Hepatitis and tuberculosis testing are much less common than HIV testing among adults in Kisumu, Kenya: results from a cross-sectional assessment

Abstract Background Kenya has a high burden of HIV, viral hepatitis, and tuberculosis. Screening is necessary for early diagnosis and treatment, which reduces morbidity and mortality across all three illnesses. We evaluated testing uptake for HIV, viral hepatitis, and tuberculosis in Kisumu, Kenya. Methods Cross-sectional data from adults aged 18–35 years who enrolled in a prospective HIV incidence cohort study from February 2017 to May 2018 were analyzed. A questionnaire was administered to each participant at screening for study eligibility to collect behavioral characteristics and to assess prior testing practices. Among participants without a history of previously-diagnosed HIV, multivariable robust Poisson regression was used to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) for factors potentially associated with HIV testing in the 12 months prior to enrollment. A hierarchical model was used to test for differential access to testing due to spatial location. Results Of 671 participants, 52 (7.7%) were living with HIV, 308 (45.9%) were female, and the median age was 24 (interquartile range 21–28) years. Among 651 (97.0%) who had ever been tested for HIV, 400 (61.2%) reported HIV testing in the past 6 months, 129 (19.7%) in the past 6–12 months, and 125 (19.1%) more than one year prior to enrollment. Any prior testing for viral hepatitis was reported by 8 (1.2%) participants and for tuberculosis by 51 (7.6%). In unadjusted models, HIV testing in the past year was more common among females (PR 1.08 [95% CI 1.01, 1.17]) and participants with secondary education or higher (PR 1.10 [95% CI 1.02, 1.19]). In the multivariable model, only secondary education or higher was associated with recent HIV testing (adjusted PR 1.10 [95% CI 1.02, 1.20]). Hierarchical models showed no geographic differences in HIV testing across Kisumu subcounties. Conclusions Prior HIV testing was common among study participants and most had been tested within the past year but testing for tuberculosis and viral hepatitis was far less common. HIV testing gaps exist for males and those with lower levels of education. HIV testing infrastructure could be leveraged to increase access to testing for other endemic infectious diseases.

Download Full-text

Factors associated with HIV testing among traditional healers and their clients in rural Uganda: Results from a cross-sectional study

International Journal of STD & AIDS ◽

10.1177/09564624211015028 ◽

2021 ◽

pp. 095646242110150

Author(s):

Doreen Nabukalu ◽

Matthew Ponticiello ◽

Thomas Bennett ◽

Sunday Clark ◽

Rachel King ◽

...

Keyword(s):

Rural Communities ◽

Hiv Testing ◽

Cross Sectional Study ◽

Traditional Healers ◽

Sectional Study ◽

Cross Sectional ◽

The Past ◽

Male Clients ◽

Hiv Test ◽

Testing Uptake

Uptake of HIV testing is suboptimal in Uganda, particularly in rural communities. Reaching UNAIDS 95-95-95 goals requires strategies to increase HIV testing among hard-to-reach populations. This cross-sectional study sought to characterize engagement with HIV testing among traditional healers and their clients in rural Uganda. We enrolled 175 traditional healers and 392 adult clients of healers in Mbarara District. The primary outcome for this study was having received an HIV test in the prior 12 months. Most clients ( n = 236, 65.9%) had received an HIV test within 12 months, compared to less than half of healers ( n = 75, 46.3%) who had not. In multivariate regression models, male clients of healers were half as likely to have tested in the past year, compared with female (adjusted odds ratios (AORs) = 0.43, 95% CI = 0.26–0.70). Increasing age negatively predicted testing within the past year (AOR = 0.95, 95% CI = 0.93–0.97) for clients. Among healers, more sexual partners predicted knowing ones serostatus (AOR = 1.6, 95% CI 1.03–2.48). Healers (AOR = 1.16, 95% CI 1.07–1.26) and clients (AOR = 1.28, 95% CI 1.13–1.34 for clients) with greater numbers of lifetime HIV tests were more likely to have tested in the past year. Traditional healers and their clients lag behind UNAIDS benchmarks and would benefit from programs to increase HIV testing uptake.

