scholarly journals Rationale, design and initial results of an educational intervention to improve provider-initiated HIV testing in primary care

2020 ◽  
Author(s):  
Saskia J Bogers ◽  
Maarten F Schim van der Loeff ◽  
Nynke van Dijk ◽  
Karlijn Groen ◽  
Marije L Groot Bruinderink ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Educational Intervention ◽  
Laboratory Data ◽  
Hiv Infections ◽  
Audit And Feedback ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Testing Rate ◽  
Positivity Ratio

Abstract Objectives In the Netherlands, general practitioners (GPs) perform two-thirds of sexually transmitted infection (STI) consultations and diagnose one-third of HIV infections. GPs are, therefore, a key group to target to improve provider-initiated HIV testing. We describe the design and implementation of an educational intervention to improve HIV testing by Amsterdam GPs and explore trends in GPs’ testing behaviour. Methods Interactive sessions on HIV and STI using graphical audit and feedback started in 2015. Participating GPs developed improvement plans that were evaluated in follow-up sessions. Laboratory data on STI testing by Amsterdam GPs from 2011 to 2017 were collected for graphical audit and feedback and effect evaluation. The primary outcome was the HIV testing rate: number of HIV tests per 10 000 person-years (PY). Secondary endpoints were chlamydia and gonorrhoea testing rates and HIV positivity ratios. Results Since 2015, 41% of GPs participated. HIV testing rate declined from 2011 to 2014 (from 175 to 116 per 10 000 PY), more in women than men (176 to 101 versus 173 to 132), and stabilized from 2015 to 2017. The HIV positivity ratio declined from 0.8% in 2011 to 0.5% in 2017. From 2011 to 2017, chlamydia and gonorrhoea testing rates declined in women (from 618 to 477 per 10 000 PY) but remained stable in men (from 270 to 278). Conclusions The stabilization of the downward trend in HIV testing coincided with this educational intervention. Follow-up data are needed to formally assess the intervention’s impact on GP testing behaviour whilst considering contextual factors and secular trends.

scholarly journals Association between eye diagnosis and positive syphilis test results in a large, urban sexually transmitted infection/primary care clinic population

2017 ◽  
Vol 29 (4) ◽  
pp. 357-361 ◽  
Author(s):  
Ann-Marie Lobo ◽  
Yan Gao ◽  
Laura Rusie ◽  
Magda Houlberg ◽  
Supriya D Mehta
Keyword(s):  
Primary Care ◽  
High Risk ◽  
Sexually Transmitted Infection ◽  
Laboratory Data ◽  
Primary Care Clinic ◽  
Eye Disease ◽  
Hiv Status ◽  
Transmitted Infection ◽  
Care Clinic ◽  
Sexually Transmitted

In 2015, the Centers for Disease Control and Prevention (CDC) and the American Academy of Ophthalmology (AAO) released clinical advisories on rising cases of ocular syphilis. We examined the association between eye disease and syphilis infection among primary care and sexually transmitted infection (STI) clinic patients attending an urban lesbian, gay, bisexual, transgender (LGBT) health center. We conducted a retrospective medical record review of all patients who underwent syphilis testing at Howard Brown Health between 1 January 2010 and 31 December 2015. Confirmed eye diagnosis was based on International Classification of Diseases, Ninth Revision (ICD-9) diagnosis codes for conjunctivitis, uveitis, keratitis, retinitis, and red eye. Demographic information, syphilis treatment, HIV status, and high-risk behaviors were abstracted. Syphilis diagnosis was defined by available laboratory data (enzyme immunoassay [EIA], rapid plasma reagin [RPR] titer, fluorescent treponemal antibody absorption [FTA-Abs], Treponema pallidum Ab). Multivariable logistic regression with robust variance was used to identify independent associations. During the study period, 71,299 syphilis tests were performed on 30,422 patients. There were 2288 (3.2%) positive syphilis tests. Seventy-seven patients had a confirmed eye diagnosis (0.25%). Patients with eye disease had higher probability of at least one positive syphilis test (33%) compared to those without eye disease (8%) ( p < 0.01). Of patients with eye disease, 77% were men who had sex with men (MSM) and 65% were HIV-positive. Patients with eye disease had 5.97 (95% CI: 3.70, 9.63) higher odds of having syphilis compared to patients without eye disease. When adjusted for age, race, gender/sexual orientation, insurance status, and HIV status, this association between positive syphilis test and eye disease decreased but was still significant (OR 2.00, 95% CI 1.17, 3.41). Patients who present with an eye diagnosis to STI/primary care clinic have a higher probability of positive syphilis tests even after adjusting for other risk factors for syphilis. High-risk patients with eye symptoms should have routine STI testing and in keeping with CDC and AAO recommendations, full ophthalmologic examination.

