scholarly journals Attitudes towards HIV testing via home-sampling kits ordered online (RUClear pilots 2011–12)

2016 ◽  
Vol 38 (3) ◽  
pp. 585-590 ◽  
Author(s):  
Y. Ahmed-Little ◽  
V. Bothra ◽  
D. Cordwell ◽  
D. Freeman Powell ◽  
D. Ellis ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Cost Effective ◽  
Time Of Day ◽  
Hard Copy ◽  
Free Text ◽  
Text Data ◽  
Hiv Test ◽  
Undiagnosed Hiv ◽  
The Uk ◽  
Blood Spot

Background The burden of disease relating to undiagnosed HIV infection is significant in the UK. BHIVA (British HIV Association) recommends population screening in high prevalence areas, expanding outside traditional antenatal/GUM settings. Methods RUClear 2011–12 piloted expanding HIV testing outside traditional settings using home-sampling kits (dry-blood-spot testing) ordered online. Greater Manchester residents (≥age 16) could request testing via an established, online chlamydia testing service (www.ruclear.co.uk). Participant attitudes towards this new service were assessed. Qualitative methods (thematic analysis) were used to analyse free-text data submitted by participants via hard copy questionnaires issued in all testing kits. Results 79.9% (2447/3062) participants completed questionnaires, of which 30.9% (756/2447) provided free-text data. Participants overwhelmingly supported the service, valuing particularly accessibility and convenience, allowing individuals to order tests any time of day and self-sample comfortably at home; avoiding the invasive nature of venipuncture and avoiding the need for face-to-face interaction with health services. The pilot was also clinically and cost-effective. Conclusion Testing via home-sampling kits ordered online (dry-blood-spot testing) was felt to be an acceptable and convenient method for accessing a HIV test. Many individuals undertook HIV testing where they would otherwise not have been tested at all. Expansion of similar services may increase the uptake of HIV testing.

scholarly journals HIV testing in patients presenting with indicator conditions in outpatient settings: offer and uptake rates, and educational and active interventions

2018 ◽  
Vol 29 (13) ◽  
pp. 1289-1294
Author(s):  
Elaney Youssef ◽  
Tanjinder Sanghera ◽  
Andrew Bexley ◽  
Madeleine Hayes ◽  
Nicky Perry ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Individual Case ◽  
Case Note ◽  
Routine Screening ◽  
People Living With Hiv ◽  
Hiv Test ◽  
Uptake Rates ◽  
Undiagnosed Hiv ◽  
The Uk ◽  
Outpatient Settings

Approximately 13% of people living with HIV in the UK are undiagnosed which has significant implications in terms of onward transmission and late diagnosis. HIV testing guidelines recommend routine screening in anyone presenting to healthcare with an HIV indicator condition (IC); however, this does not occur routinely. This study aimed to assess the feasibility and effectiveness of using case note prompts highlighting the presence of an IC to increase HIV testing. Clinicians in three outpatient departments received case note prompts either before or after a period of clinician-led identification. Test offer and uptake rates were assessed. A parallel anonymous seroprevalence study estimated the prevalence of undiagnosed HIV. A total of 4191 patients had an appointment during the study period; 608 (14.5%) had an IC. HIV test offer was significantly higher when a prompt was inserted into notes (34.3% versus 3.2%, p < 0.001). The prevalence of diagnosed HIV in the cohort was 4.1%. No cases of undiagnosed HIV infection were identified. Despite guidelines, offer of HIV testing is low. Strategies to increase routine screening of patients presenting with an IC are needed. Individual case note prompts significantly increase HIV test offer; however, the effect is lost if the strategy is withdrawn.