Download Full-text

Uptake and Correlates of Chlamydia and Gonorrhea Testing among Female Sex Workers in Southern China: A Cross-sectional Study

10.21203/rs.3.rs-55555/v1 ◽

2020 ◽

Author(s):

Peizhen Zhao ◽

Ya-Jie Wang ◽

Huan-Huan Cheng ◽

Ye Zhang ◽

Wei-Ming Tang ◽

...

Keyword(s):

Hiv Testing ◽

Sex Workers ◽

Female Sex Workers ◽

Southern China ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

The Past ◽

Syphilis Testing ◽

Testing Uptake

Abstract Background: Female sex workers (FSW) are at high risk of chlamydia and gonorrhea infection. However, there is a limited literature examining their testing uptake to date. The aim of this study was to assess the uptake and determinants of chlamydia and gonorrhea testing among FSW in Southern China.Methods: A cross-sectional study with convenience sampling was conducted in five cities in Southern China. We collected data on socio-demographic characteristics, sex behaviors, chlamydia and gonorrhea testing in the past twelve months and the utilization of health care services from participants through face-to-face interviews. Multivariable logistic regression was performed to identify factors associated with chlamydia and gonorrhea testing, respectively.Results: Overall, 1207 FSWs were recruited, with the mean age of 30.7±6.8 years old, and an average number of clients per week of 7.0(4.0-10.0). 65.4% participants consistently used condoms with clients in the past month. Only 7.5% and 10.4% had been tested for chlamydia and gonorrhea in the past twelve months, respectively. Multivariable analysis indicated that FSW who worked at low titers (adjusted Odds Ratio (aOR)=2.36, 95%CI:1.23-10.14), had more clients in past month (aOR=1.03, 95%CI:1.01-1.05), used condoms consistently (aOR=1.79, 95%CI:1.12-2.86), had STD symptoms (aOR=4.09,95%CI:2.62-6.40), had HIV testing (aOR=5.16, 95%CI:3.21-8.30) or syphilis testing (aOR=6.90, 95%CI:4.21-11.22) in the past year were more likely to have received chlamydia testing. In addition, FSW who had more clients in the past month (aOR=1.02,95%CI:1.00-1.04), had STD symptoms (aOR=3.33, 95%CI:2.03-5.46), had HIV (aOR=3.94, 95%CI:2.34-6.65) and syphilis testing (aOR=3.27, 95%CI:1.96-5.46) in the past year were more likely to have gonorrhea testing.Conclusions: The chlamydia and gonorrhea testing uptake are low among Chinese FSW. Integrating chlamydia and gonorrhea testing promotion strategies into HIV testing promotion programs may help bridge the gap among FSW.

Download Full-text

Uptake of provider-initiated HIV and syphilis testing among heterosexual STD clinic patients in Guangdong, China: results from a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2020-041503 ◽

2020 ◽

Vol 10 (12) ◽

pp. e041503

Author(s):

Peizhen Zhao ◽

Weiming Tang ◽

Huanhuan Cheng ◽

Shujie Huang ◽

Heping Zheng ◽

...

Keyword(s):