scholarly journals Challenges and motivators for male partner involvement in prenatal care for HIV testing in a tertiary setting in Brazil

2019 ◽  
Vol 30 (9) ◽  
pp. 875-884
Author(s):  
Nava Yeganeh ◽  
Tara Kerin ◽  
Mariana Simon ◽  
Karin Nielsen-Saines ◽  
Jeffrey D Klausner ◽  
...  
Keyword(s):  
Prenatal Care ◽  
Hiv Testing ◽  
Male Partner ◽  
Computer Assisted ◽  
Transmitted Infection ◽  
Entire Family ◽  
Middle Income ◽  
Sexually Transmitted ◽  
Male Partner Involvement ◽  
Partner Involvement

Male partner involvement in prenatal care has been shown to improve outcomes for the entire family in low- and middle income countries. In Brazil, partners of pregnant women are encouraged to attend prenatal care for HIV testing. From November 2016 to July 2017, male partners of women delivering at Hospital Conceiçao were interviewed using computer-assisted telephone interviews regarding individual, relationship and system-wide facilitators and barriers to attending prenatal care. Of 403 men interviewed, 202 attended prenatal care and 201 did not. Individual factors that predicted prenatal care attendance included over-estimating the risk of mother to child transmission (AOR 2.13, 95% CI: 1.35–3.4), and endorsing that HIV-infected individuals can live satisfying lives (AOR 7.24, 95% CI: 1.9–47.5). Partnership factors associated with attendance included invitation by partner (AOR 5.6, 95% CI: 2.4–15.6). Systemic factors negatively associated with prenatal care attendance included a history of not being able to afford medical care (AOR 0.3, 95% CI: 0.15–0.6) and identifying work as a barrier to prenatal care attendance (AOR 0.19 95% CI: 0.11–0.31). Partners should be actively invited to prenatal care during flexible flexible hours. Once involved, almost all would accept HIV and sexually transmitted infection (STI) testing to protect partners and unborn infants during this vulnerable period.

Mechanisms of HIV Transmission

2017 ◽  
Author(s):  
Puja Nambiar ◽  
William R. Short
Keyword(s):  
Hiv Transmission ◽  
Hiv Infections ◽  
The United States ◽  
Antiretroviral Drugs ◽  
Oral Sex ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Mucous Membranes ◽  
Perinatal Treatment ◽  
Hiv Negative

HIV is a sexually transmitted infection. Most new HIV infections in the United States are the result of sex, but it is rare for HIV to be transmitted through oral sex. The risk of HIV transmission to a receptive partner remains higher than that to an insertive one; however, both are at risk. Anything that compromises the integrity of mucous membranes, such as sexually transmitted infections, may increase the risk of transmission. Although not 100% effective, keeping an infected partner’s viral load low reduces the risk of transmission to an HIV-negative partner. Maternal transmission is a larger concern in developing countries due to lack of access to perinatal treatment with antiretroviral drugs.

Risky sexual behavior and sexually transmitted infections among men who have sex with men and purchase sex attending an Israeli sexually transmitted infection clinic

2019 ◽  
Vol 31 (3) ◽  
pp. 236-243 ◽  
Author(s):  
Rivka S Rich ◽  
Alex Leventhal ◽  
Rivka Sheffer ◽  
Zohar Mor
Keyword(s):  
High Risk ◽  
Sexually Transmitted Infections ◽  
Sexual Behaviors ◽  
Risky Sexual Behavior ◽  
Laboratory Data ◽  
Cross Sectional Study ◽  
Transmitted Infection ◽  
Cross Sectional ◽  
Sexually Transmitted ◽  
Sex With Men