Experience in the UK

2009 ◽  
Vol 20 (1_suppl) ◽  
pp. 7-14 ◽  
Author(s):  
M Fisher ◽  
V Delpech
Keyword(s):  
Hiv Testing ◽  
Significant Proportion ◽  
National Guidelines ◽  
Black African ◽  
Opt Out ◽  
Hiv Test ◽  
Undiagnosed Hiv ◽  
Sex With Men ◽  
The Uk ◽  
Prompt Diagnosis

The number of new diagnoses of HIV in the UK is increasing, with most new diagnoses reported in men who have sex with men (MSM) and black African heterosexuals the later of whom usually acquire their infection abroad. Around 31 % of people infected with HIV in the UK are unaware of their diagnosis, and one in three are diagnosed for the first time with a CD4 count <200 cells/mm3 or with AIDS. Late diagnosis is the most important factor that explains most HIV-related causes of death in the UK. Strategies to increase HIV-testing include universal approaches in antenatal and STD clinics (known as genitourinary [GU] medicine clinics), but other opportunities for prompt diagnosis are often missed during secondary and primary consultations - even when patients present with HIV-related illnesses. Furthermore, a significant proportion of people with undiagnosed HIV who attend GU medicine clinics leave without being offered an HIV test or a diagnosis of HIV. Universal offer (opt-out testing) policies seem to work well - such as in the successful antenatal testing programme - but local strategies to increase HIV-testing and prompt diagnosis, such as training courses and rapid HIV-testing initiatives have met with varied success. New national guidelines for the UK have been published and, if successfully implemented, should help to address some of these issues.

scholarly journals Distributed NLP Framework to create new federated data-sets

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Simon Thompson
Keyword(s):  
Low Cost ◽  
Cost Effective ◽  
Free Text ◽  
Data Sets ◽  
Digital Information ◽  
Text Data ◽  
Governance Model ◽  
Large Numbers ◽  
Governance Challenges ◽  
The Uk

IntroductionAlthough healthcare systems generate significant amounts of structured data, there remains a untapped wealth of unstructured narrative data. In the UK, 70% of all NHS digital information is in unstructured form. The NHS has no plans to computerise this data, as it is simply would not be cost effective. Objectives and ApproachOur aim was to make all digitised free text within partner organisations accessible for NLP processing for research, while overcoming information governance challenges. We developed a distributed GATE-based NLP platform enabling NLP models to be automatically distributed and materialised against the free text data in each organisation to create new conventional datasets, which can then be transmitted back using an established governance model. This work adds NLP capability to the UK’s National Research Data Appliances, deployed throughout Wales and beyond and uses many open source components enabling a deployment without additional software licence costs, leading to increased potential use cases. ResultsWe have been able to demonstrate a fully federated network of analytical nodes into NHS Wales, which takes the analytical NLP model to the free text data, as opposed to the data having to travel. Under a common, acceptable, governance model, an approval system enables organisations such as health boards to give permission for projects and NLP models to be used against their data. In a proof of concept project, we have run a number of NLP models over large numbers of documents, which the platform has ingested, converted and analysed. We have developed a proposal for a common NLP model definition format to enable models to be interchangeable between different research groups and systems. Sharing/discovery of established NLP models is key deliverable. Conclusion/ImplicationsThe implications of being able to send the query to the data, enables access to this untapped data source, finally enabling the realisation of new datasets, while abiding by any IG framework. The low cost and simplicity will enable a many research opportunities, some of which are already being realised.

scholarly journals Test@work: evaluation of workplace HIV testing for construction workers using the RE-AIM framework

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wendy Jones ◽  
Sarah Somerset ◽  
Catrin Evans ◽  
Katharine Whittingham ◽  
Matthew Middleton ◽  
...  
Keyword(s):  
Sexual Health ◽  
Hiv Testing ◽  
General Health ◽  
Health Check ◽  
Construction Workers ◽  
Free Text ◽  
Construction Sector ◽  
Health Checks ◽  
Hiv Test ◽  
The Uk