Condom Use ◽

Hiv Testing ◽

Transmitted Disease ◽

Cross Sectional Study ◽

Health Priorities ◽

Consistent Condom ◽

Sectional Study ◽

Cross Sectional ◽

Syphilis Testing ◽

Testing Uptake

ObjectivesUnderscreening of HIV and syphilis in clinical settings is pervasive in resource-constrained settings. Heavy patient loads and competing health priorities in these settings inhibit provider’s ability to meet screening coverage targets. The objective of this study was to examine determinants of provider-initiated HIV and syphilis testing uptake at sexually transmitted disease (STD) clinics in China.DesignA cross-sectional study was performed between July 2016 and December 2016.SettingSeven STD clinics in Guangdong Province, China.ParticipantsHeterosexual STD clinic patients met the inclusion criteria, regardless of their interest in receiving HIV or syphilis testing.Outcome measuresThe syphilis and HIV testing uptake determined by patient receipt of results.ResultsA total of 1943 individuals were recruited in this study. Among those participants, 60.6% (1177/1943) and 74.3% (1443/1943) conducted HIV testing and syphilis testing during the study, respectively, of whom, 2.2% (26/1177) and 21.5% (310/1443) were found to be HIV-positive and syphilis-positive, respectively. The most common reason for rejecting HIV and syphilis testing was a low self-perceived risk of HIV and syphilis infection. After adjusting for covariates, condom use in the last sexual act, consistent condom use in the last 6 months, having paid sex in the last 6 months and having received any kind of HIV/STD-related knowledge during the last 12 years were positively associated with both HIV and syphilis testing uptake.ConclusionsThe low-level of HIV and syphilis testing uptake, alongside with the high-level of engagement in risky sexual behaviours among heterosexual STD clinic patients, warranted a more targeted and intensive behavioural interventions to promote HIV and syphilis testing in this population.

Download Full-text

Changes over time in HIV testing and counselling uptake and associated factors among youth in Zambia: a cross-sectional analysis of demographic and health surveys from 2007 to 2018

BMC Public Health ◽

10.1186/s12889-021-10472-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Aimé Bitakuya Heri ◽

Francesca L. Cavallaro ◽

Nurilign Ahmed ◽

Maurice Mubuyaeta Musheke ◽

Mitsuaki Matsui

Keyword(s):

Pregnant Women ◽

Hiv Testing ◽

Health Surveys ◽

Health Centre ◽

Demographic And Health Surveys ◽

Common Source ◽

Cross Sectional ◽

Government Health ◽

Hiv Testing And Counselling ◽

Testing Uptake

Abstract Introduction Zambia is among the countries with the highest HIV burden and where youth remain disproportionally affected. Access to HIV testing and counselling (HTC) is a crucial step to ensure the reduction of HIV transmission. This study examines the changes that occurred between 2007 and 2018 in access to HTC, inequities in testing uptake, and determinants of HTC uptake among youth. Methods We carried out repeated cross-sectional analyses using three Zambian Demographic and Health Surveys (2007, 2013–14, and 2018). We calculated the percentage of women and men ages 15–24 years old who were tested for HIV in the last 12 months. We analysed inequity in HTC coverage using indicators of absolute inequality. We performed bivariate and multivariate logistic regression analyses to identify predictors of HTC uptake in the last 12 months. Results HIV testing uptake increased between 2007 and 2018, from 45 to 92% among pregnant women, 10 to 58% among non-pregnant women, and from 10 to 49% among men. By 2018 roughly 60% of youth tested in the past 12 months used a government health centre. Mobile clinics were the second most common source reaching up to 32% among adolescent boys by 2018. Multivariate analysis conducted among men and non-pregnant women showed higher odds of testing among 20–24 year-olds than adolescents (aOR = 1.55 [95%CI:1.30–1.84], among men; and aOR = 1.74 [1.40–2.15] among women). Among men, being circumcised (aOR = 1.57 [1.32–1.88]) and in a union (aOR = 2.44 [1.83–3.25]) were associated with increased odds of testing. For women greater odds of testing were associated with higher levels of education (aOR = 6.97 [2.82–17.19]). Education-based inequity was considerably widened among women than men by 2018. Conclusion HTC uptake among Zambian youth improved considerably by 2018 and reached 65 and 49% tested in the last 12 months for women and men, respectively. However, achieving the goal of 95% envisioned by 2020 will require sustaining the success gained through government health centres, and scaling up the community-led approaches that have proven acceptable and effective in reaching young men and adolescent girls who are less easy to reach through the government facilities.

