIV risk factors, and that individuals with substances use disorders may be more likely to be tested and linked to care due to increased interactions with the healthcare system.

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

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

Applying the risk principle to optimize accuracy and equity in correctional risk assessment: Results From a Simulation

2021 ◽  
pp. 0306624X2098652
Author(s):  
Grant Duwe
Keyword(s):  
Risk Assessment ◽  
Predictive Accuracy ◽  
Ethnic Disparities ◽  
Simulated Data ◽  
Risk Assessments ◽  
Risk Level ◽  
Risk Levels ◽  
Risk Principle ◽  
Changes In Risk ◽  
The Impact

As the use of risk assessments for correctional populations has grown, so has concern that these instruments exacerbate existing racial and ethnic disparities. While much of the attention arising from this concern has focused on how algorithms are designed, relatively little consideration has been given to how risk assessments are used. To this end, the present study tests whether application of the risk principle would help preserve predictive accuracy while, at the same time, mitigate disparities. Using a sample of 9,529 inmates released from Minnesota prisons who had been assessed multiple times during their confinement on a fully-automated risk assessment, this study relies on both actual and simulated data to examine the impact of program assignment decisions on changes in risk level from intake to release. The findings showed that while the risk principle was used in practice to some extent, the simulated results showed that greater adherence to the risk principle would increase reductions in risk levels and minimize the disparities observed at intake. The simulated data further revealed the most favorable outcomes would be achieved by not only applying the risk principle, but also by expanding program capacity for the higher-risk inmates in order to adequately reduce their risk.

scholarly journals 962. Linkage to Care Outcomes among Known HIV-Positive Patients at a High Prevalence Urban Hospital Emergency Department

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S511-S511
Author(s):  
Alexander W Sudyn ◽  
Jeffrey M Paer ◽  
Swetha Kodali ◽  
Samuel Maldonado ◽  
Amesika Nyaku ◽  
...  
Keyword(s):  
Hiv Risk ◽  
Hiv Transmission ◽  
Univariate Analysis ◽  
Linkage To Care ◽  
Retrospective Chart Review ◽  
Retention In Care ◽  
Patient Navigator ◽  
Urban Hospital ◽  
Opt Out ◽  
The Impact

Abstract Background Retention in care of persons with HIV (PWH) is essential for achieving viral suppression and decreasing community transmission. CDC estimates that the 23% of known PWH not retained in care account for 43% of all new transmissions. This study seeks to describe the impact of an opt-out ED screening with navigator-assisted linkage to care (LTC) protocol for out of care PWH. Methods An IRB-approved retrospective chart review was conducted among PWH (prior positive) inadvertently retested in the ED between 2015 and 2018. Univariate and multivariate logistic regression was used to identify factors associated with LTC with patient navigator (PN) support. Factors with p ≤ 0.1 were included in the multivariate analysis as were age and sex at birth. Patients who died were excluded from statistical analyses. Results Among 464 patients who tested positive, 338 (73%) were known positive with 120 (35%) of those out of care at the time of screening. Mean age for this group was 47 (SD 11.9); 57% male, 81% non-Hispanic black, 10% Hispanic, and 6% non-Hispanic white. Fifty-five (46%) patients were successfully LTC, 54 (45%) referred to the state for linkage, and 11 (9%) died. A total of 109 patients were included in the analysis. Univariate analysis was performed for age (F(1, 107) = 0.98, p = 0.324) and female sex at birth (OR = 1.42 [95% CI 0.66, 3.05], p = 0.373) as well as Hispanic race (OR = 3.33 [95% CI 0.84, 13.04], p = 0.085), heterosexual HIV risk (OR = 2.76 [95% CI 1.27, 5.99], p = 0.011), IDU (OR = 0.49 [95% CI 0.21, 1.11], p = 0.088), and other SUD (OR = 0.42 [95% CI 0.19, 0.94], p = 0.035). Only heterosexual HIV risk (OR = 3.01 [95% CI 1.23, 7.32], p = 0.015) maintained significance in the final multivariate model. Conclusion Opt-out ED screening revealed >30% of known positive PWH were out of care at the time of testing; of whom nearly 50% were LTC with PN support. It is possible that persons reporting heterosexual HIV risk may feel less stigmatized and therefore are more likely to LTC. Similarly, the association with SUD, albeit non-significant, may reflect underrepresentation of individuals with SUD in remission among patient navigators. Future opt-out ED screening protocols should build upon diverse care teams to further engage patients with SUD and those at risk for non-heterosexual HIV transmission. Disclosures All Authors: No reported disclosures

scholarly journals Planning prompts to promote uptake of HIV services among men: a randomised trial in rural Uganda

