Confidentiality and disclosure of HIV infection: HIV-positive persons' experience with HIV testing and coping with HIV infection in Latvia

Intravenous drug use is both a common aspect of the pre-imprisonment lifestyles of many American prisoners and a leading risk factor for contracting HIV—the virus that causes AIDS. Moreover, incarcerated inmates frequently engage in behavior that can spread the disease, particularly homosexual activity and intravenous drug use. Correctional officials face increasing pressure to protect inmates and staff from HIV infection, and some have responded by implementing policies requiring all inmates to undergo HIV testing and by housing HIV-positive inmates in separate units. Screening and segregation policies, however, have been challenged on constitutional grounds by HIV-positive prisoners. This article examines the leading constitutional developments in this emerging area of law and finds that most courts so far have been inclined to reject constitutional challenges to mandatory testing and segregation policies. There are enough unsettled issues, however, to warrant expanded appellate review and eventual U.S. Supreme Court resolution of the key constitutional questions.

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Emergencies in HIV-positive patients

Oxford Handbook of Acute Medicine ◽

10.1093/med/9780199230921.003.08 ◽

2010 ◽

pp. 479-505

Author(s):

Punit S. Ramrakha ◽

Kevin P. Moore ◽

Amir Sam

Keyword(s):

Hiv Infection ◽

Hiv Testing ◽

Hiv Positive ◽

Hiv Disease ◽

Primary Hiv Infection ◽

Clinical Indicator ◽

Factors Influencing ◽

Neurological Conditions

Emergency presentations of HIV infection 480 Factors influencing presentation in HIV disease 482 HIV testing 484 Clinical indicator diseases for adult HIV infection 486 Primary HIV infection (PHI) 487 Acute neurological conditions in HIV-positive patients: assessment 488 Acute neurological conditions in HIV-positive patients: investigations 490...

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Fear of HIV Infection and Impact of Training on the Attitudes of Surgical and Emergency Nurses Toward Inpatient HIV Testing

Infection Control and Hospital Epidemiology ◽

10.1086/510804 ◽

2007 ◽

Vol 28 (2) ◽

pp. 230-233 ◽

Cited By ~ 2

Author(s):

Maria Gańczak ◽

Peter Barss

Keyword(s):

Hiv Infection ◽

Hiv Testing ◽

Surgical Patients ◽

Hiv Positive ◽

Emergency Nurses ◽

Immunodeficiency Virus ◽

Acquired Immunodeficiency ◽

Immunodeficiency Syndrome ◽

Testing Policies ◽

Previous Training

This study evaluates the association between the degree of fear of human immunodeficiency virus (HIV) infection and support for different HIV testing policies. A strong fear of acquiring HIV infection at work was widespread among a sample of 601 Polish surgical and emergency nurses. Most favored inappropriate HIV testing of all surgical patients and inpatients. Previous training about HIV and acquired immunodeficiency syndrome (AIDS) and experience caring for HIV-positive patients had a significant impact on reducing support for testing of all inpatients but not for testing of surgical patients.

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A new surveillance system for monitoring HIV infection in Victoria, Australia

Sexual Health ◽

10.1071/sh07011 ◽

2007 ◽

Vol 4 (3) ◽

pp. 195 ◽

Cited By ~ 10

Author(s):

Rebecca Guy ◽

Megan S. C. Lim ◽

Yung-Hsuan J. Wang ◽

Nicholas Medland ◽

Jonathan Anderson ◽

...

Keyword(s):

Hiv Infection ◽

Hiv Testing ◽

Surveillance System ◽

Risk Behaviour ◽

Anal Intercourse ◽

Unprotected Anal Intercourse ◽

Hiv Positive ◽

Sexual Risk Behaviour ◽

Hiv Diagnosis ◽

Hiv Test

Objectives: To establish a new mechanism for monitoring patterns of HIV infection, in the context of a sustained increase in HIV diagnosis among men who have sex with men (MSM) in Victoria. Methods: Between April 2004 and August 2005, a linked voluntary HIV sentinel surveillance system was implemented at five medical clinics with a high case load of MSM. Using a questionnaire, doctors collected HIV testing history, demographic and sexual risk behaviour information from all clients undergoing voluntary HIV testing. Questionnaires were linked with HIV test results. Logistic regression analysis was conducted to determine factors associated with HIV infection. Results: Of 3435 MSM tested for HIV at participating sites, 1.7%, (95% CI = 1.2–2.2) were newly diagnosed with HIV; between 2004 and 2005 the proportion increased from 1.3% (95% CI = 1.2–1.5) to 2.0% (95% CI = 1.8–2.2), P = 0.107. There was no significant change in the number of HIV tests conducted per month or in demographic characteristics, testing history and sexual behaviour characteristics between time periods. In multivariate analysis, reporting unprotected anal intercourse (UAI) with any partner, UAI with a HIV-positive partner/s and being aged 30–39 years or 40 years or greater were significantly associated with HIV infection. Conclusion: This new surveillance mechanism, based on linked testing at participating clinics, indicates that the increase in HIV notifications in 2005 was unrelated to changes in testing and data from a Melbourne sexual behavioural survey suggests the increase was more likely to be attributed to increases in transmission within the past few years. The sentinel system highlighted UAI, especially with HIV positive partner/s are important transmission factors.