Abstract Background Community testing for HIV can reach previously untested populations but is rarely offered in workplaces. Targeting the construction sector could reach workers from high risk populations. Methods The RE-AIM framework was used to evaluate Test@Work, a workplace HIV testing intervention for construction workers implemented at 21 events (10 companies) in the UK. Test@Work had three components: 1) an online health toolkit to inform managers about health screening and HIV testing; 2) general health checks; and 3) opt-in HIV consultation and testing. Quantitative data were collected using registration and exit questionnaires with workers (n = 426) and pre/post-event questionnaires with managers (n = 15), with qualitative analysis of free text responses. Results Reach 426 individuals had health checks. Participants were broadly representative of the UK construction workforce, but with a higher proportion of permanent workers. Most workers reported being in good health but also believed their work had an adverse impact on their health. Effectiveness: 97% of health check participants opted to have a consultation about sexual health (n = 413) and 82% had an HIV test (n = 348), of whom 78% had not previously been tested. All HIV tests were non-reactive. HIV testing at work was considered acceptable by most participants. Participants reported learning new things about their health (74%), said they would make changes as a result (70%) and felt confident of success (median score 8/10). Adoption: Recruitment of companies was challenging and time consuming. Seven of the participating companies were very large, employing over 1000 workers, which is atypical of construction generally. Implementation: All events were completed as planned and were considered successful by all parties. Maintenance: All managers would arrange further events if they were offered them. Six managers incorporated sexual health awareness into their health programmes, but this was not possible for many as health agendas were set centrally by their organisations. Conclusions Opt-in HIV testing, when embedded within a general health check, has high uptake and acceptability in the UK construction sector, and reaches individuals at risk for HIV who may not otherwise attend for testing. Cost-effectiveness of this approach is yet to be determined. Trial registration ClinicalTrials.gov Identifier: NCT04292002.

HIV testing in black Africans living in England

2012 ◽  
Vol 141 (8) ◽  
pp. 1741-1748 ◽  
Author(s):  
B. RICE ◽  
V. DELPECH ◽  
K. E. SADLER ◽  
Z. YIN ◽  
J. ELFORD
Keyword(s):  
General Practice ◽  
Hiv Testing ◽  
Perceived Risk ◽  
Oral Fluid ◽  
Hiv Status ◽  
Black Africans ◽  
Hiv Test ◽  
Undiagnosed Hiv ◽  
Using Data ◽  
The Uk

SUMMARYWe examined the uptake of HIV testing in black Africans living in England before the introduction of national testing guidelines. Analyses were conducted using data from an anonymous self-completed questionnaire linked to oral fluid samples to establish HIV status in black Africans attending community venues in England in 2004. Of 946 participants, 44% had ever been tested for HIV and 29% had been tested in the previous 24 months. Of those with undiagnosed HIV, 45% had previously had a negative HIV test. Almost a third of people tested in the UK had been at general practice. Uptake of HIV testing was not associated with perceived risk of HIV. These findings highlight the need for the implementation of national HIV testing guidelines in the UK, including the promotion of testing in general practice. Regular testing in black Africans living in the UK should be promoted regardless of their HIV test history.

scholarly journals Promoting HIV indicator condition-guided testing in hospital settings (PROTEST 2.0): study protocol for a multicentre interventional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saskia J. Bogers ◽  
Maarten F. Schim van der Loeff ◽  
Udi Davidovich ◽  
Anders Boyd ◽  
Marc van der Valk ◽  
...  
Keyword(s):  
The Netherlands ◽  
Hiv Testing ◽  
Quantitative Methods ◽  
Hospital Setting ◽  
Audit And Feedback ◽  
Interventional Study ◽  
Hiv Diagnosis ◽  
Post Intervention ◽  
Hiv Test ◽  
Undiagnosed Hiv

