scholarly journals Implementation of different HIV self-testing models with implications for HIV testing services during the COVID-19 pandemic: study protocol for secondary data analysis of the STAR Initiative in South Africa

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e048585
Author(s):  
Mohammed Majam ◽  
Donaldson F Conserve ◽  
Vincent Zishiri ◽  
Zelalem T Haile ◽  
Angela Tembo ◽  
...  
Keyword(s):  
South Africa ◽  
Data Analysis ◽  
Hiv Testing ◽  
Linkage To Care ◽  
Secondary Data ◽  
Factors Associated ◽  
Self Testing ◽  
Hiv Testing Services ◽  
Care And Treatment ◽  
Risk Ratios

IntroductionHIV self-testing (HIVST) presents a convenient, private approach that removes barriers to providing HIV testing services. The Self-Testing Africa (STAR) Initiative aims to scale up HIVST among priority and undertested populations. HIVST has the potential to help maintain testing services during the social distancing restrictions implemented to prevent the spread of COVID-19. This project evaluates linkage to confirmatory testing and treatment for HIV-positive clients for the STAR South Africa site.Methods and analysisThis secondary data analysis protocol aims to evaluate different HIVST distribution models from a prospective study implemented during November 2017 and December 2020 by Ezintsha, a subdivision of Wits Reproductive Health and HIV Institute. Routinely collected distribution and self-reported HIVST outcomes data will be deidentified and analysed. The main outcomes of interest are linkage to care and treatment among HIVST users who report a reactive HIVST result. Additionally, we plan to determine sociodemographic factors associated with linkage to care and treatment among HIVST users. Descriptive statistics will be used to describe the variables of interest, and modified Poisson regression with robust variance estimation will be performed to identify factors associated with linkage to care and treatment among HIVST users who report a reactive HIVST result. Risk ratios and 95% CIs for the risk ratios will be reported.Ethics and disseminationThe study protocol has been approved by the University of Witwatersrand Human Research Ethics Committee. The dissemination plan for the study findings will include presentations to local and international health authorities, international conferences and publications in open access journals.

scholarly journals Factors associated with linkage to HIV care and TB treatment at community-based HIV testing services in Cape Town, South Africa

PLoS ONE ◽  
2018 ◽  
Vol 13 (4) ◽  
pp. e0195208 ◽  
Author(s):  
Sue-Ann Meehan ◽  
Rosa Sloot ◽  
Heather R. Draper ◽  
Pren Naidoo ◽  
Ronelle Burger ◽  
...  
Keyword(s):  
South Africa ◽  
Hiv Testing ◽  
Cape Town ◽  
Hiv Care ◽  
Community Based ◽  
Factors Associated ◽  
Tb Treatment ◽  
Hiv Testing Services ◽  
Linkage To Hiv Care

scholarly journals Is HIV self-testing a potential answer to the low uptake of HIV testing services among men in Rwanda? Perspectives of male youths attending tertiary institutions and Kimisagara Youth Centre in Kigali, Rwanda

2019 ◽  
Author(s):  
Tafadzwa Dzinamarira ◽  
Gashema Pirre ◽  
Nadine Rujeni
Keyword(s):  
Data Analysis ◽  
Hiv Testing ◽  
Sufficient Information ◽  
Social Harm ◽  
Tertiary Institutions ◽  
Self Testing ◽  
Hiv Testing Services ◽  
Main Barrier ◽  
The Cost ◽  
Youth Centre

Abstract Objective To explore whether HIV self-testing (HIVST) would have the capacity to improve uptake of HIV testing services among male youths in Rwanda. We conducted a qualitative study of 22 male youths attending tertiary institutions and the Kimisagara Youth Centre in Kigali, Rwanda. Data collection was conducted through open interviews. Data analysis was conducted through thematic content analysis. Results Our findings revealed that most male youths had poor knowledge of HIV self-testing (HIVST), but the majority were willing to adopt it. Four main themes emerged during data analysis. Theme one indicated that male youths experienced a lack of sufficient information on HIVST. From theme two, it was uncovered that some male youths were indifferent to HIVST. From theme three, it emerged that most men perceived the cost as the main barrier to HIVST; however, if it was offered free of charge, they were willing to adopt it. Finally, theme four revealed that most male youths willing to adopt HIVST were concerned about the potential social harm and possible adverse events associated with HIVST.

scholarly journals Same-Day CD4 Testing to Improve Uptake of HIV Care and Treatment in South Africa: Point-of-Care Is Not Enough