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HIV testing in Swedish STD clinics 1986-1994

International Journal of STD & AIDS ◽

10.1258/0956462981922629 ◽

1998 ◽

Vol 9 (8) ◽

pp. 457-462 ◽

Cited By ~ 1

Author(s):

C Anagrius ◽

A K Ruden ◽

E Sandstrom

Keyword(s):

Hiv Infection ◽

Hiv Testing ◽

National Policy ◽

Contact Tracing ◽

Hiv Positive ◽

Clinical Routine ◽

Sex With Men ◽

Specific Reason

In 1986 Swedish STD clinicians decided on a national policy of offering HIV tests routinely to all their patients. During the period July 1986 through December 1994, 224,722 tests were performed. HIV tests for one or more specific reasons were carried out on 7 of the patients, and 20 requested the test solely because of anxiety. The remaining 73 , accepted the test as part of the clinical routine without giving any specific reason. Of those offered a test, 54 had been tested at least once before. Twenty three per cent did not accept the test. Among those tested, 373 persons 0.2 were found to have a newly detected HIV infection. Contact tracing was the reason for testing in 11 , whilst 32 were tested for other specific reasons, 29 requested testing for no stated specific reason and 28 had been tested as a routine. Of all the tested men who reported sex with men, 7 proved to be HIV positive. The 373 persons with newly detected HIV infection constituted 14 of the total newly detected cases in Sweden during the period in question.

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Using repeated home-based HIV testing services to reach and diagnose HIV infection among persons who have never tested for HIV, Chókwè health demographic surveillance system, Chókwè district, Mozambique, 2014–2017

PLoS ONE ◽

10.1371/journal.pone.0242281 ◽

2020 ◽

Vol 15 (11) ◽

pp. e0242281

Author(s):

Carol Lin ◽

Isabelle Casavant ◽

Alicia Jaramillo ◽

Timothy Green

Keyword(s):

Hiv Infection ◽

Hiv Testing ◽

Surveillance System ◽

Hiv Prevalence ◽

Demographic Surveillance System ◽

Hiv Positive ◽

Home Based ◽

Testing Uptake ◽

Hiv Testing Services ◽

Testing Coverage

Background HIV prevalence in Mozambique (12.6%) is one of the highest in the world, yet ~40% of people living with HIV (PLHIV) do not know their HIV status. Strategies to increase HIV testing uptake and diagnosis among PLHIV are urgently needed. Home-based HIV testing services (HBHTS) have been evaluated primarily as a 1-time campaign strategy. Little is known about the potential of repeating HBHTS to diagnose HIV infection among persons who have never been tested (NTs), nor about factors/reasons associated with never testing in a generalized epidemic setting. Methods During 2014–2017, counselors visited all households annually in the Chókwè Health and Demographic Surveillance System (CHDSS) and offered HBHTS. Cross-sectional surveys were administered to randomly selected 10% or 20% samples of CHDSS households with participants aged 15–59 years before HBHTS were conducted during the visit. Descriptive statistics and logistic regression were used to assess the proportion of NTs, factors/reasons associated with never having been tested, HBHTS acceptance, and HIV-positive diagnosis among NTs. Results The proportion of NTs decreased from 25% (95% confidence interval [CI]:23%–26%) during 2014 to 12% (95% CI:11% –13%), 7% (95% CI:6%–8%), and 7% (95% CI:6%–8%) during 2015, 2016, and 2017, respectively. Adolescent boys and girls and adult men were more likely than adult women to be NTs. In each of the four years, the majority of NTs (87%–90%) accepted HBHTS. HIV-positive yield among NTs subsequently accepting HBHTS was highest (13%, 95% CI:10%–15%) during 2014 and gradually reduced to 11% (95% CI:8%–15%), 9% (95% CI:6%–12%), and 2% (95% CI:0%–4%) during 2015, 2016, and 2017, respectively. Conclusions Repeated HBHTS was helpful in increasing HIV testing coverage and identifying PLHIV in Chókwè. In high HIV-prevalence settings with low testing coverage, repeated HBHTS can be considered to increase HIV testing uptake and diagnosis among NTs.

