scholarly journals SURPRISING RESULTS: HIV TESTING AND CHANGES IN CONTRACEPTIVE PRACTICES AMONG YOUNG WOMEN IN MALAWI

2015 ◽  
Vol 48 (2) ◽  
pp. 174-191 ◽  
Author(s):  
Christie Sennott ◽  
Sara Yeatman
Keyword(s):  
Condom Use ◽  
Hiv Testing ◽  
Fixed Effects ◽  
Population Based ◽  
Hiv Positive ◽  
Unexpected Result ◽  
Hiv Status ◽  
Logistic Regression Models ◽  
New Information ◽  
Hiv Test

SummaryThis study uses eight waves of data from the population-based Tsogolo la Thanzi study (2009–2011) in rural Malawi to examine changes in young women’s contraceptive practices, including the use of condoms, non-barrier contraceptive methods and abstinence, following positive and negative HIV tests. The analysis factors in women’s prior perceptions of their HIV status that may already be shaping their behaviour and separates surprise HIV test results from those that merely confirm what was already believed. Fixed-effects logistic regression models show that HIV testing frequently affects the contraceptive practices of young Malawian women, particularly when the test yields an unexpected result. Specifically, women who are surprised to test HIV positive increase their condom use and are more likely to use condoms consistently. Following an HIV-negative test (whether a surprise or expected), women increase their use of condoms and decrease their use of non-barrier contraceptives; the latter may be due to an increase in abstinence following a surprise negative result. Changes in condom use following HIV testing are robust to the inclusion of potential explanatory mechanisms, including fertility preferences, relationship status and the perception that a partner is HIV positive. The results demonstrate that both positive and negative tests can influence women’s sexual and reproductive behaviours, and emphasize the importance of conceptualizing of HIV testing as offering new information only insofar as results deviate from prior perceptions of HIV status.

Observational study of the populations accessing rapid point-of-care HIV testing in Winnipeg, Manitoba, Canada, through a retrospective chart review of site records

2017 ◽  
Vol 94 (3) ◽  
pp. 194-199 ◽  
Author(s):  
James Blain Johnston ◽  
Joss N Reimer ◽  
John L Wylie ◽  
Jared Bullard
Keyword(s):  
Viral Load ◽  
Hiv Testing ◽  
Clinical Outcomes ◽  
Point Of Care ◽  
Age Groups ◽  
Linkage To Care ◽  
Hiv Positive ◽  
Hiv Status ◽  
Viral Load Suppression ◽  
Hiv Test

ObjectivesHIV point-of-care testing (POCT) has been available in Manitoba since 2008. This study evaluated the effectiveness of POCT at identifying individuals with previously unknown HIV status, its effects on clinical outcomes and the characteristics of the populations reached.MethodsA retrospective database review was conducted for individuals who received HIV POCT from 2011 to 2014. Time to linkage to care and viral load suppression were compared between individuals who tested positive for HIV using POCT and controls identified as positive through standard screening. Testing outcomes for labouring women with undocumented HIV status accessing POCT during labour were also assessed.Results3204 individuals received POCT (1055 females (32.9%) and 2149 males (67.1%)), being the first recorded HIV test for 2205 (68.8%). Males were more likely to be targeted with POCT as their first recorded HIV test (adjusted OR (AOR) 1.40). Between the two main test sites (Main Street Project (MSP) and Nine Circles Community Health Centre), MSP tested relatively fewer males (AOR 0.79) but a higher proportion of members of all age groups over 30 years old (AOR 1.83, 2.51 and 3.64 for age groups 30–39, 40–49 and >50, respectively). There was no difference in time to linkage to care (p=0.345) or viral load suppression (p=0.405) between the POCT and standard screening cohorts. Of 215 women presenting in labour with unknown HIV status, one was identified as HIV positive.ConclusionsPOCT in Manitoba has been successful at identifying individuals with previously unknown HIV-positive status. Demographic differences between the two main testing sites support that this intervention is reaching unique populations. Given that we observed no significant difference in time to clinical outcomes, it is reasonable to continue using POCT as a targeted intervention.MeSH termsHIV infection; rapid HIV testing; vertical infectious disease transmission; community outreach; service delivery; marginalised populations.