Abstract Background Late presentation remains a key barrier towards controlling the HIV epidemic. Indicator conditions (ICs) are those that are AIDS-defining, associated with a prevalence of undiagnosed HIV > 0.1%, or whose clinical management would be impeded if an HIV infection were undiagnosed. IC-guided HIV testing is an effective strategy in identifying undiagnosed HIV, but opportunities for earlier HIV diagnosis through IC-guided testing are being missed. We present a protocol for an interventional study to improve awareness of IC-guided testing and increase HIV testing in patients presenting with ICs in a hospital setting. Methods We designed a multicentre interventional study to be implemented at five hospitals in the region of Amsterdam, the Netherlands. Seven ICs were selected for which HIV test ratios (proportion of patients with an IC tested for HIV) will be measured: tuberculosis, cervical/vulvar cancer or high-grade cervical/vulvar dysplasia, malignant lymphoma, hepatitis B and C, and peripheral neuropathy. Prior to the intervention, a baseline assessment of HIV test ratios across ICs will be performed in eligible patients (IC diagnosed January 2015 through May 2020, ≥18 years, not known HIV positive) and an assessment of barriers and facilitators for HIV testing amongst relevant specialties will be conducted using qualitative (interviews) and quantitative methods (questionnaires). The intervention phase will consist of an educational intervention, including presentation of baseline results as competitive graphical audit and feedback combined with discussion on implementation and opportunities for improvement. The effect of the intervention will be assessed by comparing HIV test ratios of the pre-intervention and post-intervention periods. The primary endpoint is the HIV test ratio within ±3 months of IC diagnosis. Secondary endpoints are the HIV test ratio within ±6 months of diagnosis, ratio ever tested for HIV, HIV positivity percentage, proportion of late presenters and proportion with known HIV status prior to initiating treatment for their IC. Discussion This protocol presents a strategy aimed at increasing awareness of the benefits of IC-guided testing and increasing HIV testing in patients presenting with ICs in hospital settings to identify undiagnosed HIV in Amsterdam, the Netherlands. Trial registration Dutch trial registry: NL7521. Registered 14 February 2019.

scholarly journals Unsupervised identification of crime problems from police free-text data

Crime Science ◽  
2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Daniel Birks ◽  
Alex Coleman ◽  
David Jackson
Keyword(s):  
Crime Reduction ◽  
Free Text ◽  
Topic Modelling ◽  
Modus Operandi ◽  
Text Data ◽  
Machine Learning Methods ◽  
Major Metropolitan Area ◽  
Operational Decision Making ◽  
The Uk ◽  
Crime Classification

Abstract We present a novel exploratory application of unsupervised machine-learning methods to identify clusters of specific crime problems from unstructured modus operandi free-text data within a single administrative crime classification. To illustrate our proposed approach, we analyse police recorded free-text narrative descriptions of residential burglaries occurring over a two-year period in a major metropolitan area of the UK. Results of our analyses demonstrate that topic modelling algorithms are capable of clustering substantively different burglary problems without prior knowledge of such groupings. Subsequently, we describe a prototype dashboard that allows replication of our analytical workflow and could be applied to support operational decision making in the identification of specific crime problems. This approach to grouping distinct types of offences within existing offence categories, we argue, has the potential to support crime analysts in proactively analysing large volumes of modus operandi free-text data—with the ultimate aims of developing a greater understanding of crime problems and supporting the design of tailored crime reduction interventions.

FC30-01 - Severe mental illness is an HIV indicator disease

2011 ◽  
Vol 26 (S2) ◽  
pp. 1983-1983
Author(s):  
M. Ferrara ◽  
G. Solignani ◽  
S. Ferrari ◽  
M. Rigatelli ◽  
G. Guaraldi
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Hiv Testing ◽  
Psychiatric Symptoms ◽  
Case Histories ◽  
Hiv Diagnosis ◽  
Hiv Test ◽  
Mental Health Settings ◽  
Undiagnosed Hiv ◽  
Routine Hiv Testing