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Epidemiological factors associated with the absence of previous HIV testing among HIV-positive persons in Singapore, 2012–2017

BMJ Open ◽

10.1136/bmjopen-2021-050133 ◽

2021 ◽

Vol 11 (8) ◽

pp. e050133

Author(s):

Li Wei Ang ◽

Matthias Paul Han Sim Toh ◽

Irving Charles Boudville ◽

Chen Seong Wong ◽

Sophia Archuleta ◽

...

Keyword(s):

Risk Factors ◽

Hiv Infection ◽

Hiv Testing ◽

Heterosexual Transmission ◽

Hiv Positive ◽

Multivariable Logistic Regression Analysis ◽

Targeted Prevention ◽

Hiv Diagnosis ◽

Factors Associated ◽

Epidemiological Factors

ObjectiveTo assess the temporal trend and identify risk factors associated with the absence of previous HIV testing prior to their diagnosis among HIV-positive persons in Singapore.Study designCross-sectional.Setting and participantsWe analysed data of HIV-positive persons infected via sexual transmission, who were notified to the National HIV Registry in 2012–2017.OutcomesEpidemiological factors associated with the absence of HIV testing prior to diagnosis were determined separately for two groups of HIV-positive persons: early and late stages of HIV infection at diagnosis.Results2188 HIV-positive persons with information on HIV testing history and CD4 cell count were included in the study. The median age at HIV diagnosis was 40 years (IQR 30–51). Nearly half (45.1%) had never been tested for HIV prior to their diagnosis. The most common reason cited for no previous HIV testing was ‘not necessary to test’ (73.7%). The proportion diagnosed at late-stage HIV infection was significantly higher among HIV-positive persons who had never been tested for HIV (63.9%) compared with those who had undergone previous HIV tests (29.0%). Common risk factors associated with no previous HIV testing in multivariable logistic regression analysis stratified by stage of HIV infection were: older age at HIV diagnosis, lower educational level, detection via medical care and HIV infection via heterosexual transmission. In the stratified analysis for persons diagnosed at early-stage of HIV infection, in addition to the four risk factors, women and those of Malay ethnicity were also less likely to have previous HIV testing prior to their diagnosis.ConclusionTargeted prevention efforts and strategies are needed to raise the level of awareness of HIV/AIDS and to encourage early and regular screening among the at-risk groups by making HIV testing more accessible.

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HIV testing uptake and prevalence among hospitalized older adults in Togo: A cross-sectional study

PLoS ONE ◽

10.1371/journal.pone.0246151 ◽

2021 ◽

Vol 16 (2) ◽

pp. e0246151

Author(s):

Fifonsi Adjidossi Gbeasor-Komlanvi ◽

Wendpouire Ida Carine Zida-Compaore ◽

Arnold Junior Sadio ◽

Martin Kouame Tchankoni ◽

Balakiyem Magnim Kadangha ◽

...

Keyword(s):

Older Adults ◽

Hiv Infection ◽

Hiv Testing ◽

Cross Sectional Study ◽

Hiv Positive ◽

Newly Diagnosed ◽

Sectional Study ◽

Cross Sectional ◽

Testing Uptake ◽

Hospitalized Older Adults

Objectives This study aimed to describe HIV testing uptake, as well as HIV prevalence and its associated factors among older adults aged ≥50 years in health facilities in Togo. Methods A cross-sectional study was carried out from February 2018 to June 2019 among hospitalized older adults aged ≥50 years in tertiary and secondary hospitals in Togo. HIV testing was performed according to the national algorithm. Socio-demographic data and HIV testing history were collected using a standardized questionnaire. Results A total of 619 patients (43.9% female) of median age 61 years, (IQR: 55–70) were recruited and offered HIV testing. Among them, 25.7% had never previously tested for HIV. In total, 91.6% (567/619) accepted HIV testing while 8.4% (52/619) refused to be tested. Of those who tested, forty patients were HIV positive, yielding a prevalence of 7.1%. Twenty-three patients (57.5%) were newly diagnosed with HIV infection. In multivariable analysis, two factors were associated with HIV infection: living alone (aOR = 5.83; 95%CI = [2.26–14.53]) and being <60 years (aOR = 3.12; 95%CI = [1.51–6.66]). Conclusion The majority of older adults in this study accepted testing for HIV and almost three in five HIV positive older adults were newly diagnosed with HIV as a result of this testing. There is an urgent need to integrate older adults into responses to the HIV epidemic and to strengthen targeted prevention care and treatment in this population.

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Influence of anonymous HIV testing on national HIV surveillance in the Republic of Korea (2000 to 2015): a retrospective analysis

BMC Public Health ◽

10.1186/s12889-019-7866-y ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Mee-Kyung Kee ◽

Myeongsu Yoo ◽

Jaehyung Seong ◽

Ju-Yeon Choi ◽

Myung Guk Han ◽

...