HIV-Positive Out-of-Treatment Drug Users Who are Unaware of Their HIV Status: Predictors of Who Gets Tested and Who Returns for Test Results

2002 ◽  
Vol 32 (4) ◽  
pp. 1017-1032 ◽  
Author(s):  
Shiela M. Strauss ◽  
Sherry Deren ◽  
David M. Rindskopf ◽  
Gregory P. Falkin
Keyword(s):  
Hiv Testing ◽  
Risk Behaviors ◽  
Drug Users ◽  
Hiv Positive ◽  
Test Results ◽  
Hiv Status ◽  
Biological Specimen ◽  
The Past ◽  
Hiv Test ◽  
Using Data

Many HIV positive drug users are unaware that they have the virus, either because they never obtained testing for HIV or because they submitted a biological specimen for testing but never returned to obtain the result of the test. Using data collected from a large multi-site sample of out-of-treatment HIV positive drug users (N=1,544), we identify a variety of socio-demographic characteristics and drug use and sexual risk behaviors that differentiate HIV-positive individuals who had obtained HIV testing in the past and those who had not and, among those who had been tested, what differentiates individuals who had returned to obtain their HIV test results and those who had failed to return. Results of the analyses suggest that there is a need to target different subgroups of high risk drug users for interventions to obtain HIV testing as compared with those that need encouragement to obtain the results of this testing.

scholarly journals ‘It is not fashionable to suffer nowadays’: Community motivations to repeatedly participate in outreach HIV testing indicate UHC potential in Tanzania

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261408
Author(s):  
Josien de Klerk ◽  
Arianna Bortolani ◽  
Judith Meta ◽  
Tusajigwe Erio ◽  
Tobias Rinke de Wit ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Ethnographic Study ◽  
Hiv Positive ◽  
Health Coverage ◽  
Hiv Status ◽  
Community Members ◽  
Community Based ◽  
Multidisciplinary Study ◽  
Hiv Test ◽  
Hiv Negative

Objective This study examined people’s motivations for (repeatedly) utilizing HIV testing services during community-based testing events in urban and rural Shinyanga, Tanzania and potential implications for Universal Health Coverage (UHC). Methods As part of a broader multidisciplinary study on the implementation of a HIV Test and Treat model in Shinyanga Region, Tanzania, this ethnographic study focused on community-based testing campaigns organised by the implementing partner. Between April 2018 and December 2019, we conducted structured observations (24), short questionnaires (42) and in-depth interviews with HIV-positive (23) and HIV-negative clients (8). Observations focused on motivations for (re-)testing, and the counselling and testing process. Thematic analysis based on inductive and deductive coding was completed using NVivo software. Results Regular HIV testing was encouraged by counsellors. Most participants in testing campaigns were HIV-negative; 51.1% had tested more than once over their lifetimes. Testing campaigns provided an accessible way to learn one’s HIV status. Motivations for repeat testing included: monitoring personal health to achieve (temporary) reassurance, having low levels of trust toward sexual partners, feeling at risk, seeking proof of (ill)-health, and acting responsibly. Repeat testers also associated testing with a desire to start treatment early to preserve a healthy-looking body, should they prove HIV positive. Conclusions Community-based testing campaigns serve three valuable functions related to HIV prevention and treatment: 1) enable community members to check their HIV status regularly as part of a personalized prevention strategy that reinforces responsible behaviour; 2) identify recently sero-converted clients who would not otherwise be targeted; and 3) engage community with general prevention and care messaging and services. This model could be expanded to include routine management of other (chronic) diseases and provide an entry for scaling up UHC.

scholarly journals Factors Associated with Uptake of HIV Test Results in a Nationally Representative Population-Based AIDS Indicator Survey

2014 ◽  
Vol 8 (1) ◽  
pp. 7-16 ◽  
Author(s):  
Mary Mwangi ◽  
Timothy A. Kellogg ◽  
Sufia S. Dadabhai ◽  
Rebecca Bunnell ◽  
Godfrey Baltazar ◽  
...  
Keyword(s):  
Wealth Quintile ◽  
Population Based ◽  
Test Results ◽  
Hiv Status ◽  
Blood Draw ◽  
Eastern Province ◽  
Logistic Regression Models ◽  
Hiv Test ◽  
Undiagnosed Hiv ◽  
Nationally Representative