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Bruce A. Larson ◽  
Kathryn Schnippel ◽  
Alana Brennan ◽  
Lawrence Long ◽  
Thembi Xulu ◽  
...  
Keyword(s):  
South Africa ◽  
Hiv Testing ◽  
Point Of Care ◽  
Linkage To Care ◽  
Retention In Care ◽  
Baseline Period ◽  
Hiv Care ◽  
Hiv Positive ◽  
Care And Treatment ◽  
Cd4 Testing

Background. We evaluated whether a pilot program providing point-of-care (POC), but not rapid, CD4 testing (BD FACSCount) immediately after testing HIV-positive improved retention in care.Methods. We conducted a retrospective record review at the Themba Lethu Clinic in Johannesburg, South Africa. We compared all walk-in patients testing HIV-positive during February, July 2010 (pilot POC period) to patients testing positive during January 2008–February 2009 (baseline period). The outcome for those with a≤250cells/mm3when testing HIV-positive was initiating ART<16weeks after HIV testing.Results. 771 patients had CD4 results from the day of HIV testing (421 pilots, 350 baselines). ART initiation within 16 weeks was 49% in the pilot period and 46% in the baseline period. While all 421 patients during the pilot period should have been offered the POC test, patient records indicate that only 73% of them were actually offered it, and among these patients only 63% accepted the offer.Conclusions. Offering CD4 testing using a point-of-care, but not rapid, technology and without other health system changes had minor impacts on the uptake of HIV care and treatment. Point-of-care technologies alone may not be enough to improve linkage to care and treatment after HIV testing.

scholarly journals Is HIV Self-Testing a Potential Answer to the Low Uptake of HIV Testing Services Among Men in Rwanda? Perspectives of Men Attending Tertiary Institutions and Kimisagara Youth Centre in Kigali, Rwanda

2019 ◽  
Vol 11 (11) ◽  
pp. 67 ◽  
Author(s):  
Tafadzwa Dzinamarira ◽  
Gashema Pierre ◽  
Nadine Rujeni
Keyword(s):  
Data Analysis ◽  
Hiv Testing ◽  
Sufficient Information ◽  
Social Harm ◽  
Tertiary Institutions ◽  
Self Testing ◽  
Hiv Testing Services ◽  
Main Barrier ◽  
The Cost ◽  
Youth Centre

BACKGROUND &amp; OBJECTIVE: Rwanda has generally experienced low uptake of HIV testing services among men. However, the reasons behind this have not been researched. The main aim of this study was to explore whether HIV self-testing (HIVST) would have the capacity to improve uptake of HIV testing services among men in Rwanda. METHODS: We conducted a qualitative study of 22 men attending tertiary institutions and the Kimisagara Youth Centre in Kigali, Rwanda. Data collection was conducted through open interviews. Data analysis was conducted through thematic content analysis. RESULTS: Our findings revealed that most men had poor knowledge of HIVST, but the majority were willing to adopt it. Four main themes emerged during data analysis. Theme one indicated that men experienced a lack of sufficient information on HIVST. From theme two, it was uncovered that some men were indifferent to HIVST. From theme three, it emerged that most men perceived the cost as the main barrier to HIVST; however, if it was offered free of charge, they were willing to adopt it. Finally, theme four revealed that most men willing to adopt HIVST were concerned about the potential social harm and possible adverse events associated with HIVST.

scholarly journals Drivers and barriers to workplace-based HIV self-testing among high-risk men in Uganda: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Patience A. Muwanguzi ◽  
Robert C. Bollinger ◽  
Stuart C. Ray ◽  
LaRon E. Nelson ◽  
Noah Kiwanuka ◽  
...  
Keyword(s):  
Focus Group ◽  
Hiv Testing ◽  
Private Security ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Private Security Companies ◽  
Self Testing ◽  
Key Informant ◽  
Hiv Testing Services ◽  
Security Companies

Abstract Background Men in Sub-Saharan Africa are less engaged than women in accessing HIV testing and treatment and, consequently, experience higher HIV-related mortality. Reaching men with HIV testing services is challenging, thus, increasing the need for innovative ways to engage men with low access and those at higher risk. In this study, we explore men’s perceptions of drivers and barriers of workplace-based HIV self-testing in Uganda. Methods An exploratory study involving men working in private security companies employing more than 50 men in two districts, in central and western Uganda. Focus group discussions and key informant interviews were conducted. Data were analyzed using inductive content analysis. Results Forty-eight (48) men from eight private security companies participated in 5 focus group discussions and 17 key informant interviews. Of the 48 men, 14(29.2%) were ages 26–35 years. The majority 31(64.6%) were security guards. The drivers reported for workplace-based HIV self-testing included convenience, autonomy, positive influence from work colleagues, the need for alternative access for HIV testing services, incentives, and involvement of employers. The barriers reported were the prohibitive cost of HIV tests, stigma, lack of testing support, the fear of discrimination and isolation, and concerns around decreased work productivity in the event of a reactive self-test. Conclusions We recommend the involvement of employers in workplace-based HIV self-testing to encourage participation by employees. There is need for HIV self-testing support both during and after the testing process. Both employers and employees recommend the use of non-monetary incentives, and regular training about HIV self-testing to increase the uptake and acceptability of HIV testing services at the workplace.