Download Full-text

Opioid overdose in public libraries: Results from a five state survey

10.1101/2020.06.05.20123422 ◽

2020 ◽

Author(s):

Rachel Feuerstein-Simon ◽

Margaret Lowenstein ◽

Roxanne Dupuis ◽

Xochitl Luna Marti ◽

Abby Dolan ◽

...

Keyword(s):

Substance Use ◽

Public Libraries ◽

Public Library ◽

Opioid Overdose ◽

Cross Sectional ◽

Public And Private ◽

The Past ◽

Library Staff ◽

One Year ◽

The One

AbstractIntroductionPublic libraries are increasingly impacted by the overdose crisis. A 2017 survey of public librarians in the state of Pennsylvania revealed that 12% had reported an on-site overdose in the previous year. There are increasing public and private efforts to equip public libraries with the opioid overdose antidote, naloxone.MethodsWe conducted a cross-sectional web-based survey of all public library branches in Colorado, Connecticut, Florida, Michigan, and Virginia. Survey questions. We used descriptive statistics to report frequencies of responses and crude odds ratios were calculated to predict the dichotomized variable of endorsement of naloxone uptake.ResultsLibrary staff reported witnessing on-site alcohol (45%) and injection drug (14%) use in the past month. The one-year cumulative incidence (12% overall) of on-site overdose ranged from a low of 10% in MI, to a high of 17% in FL. Among libraries with on-site overdoses, a minority (21%) stocked naloxone, and 12% had administered naloxone. Overall, 11% of libraries stocked naloxone on-site. Although 24% of respondents reported attending at least one training regarding SUD in the past year, 91% wanted more training on the topic.ConclusionsPublic library staff routinely address issues related to substance use and overdose in their institutions. This work highlights the importance of including public libraries as part of a comprehensive public health strategy to address substance use-related morbidity and mortality in the U.S.

Download Full-text

Are Opportunities Being Missed? Burden of HIV, STI and TB, and Unawareness of HIV among African Migrants

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16152710 ◽

2019 ◽

Vol 16 (15) ◽

pp. 2710

Author(s):

Sónia Dias ◽

Ana Gama ◽

Ana Maria Tavares ◽

Vera Reigado ◽

Daniel Simões ◽

...

Keyword(s):

Infectious Diseases ◽

Hiv Testing ◽

Low Socioeconomic Status ◽

Rapid Test ◽

Sexual Practices ◽

Hiv Positive ◽

Transmitted Infection ◽

Cross Sectional ◽

The Past ◽

African Migrants

Sub-Saharan African migrants (SSAMs) have been disproportionately affected by infectious disease burden. We aimed to identify correlates of HIV, past sexually transmitted infection (STI) and past Tuberculosis infection (TB), as well as examine HIV seropositivity unawareness and testing history among SSAMs. A venue-based sample of 790 SSAMs completed a cross-sectional biobehavioral survey on sexual practices, HIV testing and self-reported infectious diseases; an HIV rapid test was offered. Overall, 5.4% of participants were HIV-positive and 16.7% reported a past STI. Odds of being HIV positive or having a past STI were higher among participants with low socioeconomic status and who experienced violence from a partner. Increased odds of having a past STI were also found among long-term migrants and those who reported sexual risk behaviors. In total, 4.1% of participants had TB in the past; these were more likely male and HIV positive. Unawareness of HIV-positive status was notably high (35%). Half of the participants had never been tested for HIV before, including over a third of those who had STI or TB in the past. Efforts are needed to reduce missed opportunities for HIV/STIs prevention and uptake of HIV testing among SSAMs through more integrated care, while addressing social determinants of infectious diseases.