IntroductionHIV testing is not yet a routine procedure in most mental health settings although adults with severe mental illness (SMI) are disproportionately affected by HIV/AIDS.ObjectivesWe focused our attention to explore if the appropriate care of patients with SMI may include a routine HIV testing offering and thus contribute to diagnose HIV-infected persons earlier in the course of their infection.MethodsWe present three case histories related to primary HIV diagnosis in patients presenting with different psychiatric disorders, admitted to Modena teaching Hospital in the passed two years.ResultsPsychiatric symptoms delayed HIV diagnosis in all of the three reported cases.ConclusionsThe case histories here presented suggest that HIV testing is appropriate in the care of people with SMI, avoiding delay in HIV diagnosis with an obvious clinical benefit for the patient. Further studies are needed to assess the prevalence of HIV in those patients. These will be able to validate psychiatric diseases within a specific HIV indicator diseases list and help identifying a segment of the population in which HIV test must be routinely offered as a public health strategy, to face the burden of undiagnosed HIV infection.

scholarly journals The Impact of HIV Knowledge and Attitudes on HIV Testing Acceptance among Patients in an Emergency Department in the Eastern Cape, South Africa

2019 ◽  
Author(s):  
Sofia Ryan ◽  
Elizabeth Hahn ◽  
Aditi Rao ◽  
George Mwinnyaa ◽  
John Black ◽  
...  
Keyword(s):  
South Africa ◽  
Emergency Department ◽  
Hiv Testing ◽  
Eastern Cape ◽  
Hiv Knowledge ◽  
Knowledge And Attitudes ◽  
Knowledge And Beliefs ◽  
Hiv Test ◽  
Undiagnosed Hiv ◽  
The Impact

Abstract Background: Transmission of HIV in South Africa continues to be high due to a large proportion of individuals living with undiagnosed HIV. Uptake of HIV testing is influenced by a multitude of factors including the patient’s knowledge and beliefs about HIV. Methods: This study sought to quantify the impact of knowledge and attitudes on HIV testing acceptance in an emergency department by co-administering a validated HIV knowledge and attitudes survey to patients who were subsequently offered HIV testing. Results: During the study period 223 patients were interviewed and offered HIV testing. Individuals reporting more negative overall attitudes (p = 0.006), higher levels of stigma to HIV testing (p<0.001), and individuals who believed their test was confidential (p<0.001) were more likely to accept an HIV test. Conclusions: Interventions focused on improving patient perceptions around testing confidentiality will likely have the greatest impact on testing acceptance in the emergency department.

scholarly journals Timing Matters: HIV Testing Rates in the Emergency Department

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Rebecca Schnall ◽  
Nan Liu
Keyword(s):  
Emergency Department ◽  
New York ◽  
New York City ◽  
Hiv Testing ◽  
New York State ◽  
Time Of Day ◽  
Patient Acuity ◽  
York State ◽  
Hiv Test ◽  
Day Of The Week

Study Objectives.In response to the 2010 New York State HIV testing law, we sought to understand the contextual factors that influence HIV testing rates in the emergency department (ED).Methods.We analyzed electronic health record logs from 97,655 patients seen in three EDs in New York City. We used logistic regression to assess whether time of day, day of the week, and season significantly affected HIV testing rates.Results.During our study period, 97,655 patients were evaluated and offered an HIV test. Of these, 7,763 (7.9%) agreed to be tested. Patients arriving between 6 a.m. and 7:59 p.m. were significantly (P<0.001) more likely to be tested for HIV, followed by patients arriving between 8:00 p.m. and 9:59 p.m. (P<0.01) and followed by patients arriving between 5–5:59 a.m. and 10–10:59 p.m. (P<0.05) compared to patients arriving at midnight. Seasonal variation was also observed, where patients seen in July, August, and September (P<0.001) were more likely to agree to be tested for HIV compared to patients seen in January, while patients seen in April and May (P<0.001) were less likely to agree to be tested for HIV.Conclusion.Time of day and season affect HIV testing rates in the ED, along with other factors such as patient acuity and completion of other blood work during the ED visit. These findings provide useful information for improving the implementation of an HIV testing program in the ED.

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