scholarly journals FACTORS THAT INFLUENCE PSYCHOTROPIC MEDICATION USE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S558-S558
Author(s):  
Barbara Resnick ◽  
Elizabeth Galik
Keyword(s):  
Cognitive Impairment ◽  
Data Analysis ◽  
Antipsychotic Medication ◽  
Psychotropic Medication ◽  
Medication Use ◽  
Secondary Data ◽  
Behavioral Symptoms ◽  
Factors Associated ◽  
Resistiveness To Care ◽  
N 93

Abstract Understanding the factors that influence psychotropic can guide reduction in use of these medications. This study described predictors of psychotropics use among residents with moderate to severe cognitive impairment. This was a secondary data analysis using baseline data from the first 341 residents in the EIT-4-BPSD trial. Predictive measures included demographics, agitation, resistiveness to care, depression, cognition, pain, facility factors and state. Overall 63% (n=211) received at least one psychotropic medication, 16% (n=52) an anti-seizure medication, 23% (n=77) an anxiolytic, 30% (n=99) an antidepressant, 2% (n=8) a sedative hypnotic, 28% (n=93) an antipsychotic medication, and 9% (n=29) an opioid. Model testing explained 9 to 15% of psychotropic medication use. There were high rates of psychotropic medication use and a limited association between demographic factors, behavioral symptoms, and psychotropic medication use. Continued research is needed to explore additional factors associated with psychotropic medication use such as beliefs of providers.

scholarly journals Formative research to inform the development of a peer-led HIV self-testing intervention to improve HIV testing uptake and linkage to HIV care among adolescents, young people and adult men in Kasensero fishing community, Rakai, Uganda: a qualitative study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Joseph K. B. Matovu ◽  
Aminah Nambuusi ◽  
Scovia Nakabirye ◽  
Rhoda K. Wanyenze ◽  
David Serwadda
Keyword(s):  
Young People ◽  
Hiv Testing ◽  
Hiv Care ◽  
Hiv Positive ◽  
Fishing Community ◽  
Adult Men ◽  
Self Testing ◽  
Testing Uptake ◽  
Hiv Testing Services ◽  
Linkage To Hiv Care

Abstract Background Despite efforts to improve HIV testing and linkage to HIV care among adolescents, young people and adult men, uptake rates remain below global targets. We conducted formative research to generate data necessary to inform the design of a peer-led HIV self-testing (HIVST) intervention intended to improve HIV testing uptake and linkage to HIV care in Kasensero fishing community in rural Uganda. Methods This qualitative study was conducted in three study communities in Kasensero fishing community in Rakai district, Uganda, in May 2019. Six single-sex focus group discussions (FGDs) comprising 7–8 participants were conducted with adolescents and young people (15–24 years) and adult men (25+ years). We collected data on people’s perceptions about peer-led HIVST; potential acceptability of a peer-led HIVST intervention and suggestions on how to improve linkage to HIV care after a positive HIVST result. Peer-led HIVST was defined as an approach where trained lay people distribute HIVST kits to other people in the community. FGDs were audio-recorded with permission from the participants, transcribed verbatim and analysed manually following a thematic framework approach. Results Forty-seven participants (31 men and 16 women) participated in the FGDs. Across communities and age-groups, most participants mentioned that peer-led HIVST would be generally acceptable to people in the fishing community but people will need support in performing the test due to fear of performing the test wrongly or failing to cope with HIV-positive results. Most participants felt that peer-led HIVST would bring HIV testing services closer to the community “because [the peer-leader] could be my immediate neighbour”, making it easier for people to obtain the kits at any time of their convenience. To improve linkage to HIV care, participants felt that the use of peer-leaders to deliver the initial ART dose to self-tested HIV-positive individuals would be more preferable to the use of community-based ART groups or home-based ART initiation. Conclusion Our study shows that peer-led HIVST is potentially acceptable in the fishing community. These findings suggest that this approach can improve uptake of HIV testing and linkage to HIV care services among populations that are usually missed through conventional HIV testing services.

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