Keyword(s):

Hiv Infection ◽

Hiv Testing ◽

Hiv Prevalence ◽

Screening Tests ◽

Hiv Positive ◽

Hiv Screening ◽

Continuous Increase ◽

Hiv Surveillance ◽

Hiv Test ◽

Anonymous Hiv Testing

Abstract Background Owing to the continuous increase in the number of new human immunodeficiency virus (HIV) infection in Korea, public health centers (PHCs) have performed anonymous tests since 1989. No study has examined the patterns of anonymous HIV testing performed at PHCs and the characteristics of HIV infection detected in those tests. We aimed to assess the influence of anonymous HIV testing on Korea’s national HIV surveillance. Methods HIV screening test data from 253 PHCs over a 16-year period were classified into 13 groups based on reason for testing. For anonymous HIV test takers (Anonymous), the HIV positivity per 10,000 tests was calculated, as repetitions could not be distinguished. Those with suspected HIV infection voluntarily underwent HIV testing and revealed their identity (Suspected). HIV prevalence was calculated as the number of HIV-positive persons per 10,000 test takers. Analyses were performed using chi-square and Cochran-Armitage trend test with SAS 9.4. Results Approximately 400,000 HIV screening tests were performed at PHCs annually, which remained unchanged in the past 10 years. The proportion of anonymous testing increased from < 3.0% before 2014 to 4.8% in 2014 and 6.1% in 2015. While the number of HIV cases increased, the number of anonymous HIV-positive test results per 10,000 tests decreased from 68.8 in 2010 to 41.8 in 2015. The HIV prevalence among the suspected was approximately 20.0 per 10,000 test takers before 2014, which steeply increased to 71.6 in 2015. Those with suspected HIV were predominantly men, aged 20 years, foreigners, and metropolitan city dwellers in the last 6 years. The high prevalence of persons with suspected HIV resulted in a doubling of HIV prevalence at PHCs between 2014 and 2015. Conclusions Anonymous and Suspected, which were driven by similar motives, impacted each other. Increase in HIV prevalence among the suspected led to a higher HIV prevalence among all test takers in PHCs and higher proportions of HIV infection nationwide, which could be attributed to the increase in the number of anonymous tests performed in PHCs. HIV positivity among the anonymous and HIV prevalence among the suspected are key indexes of the national HIV surveillance in Korea.

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1273. Routine Opt-out HIV Screening and Detection of HIV Infection Among Emergency Department Patients

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy210.1106 ◽

2018 ◽

Vol 5 (suppl_1) ◽

pp. S388-S388

Author(s):

Nada Fadul ◽

Ciarra Dortche ◽

Richard Baltaro ◽

Tim Reeder

Keyword(s):

Emergency Department ◽

Hiv Infection ◽

Hiv Testing ◽

Medical Center ◽

Linkage To Care ◽

Hiv Care ◽

Hiv Positive ◽

Newly Diagnosed ◽

Opt Out ◽

Post Test

Abstract Background The Southeastern United States bears a disproportionate burden of HIV infection, accounting for nearly half of all new cases. The Centers for Disease Control and Prevention released routine opt-out testing recommendations in 2006. Our emergency department collaborated with our infectious diseases clinic (ECU-ID) to implement suggested guidelines among adults since March 2017. Methods Our primary aim was to implement routine, opt-out HIV testing in the Vidant Medical Center Emergency Department (ED) for patients between 18 and 65 years of age who have blood work completed, and have not had a test documented in the electronic medical record (EMR) in the last year. A secondary aim was to successfully link HIV-positive patients to care at ECU-ID or preferred clinic. Methods defining programmatic success included developing nurse directed opt-out ordering protocol, integrating testing into normal ED workflow, utilizing the existing EMR to prompt testing, and hiring a linkage coordinator to initiate post-test counseling and linkage-to-care. Results Since March 2, 2017, a total of 7,109 HIV tests were performed; an average of 592 monthly tests conducted compared with a previous average of 10 stat tests. Testing increased 5,820% compared with 2015. Of the 21 HIV-positive patients found, 16 were newly diagnosed. Among those newly diagnosed, 14 (87.5%) were linked to care; and among the five known positives, two (40%) were linked to care. Reasons why patients could not be linked included incarceration, refusal to link to care, and re-location. Conclusion Joined with the implementation of a routinized ED HIV testing program, a seamless process was developed to link persons found to be positive in the ED to HIV care services; therefore, establishing a systems-level prevention model. Future plans include expanding testing to adolescents and utilizing similar methods to integrate Hepatitis C testing. Disclosures All Authors. Gilead Sciences, Inc.: Grant Investigator, Grant recipient and Salary.

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