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 ◽  
...  
2020 ◽  
Vol 5 (11) ◽  
pp. e003390
Author(s):  
Nolan M Kavanagh ◽  
Elisabeth M Schaffer ◽  
Alex Ndyabakira ◽  
Kara Marson ◽  
Diane V Havlir ◽  
...  

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.


Author(s):  
Jens Seeberg

Jens Seeberg: Stigma Statistics: Agendas in the Making in Danish AIDS Policy This article explores a number of paradoxes and assumptions in the public debate on AIDS in Denmark. They form part of a recurrent attack on the Danish ‘soft line’ AIDS policy that maintains anonymity and voluntary HIV-testing. One central issue in recent years has been obligatory testing of asylum seekers from high risk areas as a precondition for considering the asylum request. Especially asylum seekers from African countries are pointed out as constituting a major threat to the native Danish population in terms of spread of HIV. This is shown to rest on a misreading of the official statistics, repeated as often as the statistics themselves. The assumption that there is a basic clash between the human rights of the HIV-infected person and the population in general is discussed. This conceived clash rests on the assumption that restrictions of the human rights of the HIV-infected person will provide efficient protection for the noninfected majority. The potential counterproductive effects of this line of thought are discussed. Contact tracing is sometimes considered as an effective preventive measure. Part of the critique of the present AIDS policy States that contact tracing is virtually non-existing and that this has a major negative impact on the preventive efforts. It is argued that while the impact of contact tracing in itself may be rather limited, the lack of contact tracing may be seen as a symptom of insufficient counselling. While obligatory HIV testing may never be practiced in Denmark, its recurrent appearance on the agenda serves to provoke a defensive stand among AIDS policy makers. It is argued that this debate has hitherto had the effect of keeping the needs of HIV-infected people - and especially HIV-infected immigrants — away from public debate and serious concern.


2014 ◽  
Vol 17 (5) ◽  
pp. 1322-1329
Author(s):  
Terence T. Sio ◽  
Kenneth Chang ◽  
Ritujith Jayakrishnan ◽  
Allon Amitai ◽  
He Xu ◽  
...  

2011 ◽  
Vol 87 (7) ◽  
pp. 588-593 ◽  
Author(s):  
D. P. Wilson ◽  
C. K. Fairley ◽  
D. Sankar ◽  
H. Williams ◽  
P. Keen ◽  
...  

Sexual Health ◽  
2015 ◽  
Vol 12 (4) ◽  
pp. 360 ◽  
Author(s):  
Byron C. Minas ◽  
Carolien M. Giele ◽  
Sue C. Laing ◽  
Lisa Bastian ◽  
Andrew W. Burry ◽  
...  

Background In July 2010, the Western Australian AIDS Council established the ‘M Clinic’, a peer-led STI testing service for MSM. This study describes trends in HIV notifications among MSM in WA from 2004 to 2013, particularly the impact of the M Clinic on newly acquired HIV diagnoses. Methods: The number and proportion of MSM HIV cases with newly acquired infection were compared for the 2004–2006, 2007–2009 and 2011–2013 time periods. Data from 2010 were excluded as the M Clinic opened in July 2010. Results: Between the 2004–2006 and 2007–2009 periods, the number of MSM with newly acquired HIV increased by 50% (23 to 33 cases) and the number of newly acquired cases as a proportion of all new HIV diagnoses among MSM increased from 27% to 35% (30% increase) (P = 0.25). In the 2011–2013 period, the number of newly acquired HIV cases among MSM more than doubled to 70 cases and comprised 53% of all new HIV diagnoses among MSM (P < 0.05). Of the 70 newly acquired HIV cases in the 2011–2013 period, 30% (n = 21) were diagnosed at the M Clinic. Conclusions: The proportion of MSM HIV notifications that were newly acquired increased between 2004 and 2013 in WA, with the greatest increase seen after the M Clinic commenced operation. A peer-led approach to HIV testing should be considered in order to achieve early diagnosis and treatment of HIV among MSM.


Sexual Health ◽  
2005 ◽  
Vol 2 (3) ◽  
pp. 143 ◽  
Author(s):  
Maria de Bruyn ◽  
Susan Paxton

With increased availability of antiretroviral therapy, there is an escalating global trend to test all pregnant women for HIV in order to stop perinatal transmission. However, insufficient consideration is given to the impact this may have on the lives of these women and their families. Many women feel pressured into HIV testing during pregnancy, do not receive adequate pre-test counselling or do not give truly informed consent. Some women who test positive experience significantly more discrimination from their partners, families and community members than HIV-positive men do. As a consequence, large numbers of women diagnosed during pregnancy do not tell their husband their status because they fear blame, abandonment or abuse, including physical assault. Women who do disclose their HIV status may face dramatic negative repercussions on their own and their children’s wellbeing. Consequently, it is unfair to test women during pregnancy solely or mainly to help prevent perinatal transmission if there are no available support services to protect the women’s rights, enable them to live healthily after an HIV-positive diagnosis and engage them in the policies and programmes that affect women’s lives. We need to create a climate that encourages HIV testing before pregnancy so that women can make informed reproductive choices. Men must be brought into the testing process through couple counselling before pregnancy and scaling up of voluntary counselling and testing programmes outside the antenatal care setting. In addition, people living with HIV have unique expertise and are very effective as peer counsellors. They have been under-utilised in the health care sector to provide support to newly-diagnosed people and to help eliminate AIDS-related shame and stigma.


2014 ◽  
Vol 05 (01) ◽  
pp. 299-312 ◽  
Author(s):  
N. Liu ◽  
J. Sperling ◽  
R. Green ◽  
S. Clark ◽  
D. Vawdrey ◽  
...  

SummaryObjective: Based on US. Centers for Disease Control and Prevention recommendations, New York State enacted legislation in 2010 requiring healthcare providers to offer non-targeted human immunodeficiency virus (HIV) testing to all patients aged 13–64. Three New York City adult emergency departments implemented an electronic alert that required clinicians to document whether an HIV test was offered before discharging a patient. The purpose of this study was to assess the impact of the electronic alert on HIV testing rates and diagnosis of HIV positive individuals.Methods: During the pre-intervention period (2.5–4 months), an electronic “HIV Testing” order set was available for clinicians to order a test or document a reason for not offering the test (e.g., patient is not conscious). An electronic alert was then added to enforce completion of the order set, effectively preventing ED discharge until an HIV test was offered to the patient. We analyzed data from 79,786 visits, measuring HIV testing and detection rates during the pre-intervention period and during the six months following the implementation of the alert.Results: The percentage of visits where an HIV test was performed increased from 5.4% in the pre-intervention period to 8.7% (p<0.001) after the electronic alert. After the implementation of the electronic alert, there was a 61% increase in HIV tests performed per visit. However, the percentage of patients testing positive per total patients-tested was slightly lower in the post-intervention group than the pre-intervention group (0.48% vs. 0.55%), but this was not significant. The number of patients-testing positive per total-patient visit was higher in the post-intervention group (0.04% vs. 0.03%).Conclusions: An electronic alert which enforced non-targeted screening was effective at increasing HIV testing rates but did not significantly increase the detection of persons living with HIV. The impact of this electronic alert on healthcare costs and quality of care merits further examination.Citation: Schnall R, Liu N, Sperling J, Green R, Clark S, Vawdrey D. An electronic alert for HIV screening in the emergency department increases screening but not the diagnosis of HIV. Appl Clin Inf 2014; 5: 299–312 http://dx.doi.org/10.4338/ACI-2013-09-RA-0075


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