Download Full-text

Social Capital and HIV Testing Uptake among Indirect Female Sex Workers in Bali, Indonesia

Tropical Medicine and Infectious Disease ◽

10.3390/tropicalmed5020073 ◽

2020 ◽

Vol 5 (2) ◽

pp. 73

Author(s):

I Gusti Ngurah Edi Putra ◽

Pande Putu Januraga

Keyword(s):

Social Capital ◽

Hiv Testing ◽

Peer Support ◽

Social Cohesion ◽

Social Participation ◽

Sex Workers ◽

Female Sex Workers ◽

Cross Sectional ◽

Female Sex ◽

Testing Uptake

Indirect female sex workers (FSWs), a type of FSW working under the cover of entertainment enterprises (e.g., karaoke lounge, bar, etc.), remain as an important key population for HIV transmission, signaling the need of appropriate interventions targeting HIV-related behaviors. This study aimed to investigate the association between social capital and HIV testing uptake. A cross-sectional study was conducted among 200 indirect FSWs in Denpasar, Bali. The dependent variable was HIV testing uptake in the last six months preceding the survey. The main independent variables were social capital constructs: social cohesion (perceived peer support and trust) and social participation. Variables of socio-demographic characteristics were controlled in this study to adjust the influence of social capital. Binary logistic regression was performed. The prevalence of HIV testing in the last six months was 72.50%. The multivariate analysis showed that only peer support from the social capital constructs was associated with HIV testing uptake. Indirect FSWs who perceived a high level of support within FSWs networks were 2.98-times (95% CI = 1.43–6.24) more likely to report for HIV testing. Meanwhile, perceived trust and social participation did not show significant associations in relation to HIV testing uptake. As social cohesion (support) within FSWs’ relationships can play an important role in HIV testing uptake, existing HIV prevention programs should consider support enhancement to develop a sense of belonging and solidarity.

Download Full-text

Trends in HIV prevalence and risk behaviours among men who have sex with men from 2013 to 2017 in Nanjing, China: a consecutive cross-sectional survey

BMJ Open ◽

10.1136/bmjopen-2018-021955 ◽

2019 ◽

Vol 9 (1) ◽

pp. e021955 ◽

Cited By ~ 2

Author(s):

Zhengping Zhu ◽

Hongjing Yan ◽

Sushu Wu ◽

Yuanyuan Xu ◽

Wenjiong Xu ◽

...

Keyword(s):

Hiv Infection ◽

Hiv Testing ◽

Protective Factor ◽

Hiv Prevalence ◽

Secondary Outcome ◽

Risk Behaviours ◽

Cross Sectional ◽

The Past ◽

Testing Rate ◽

Sex With Men

ObjectiveTo examine the trends of HIV prevalence, risk behaviours and HIV testing among men who have sex with men (MSM) in Nanjing.DesignFive consecutive cross-sectional surveys.SettingNanjing, China.Primary and secondary outcome measuresHIV and syphilis prevalence, HIV testing rate and factors associated with HIV infection; demographic characteristics and behaviours.Results649, 669, 577, 633, 503 MSM were recruited from 2013 to 2017. HIV prevalence was 9.9%, 12.3%, 12.5%, 9.8% and 10.1%, respectively. Syphilis prevalence decreased with a range from 10.6% to 5.6%. Risk behaviours like unprotected anal intercourse (UAI) and unprotected virginal sex in the past 6 months decreased, but multiple sex partners and ever used rush popper rose significantly. MSM tested for HIV in the previous year remained stable from 57.0% to 64.1% (P=0.633). Multivariate analysis showed that tested for HIV in the past year was protective factor against HIV infection. MSM who had UAI in the past 6 months, sex role as receptive and dual, diagnosed with sexually transmitted diseases (STDs) in the past year and currently syphilis infected were risk factors for HIV infection.ConclusionsWe observed stable high HIV prevalence, a steady HIV testing rate, decreasing syphilis prevalence and UAI among MSM in Nanjing. However, rush popper use rose dramatically. The HIV preventive strategies for MSM including condom promotion, HIV testing expansion and reduction of rush popper use, STDs screening and standardised treatment should be strengthened.