2020 ◽  
Vol 5 (11) ◽  
pp. e003390
Author(s):  
Nolan M Kavanagh ◽  
Elisabeth M Schaffer ◽  
Alex Ndyabakira ◽  
Kara Marson ◽  
Diane V Havlir ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Community Health ◽  
Control Group ◽  
Health Campaign ◽  
Percentage Point Increase ◽  
Percentage Points ◽  
Point Increase ◽  
Cost Planning ◽  
Testing Uptake ◽  
The Impact

IntroductionInterventions informed by behavioural economics, such as planning prompts, have the potential to increase HIV testing at minimal or no cost. Planning prompts have not been previously evaluated for HIV testing uptake. We conducted a randomised clinical trial to evaluate the effectiveness of low-cost planning prompts to promote HIV testing among men.MethodsWe randomised adult men in rural Ugandan parishes to receive a calendar planning prompt that gave them the opportunity to make a plan to get tested for HIV at health campaigns held in their communities. Participants received either a calendar showing the dates when the community health campaign would be held (control group) or a calendar showing the dates and prompting them to select a date and time when they planned to attend (planning prompt group). Participants were not required to select a date and time or to share their selection with study staff. The primary outcome was HIV testing uptake at the community health campaign.ResultsAmong 2362 participants, 1796 (76%) participants tested for HIV. Men who received a planning prompt were 2.2 percentage points more likely to test than the control group, although the difference was not statistically significant (77.1% vs 74.9%; 95% CI –1.2 to 5.7 percentage points, p=0.20). The planning prompt was more effective among men enrolled ≤40 days before the campaigns (3.6 percentage-point increase in testing; 95% CI –2.9 to 10.1, p=0.27) than among men enrolled >40 days before the campaigns (1.8 percentage-point increase; 95% CI –2.3 to 5.8, p=0.39), although the effects within the subgroups were not significant.ConclusionThese findings suggest that planning prompts may be an effective behavioural intervention to promote HIV testing at minimal or no cost. Large-scale studies should further assess the impact and cost-effectiveness of such interventions.

Refining POSSIBLE: A Multicomponent Intervention to Increase HIV Risk Perceptions and PrEP Initiation Among Black Sexual Minority Men (Preprint)

2021 ◽  
Author(s):  
Derek Dangerfield ◽  
Janeane N. Anderson ◽  
Charleen Wylie ◽  
Renata Arrington-Sanders ◽  
Ricky N. Bluthenthal ◽  
...  
Keyword(s):  
Hiv Risk ◽  
Sexual Behaviors ◽  
Sexual Minority ◽  
Risk Perceptions ◽  
Future Research ◽  
Self Monitoring ◽  
Hiv Prevention Intervention ◽  
Sexual Minority Men ◽  
Minority Men ◽  
The Impact

BACKGROUND Increased HIV pre-exposure prophylaxis (PrEP) initiation is urgently needed to substantially decrease the incidence among Black sexual minority men (BSMM). However, BSMM are less likely than other groups to accept a clinician’s recommendation to initiate PrEP and uptake remains suboptimal. Peers and smartphone apps are popular HIV prevention-intervention mechanisms that are typically used independently. Few studies have combined these strategies into a multi-component intervention to increase PrEP initiation for BSMM. OBJECTIVE This study refined an intervention using a smartphone app and a peer change agent (PCA) to increase HIV risk perceptions (HRP) and PrEP initiation among BSMM. METHODS Data were obtained from 12 focus groups and one in-depth interview among BSMM from Baltimore, MD, between October 2019 and May 2020 (N=39). Groups were stratified by age group: 18-24, 25-34, and 35 and older. Facilitators probed on attitudes towards the app, working with a PCA, and preferences for PCA characteristics. RESULTS Most self-identified as homosexual, gay, or same gender-loving (68%), were employed (69%), single (66%), and interested in self-monitoring sexual behaviors (68.4%). Overall, participants had low HRP and suggested that self-monitoring sexual behaviors could trigger internalized stigma. An acceptable PCA should be a “possible self” for BSMM to aspire. CONCLUSIONS Future research should explore the impact of implementing this strategy on HRP and PrEP initiation among BSMM.

scholarly journals The impact of lay counselors on HIV testing rates

AIDS ◽  
2018 ◽  
pp. 1
Author(s):  
Janice Hu ◽  
Pascal Geldsetzer ◽  
Sarah Jane Steele ◽  
Philippa Matthews ◽  
Katrina Ortblad ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Lay Counselors ◽  
The Impact
Sign in / Sign up

Export Citation Format

Share Document