Men who have sex with men (MSM) and purchase sex (MPS) are a sub-group potentially at high risk for acquiring and transmitting sexually transmitted infections (STIs). This is a hard-to-reach population resulting in a scarcity of studies covering the issue. This cross-sectional study aimed to assess the association between purchasing sex and high-risk behaviors related to HIV/STI transmission and appraise the STI prevalence among MSM. All MSM who attended the STI clinic in Tel Aviv between 2003 and 2010 were included. Demographics, behavioral, clinical, and laboratory data were compared between MPS and non-MPS to identify high-risk sexual behaviors and STI prevalence associated with purchasing sex. Of the first visits of 2694 MSM who attended the STI clinic during the study period, 151 (5.6%) paid for sex. MPS were more commonly older and married than non-MPS. MPS were more likely to engage in behaviors associated with high risk for HIV/STI transmission, including infrequent condom use during anal sex, substance use during sex, and selling sex themselves. MPS had a higher STI prevalence than non-MPS, although this was not statistically significant ( p = 0.05). These findings highlight the need to establish culturally tailored interventions for MPS addressing the potential risks associated with purchasing sex.

scholarly journals Results from a Multiple Morbidities Testing Program Offering Rapid HIV Testing Bundled with Hepatitis and Sexually Transmitted Infection Testing

2008 ◽  
Vol 123 (3_suppl) ◽  
pp. 63-69 ◽  
Author(s):  
Grace L. Reynolds ◽  
Dennis G. Fisher ◽  
Lucy E. Napper ◽  
Kimberly A. Marsh ◽  
Christine Willey ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Test Results ◽  
Long Beach ◽  
Transmitted Infection ◽  
Testing Program ◽  
Sexually Transmitted ◽  
Rapid Hiv Testing ◽  
Hiv Test ◽  
Rapid Hiv Test ◽  
Multiple Morbidities

Objectives. Bundling human immunodeficiency virus (HIV) testing with tests for other infectious diseases such as hepatitis C, syphilis, or gonorrhea has been proposed as a method to recruit at-risk individuals into HIV testing. The objectives of this study were to determine ( 1) the types of at-risk clients who choose the rapid vs. standard HIV test when bundled with hepatitis and sexually transmitted infection (STI) tests, and ( 2) whether clients receiving a rapid HIV test are more likely to return on time for hepatitis and STI test results. Methods. We recruited individuals from drug treatment programs, methadone maintenance programs, needle-exchange programs, a community-based agency serving the gay and lesbian community, and the Center for Behavioral Research and Services' office-based testing facility at California State University, Long Beach from January 2005 through November 2007. Results. A total of 2,031 clients from a multiple morbidities testing program in Long Beach, California, were tested between January 2005 and November 2007. For clients receiving hepatitis and STI testing, the majority chose the standard HIV test. Clients who received a rapid HIV test returned in significantly fewer days than clients who received a standard HIV test. Injection drug users and sex traders were more likely to choose the standard HIV test and more likely to fail to return for test results on time. Conclusion. The rapid HIV test, in conjunction with hepatitis and STI tests, results in clients being more likely to return on time for hepatitis and STI results. Public health efforts should focus on acquainting high-risk clients with rapid HIV testing.

scholarly journals Immediate PrEP after PEP: Results from an Observational Nurse-Led PEP2PrEP Study

2020 ◽  
Vol 19 ◽  
pp. 232595822093976
Author(s):  
Patrick O’Byrne ◽  
Lauren Orser ◽  
Amanda Vandyk
Keyword(s):  
Seroconversion Rate ◽  
Male Partner ◽  
Post Exposure Prophylaxis ◽  
Hiv Status ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Control And Prevention ◽  
Hiv Acquisition ◽  
Exposure Prophylaxis

Patients who use post-exposure prophylaxis (PEP) are at ongoing risk for HIV acquisition after completing PEP. While the Centers for Disease Control and Prevention recommends pre-exposure prophylaxis (PrEP) use immediately after PEP, some practitioners are hesitant to offer PEP-to-PrEP (PEP2PrEP). We began offering PEP2PrEP in the sexually transmitted infection clinic in Ottawa, Canada on August 5, 2018. During the first 16 months of PEP2PrEP, 61 patients requested PEP and 46 were initiated; 30 of these patients agreed to PEP2PrEP and 26 followed through. None of our PEP patients had confirmed HIV exposures; all fulfilled the initiation criterion of condomless anal sex with a male partner of unknown HIV-status. During the study, the number of PEP requests and initiations was statistical unchanged, yet the seroconversion rate among patients who used PEP decreased from 1.7% pre-PEP2PrEP to 0% post-PEP2PrEP. Regarding follow-up, most discontinuations occurred between the PrEP intake and 1-month follow-up visit.

Sign in / Sign up

Export Citation Format

Share Document