Population-based surveys with HIV testing in settings with low testing coverage provide opportunities for participants to learn their HIV status. Survey participants (15-64 years) in a 2007 nationally representative population-based HIV serologic survey in Kenya received a voucher to collect HIV test results at health facilities 6 weeks after blood draw. Logistic regression models were fitted to identify predictors of individual and couple collection of results. Of 15,853 adults consenting to blood draw, 7,222 (46.7%) collected HIV test results (46.5% men, 46.8% women). A third (39.5%) of HIV-infected adults who were unaware of their infection and 48.2% of those who had never been tested learned their HIV status during KAIS. Individual collection of HIV results was associated with older age, with the highest odds among adults aged 60-64 years (adjusted odds ratio [AOR], 1.6, 95% confidence interval [CI] 1.2-2.1); rural residence (AOR 1.8, 95%CI 1.2-2.6); and residence outside Nairobi, with the highest odds in the sparsely populated North Eastern province (AOR 8.0, 95%CI 2.9-21.8). Of 2,685 married/cohabiting couples, 18.5% collected results as a couple. Couples in Eastern province and in the second and middle wealth quintiles were more likely to collect results than those in Nairobi (AOR 3.2, 95%CI 1.1-9.4) and the lowest wealth quintile (second AOR 1.5, 95%CI 1.1-2.3; middle AOR 1.6, 95% CI 1.2-2.3, respectively. Many participants including those living with HIV learned their HIV status in KAIS. Future surveys need to address low uptake of results among youth, urban residents, couples and those with undiagnosed HIV infection.

scholarly journals Improving uptake of prevention of mother-to-child HIV transmission services in Benue State, Nigeria through a faith-based congregational strategy

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0260694
Author(s):  
Michele Montandon ◽  
Timothy Efuntoye ◽  
Ijeoma U. Itanyi ◽  
Chima A. Onoka ◽  
Chukwudi Onwuchekwa ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Hiv Testing ◽  
Hiv Transmission ◽  
Male Partner ◽  
Hiv Positive ◽  
Linkage Data ◽  
Hiv Status ◽  
Faith Based ◽  
Hiv Test ◽  
The Impact

Background Nigeria has low antiretroviral therapy (ART) coverage among HIV-positive pregnant women. In a previous cluster-randomized trial in Nigeria, Baby Shower events resulted in higher HIV testing coverage and linkage of pregnant women to ART; here, we assess outcomes of Baby Shower events in a non-research setting. Methods Baby Shower events, including a prayer ceremony, group education, music, gifting of a “mama pack” with safe delivery supplies, and HIV testing with ART linkage support for HIV-positive pregnant women, were conducted in eighty sites in Benue State, Nigeria. Client questionnaires (including demographics, ANC attendance, and HIV testing history), HIV test results, and reported linkage to ART were analyzed. Descriptive data on HIV testing and ART linkage data for facility-based care at ANC clinics in Benue State were also analyzed for comparison. Results Between July 2016 and October 2017, 10,056 pregnant women and 6,187 male partners participated in Baby Shower events; 61.5% of women attended with a male partner. Nearly half of female participants (n = 4515, 44.9%) were not enrolled in ANC for the current pregnancy, and 22.3% (n = 2,241) of female and 24.8% (n = 1,532) of male participants reported they had never been tested for HIV. Over 99% (n = 16,240) of participants had their HIV status ascertained, with 7.2% of females (n = 724) and 4.0% of males (n = 249) testing HIV-positive, and 2.9% of females (n = 274) and 2.3% of males (n = 138) receiving new HIV-positive diagnoses. The majority of HIV-positive pregnant women (93.0%, 673/724) were linked to ART. By comparison, at health facilities in Benue State during a similar time period, 99.7% of pregnant women had HIV status ascertained, 8.4% had a HIV-positive status, 2.1% were newly diagnosed HIV-positive, and 100% were linked to ART. Conclusion Community-based programs such as the faith-based Baby Shower intervention complement facility-based approaches and can reach individuals who would not otherwise access facility-based care. Future Baby Showers implementation should incorporate enhanced support for ART linkage and retention to maximize the impact of this intervention on vertical HIV transmission.

scholarly journals Learning from Others' HIV Testing: Updating Beliefs and Responding to Risk

2013 ◽  
Vol 103 (3) ◽  
pp. 439-444 ◽  
Author(s):  
Susan Godlonton ◽  
Rebecca L Thornton
Keyword(s):  
Hiv Infection ◽  
Condom Use ◽  
Hiv Testing ◽  
Behavioral Responses ◽  
Hiv Status ◽  
Hiv Test ◽  
Learning From Others ◽  
Hiv Negative ◽  
Hiv Aids

An individual who takes an HIV test can be informed about their own status and risk. Similarly, when friends, family or neighbors learn of a person's HIV status, they may update their beliefs about HIV infection among people they know. Using an experiment conducted in rural Malawi which randomly assigned incentives to learn HIV results, we find that as people in the community learn their HIV results, individuals revise their beliefs downward about deaths attributable to HIV/AIDS. We find corresponding behavioral responses with a significant decrease in condom use and no significant increase in multiple partnerships among those who are HIV-negative.

scholarly journals Low Proportion of Women who came knowing their HIV Status at First Antenatal Care Visit, Uganda, 2012-2016: A Descriptive Analysis of Surveillance Data

2019 ◽  
Author(s):  
Miriam Nakanwagi ◽  
Lilian Bulage ◽  
Benon Kwesiga ◽  
Alex Riolexus Ario ◽  
Doreen Agasha Birungi ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Hiv Testing ◽  
Hiv Care ◽  
Hiv Positive ◽  
Hiv Status ◽  
Antenatal Care Visit ◽  
Care Visit ◽  
Hiv Test ◽  
Significant Difference

Abstract Background HIV testing is the cornerstone for all HIV care and support services, including Prevention of Mother to Child Transmission of HIV (PMTCT). The earlier women of reproductive age know their HIV status, the better informed their reproductive decisions and their infants’ outcomes may be. We analyzed trends in known current HIV status among pregnant women attending their first antenatal care visit (ANC1) in Uganda, 2012-2016. Methods We conducted secondary data analysis using District Health Information Software2 data on all pregnant women who came for ANC1 during 2012-2016. Women who brought documentation with them to ANC1 of an HIV test within the previous four weeks or an HIV care card as evidence of being in HIV care were considered as knowing their HIV status in antenatal care clinics. We calculated proportions of women with known current HIV status at ANC1, and described the linear trends both nationally and regionally. We used improved Poisson regression with generalized linear models to test the statistical significance of the trend. Results There was no significant difference in the number of women that attended ANC1 visits over the years 2012 to 2016. The proportion of women that came with known HIV status was highest at 6.9% in 2016 and this was an increasing trend (p<0.001). Most of the regions had an increase in trend except the West Nile and Mid-Eastern (p<0.001). The proportion of women that came knowing their HIV positive status at ANC1 is slightly higher than that of women that were newly tested HIV positive at ANC1 in 2015 and 2016. Conclusion Although the gap in women that come at ANC1 without knowing their HIV positive status might be reducing, still a large proportion of women who were infected with HIV did not know their status before their ANC1 HIV test, indicating a major public health gap. Therefore, more efforts are still required to achieve full PMTCT. In light of the considerable number that comes not knowing their HIV positive status at ANC1, we recommend advocacy for early ANC attendance and hence HIV testing so that timely PMTCT interventions can be made.

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 Factors associated with unawareness of HIV-positive status in urban Ethiopia: Evidence from the Ethiopia population-based HIV impact assessment 2017-2018

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255163
Author(s):  
Sileshi Lulseged ◽  
Wudinesh Belete ◽  
Jelaludin Ahmed ◽  
Terefe Gelibo ◽  
Habtamu Teklie ◽  
...  
Keyword(s):  
Impact Assessment ◽  
Hiv Testing ◽  
Urban Areas ◽  
Addis Ababa ◽  
Population Based ◽  
Self Report ◽  
Bivariate Analysis ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Hiv Status

Background The HIV epidemic in Ethiopia is concentrated in urban areas. Ethiopia conducted a Population-based HIV Impact Assessment (EPHIA) in urban areas between October 2017 and April 2018 to measure the status of the country’s response to the epidemic. Methods We conducted field data collection and HIV testing in randomly selected households using the national, rapid testing algorithm with laboratory confirmation of seropositive samples using a supplemental assay. In addition to self-report on HIV diagnosis and treatment, all HIV-positive participants were screened for a set of HIV antiretroviral (ARV) drugs indicative of the first- and second-line regimens. We calculated weighted frequencies and 95% confidence intervals to assess regional variation in participants’ level of unawareness of their HIV-positive status (adjusted for ARV status). Results We interviewed 20,170 survey participants 15–64 years of age, of which 19,136 (95%) were tested for HIV, 614 (3.2%) tested positive, and 119 (21%) of HIV-positive persons were unaware of their HIV status. Progress towards the UNAIDS first 90 target (90% of people living with HIV would be aware of their HIV status by 2020) substantially differed by administrative region of the country. In the bivariate analysis using log binomial regression, three regions (Oromia, Addis Ababa, and Harari), male gender, and young age (15–24 years) were significantly associated with awareness of HIV positive status. In multivariate analysis, the same variables were associated with awareness of HIV-positive status. Conclusion One-fifth of the HIV-positive urban population were unaware of their HIV-positive status. The number of unaware HIV-positive individuals has a different distribution than the HIV prevalence. National and regional planning and monitoring activities could address this potentially substantial source of undetected HIV infection by increasing HIV testing among young people, men and individuals who do not use condoms.

Correlates of HIV-Positive Fathers’ Involvement in Prevention of Motherto- child Transmission Programs in Northern Nigeria

2020 ◽  
Vol 18 (6) ◽  
pp. 443-457
Author(s):  
Zubairu Iliyasu ◽  
Hadiza S. Galadanci ◽  
Bashir Muhammad ◽  
Fatima Z. Yadudu ◽  
Aminatu A. Kwaku ◽  
...  
Keyword(s):  
Condom Use ◽  
Hiv Transmission ◽  
Male Partner ◽  
Tertiary Hospital ◽  
Consistent Condom ◽  
Hiv Positive ◽  
Northern Nigeria ◽  
Male Partners ◽  
Logistic Regression Models ◽  
Paternal Education

Background: The involvement of men in the prevention of mother-to-child HIV transmission (PMTCT) programs could accelerate the elimination of vertical transmission. Yet, little research has focused on HIV-positive male partners. This study determined predictors of male partners’ PMTCT knowledge and involvement in a tertiary hospital in northern Nigeria. Methods: A clinic-based sample of 401 HIV-positive male partners of women who delivered within 12 months prior were interviewed using structured questionnaires. PMTCT knowledge and involvement scores were computed. Adjusted odd ratios (AOR) for predictors were derived from multivariate logistic regression models. Results: The proportion of respondents with adequate PMTCT knowledge was 40.9%. Less than half (43.6%) of the respondents participated in PMTCT, with median involvement score of 2.00 (interquartile range, IQR = 0, 5.0). One quarter of respondents (25.7%, n =103) reported >1 sex partners, 10.5% consistently used condoms, and 20.7% had disclosed to all partners. Father’s involvement in PMTCT was predicted by paternal education (AOR = 0.30; 95% Confidence Interval (CI): 0.12-0.77, no formal vs. post-secondary), HIV-positive child (AOR = 3.85; 95%CI: 1.41-10.54, yes vs. no), treatment duration (AOR = 4.17; 95%CI: 1.67-10.41, ≤1 vs. ≥10 years), disclosure to partner(s) (AOR = 1.21; 95%CI: 1.15-3.52, ‘disclosed to all’ vs. ‘not disclosed’), condom use (AOR = 5.81; 95%CI: 3.07-11.0, always vs. never), and PMTCT knowledge (AOR = 0.62; 95%CI: 0.31-0.92, inadequate versus adequate). Conclusion: The involvement of fathers in HIV PMTCT programs was low and predicted by paternal education, HIVpositive child, duration of antiretroviral treatment, disclosure to partner, consistent condom use, and level of PMTCT knowledge. Our findings will inform the development of policies to increase male partner involvement in PMTCT in Nigeria.

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