Download Full-text

Prevalence and Factors Associated With HIV Self-testing Uptake Among Men Who Have Sex With Men in Ningbo, China: A Cross-sectional Study

10.21203/rs.3.rs-76060/v1 ◽

2020 ◽

Author(s):

Hang Hong ◽

Hong-bo Shi ◽

Hai-bo Jiang ◽

Hong-jun Dong ◽

Yun-liang Shen

Keyword(s):

Hiv Testing ◽

Cross Sectional Study ◽

Sexual Contact ◽

Categorical Variables ◽

Sectional Study ◽

Cross Sectional ◽

Factors Associated ◽

The Past ◽

Self Testing ◽

Sex With Men

Abstract BackgroundHIV testing and early linkage to care are critical for reducing the risk of HIV transmission. HIV self-testing (HIVST) is an useful tool for increasing HIV testing frequency.This study aimed to investigate HIVST rates among men who have sex with men (MSM), the characteristics of MSM who had HIVST, and factors associated with HIVST uptake among MSM in Ningbo, China. MethodsA cross-sectional study was conducted from April to October 2019 in Ningbo,China. Participants were aged at least 18 years and having had sexual contact with men in the past year. Proportions were used for categorical variables. Adjusted Odds Ratio (AOR) and 95% Confidence Interval (CI) for characteristics associated with HIVST uptake was processed by multiple logistic regression models.ResultsAmong a sample of 699 MSM recruited, 38.2% had reported previous use of an HIV self-test kit. A greater proportion of HIVST Users had a higher frequency of HIV testing(≥2 times: 70.0% versus 41.2%, p<0.001) in the past one year. Factor associated with HIVST uptake was gay apps use(AOR=1.86,CI=1.13-3.05), multiple male sex partners (AOR=1.90,CI=1.29-2.80), frequency of male-male sexual contact ≥1 times per week(AOR=1.86, CI=1.30-2.66), syphilis infection(AOR=5.48, CI=2.53-11.88).ConclusionsFurther HIVST education should be strengthened for school-aged children and teenagers, and free HIVST kits may be provided to low-income high-risk MSM through gay apps and NGOs to achieve the increased HIV testing frequency.

Download Full-text

Socio-economic Status and Associated Factors in the Uptake of HIV Testing: Findings from the South African Population-based National Household Survey Conducted in 2017

10.21203/rs.3.rs-108686/v1 ◽

2020 ◽

Author(s):

Sean Jooste ◽

Musawenkosi Mabaso ◽

Myra Taylor ◽

Alicia North ◽

Yolande Shean ◽

...

Keyword(s):

Hiv Testing ◽

Perceived Risk ◽

Negative Impact ◽

Economic Status ◽

Household Survey ◽

Population Based ◽

Hiv Treatment ◽

Cluster Sampling ◽

Cross Sectional ◽

Testing Uptake

Abstract Background: Improved understanding of barriers to HIV testing is important for reaching the first of the UNAIDS 90-90-90 targets, which states that 90 percent of HIV positive individuals ought to know their HIV status. This study examined socioeconomic status (SES) factors and related covariates associated with HIV testing uptake in the general population in South Africa. Information on SES and HIV testing may impact the HIV treatment and care cascade and prevention of HIV transmission. Methods: This study used data obtained from a national cross-sectional, population-based household survey conducted in 2017 using a multi-stage stratified random cluster sampling design. A composite SES score was created using multiple correspondence analyses of household assets; households were classified into wealth quintiles and dichotomized into low SES/poorest (lowest 3 quintiles) and high SES/less-poor (highest 2 quintiles). Bivariate and multivariate logistic regression models were fitted to analyse associations between the uptake of HIV testing and a set of socio-demographic and HIV-related variables. Results: HIV testing uptake was 73.8% and 76.7% among low and high SES household, respectively, both of which were below the first 90 target. The findings showed increased uptake of HIV testing was associated with being female and having a higher educational level independent of SES. Decreased uptake of HIV testing was associated with being from White and Indian/Asian race groups, residing in rural formal areas, alcohol consumption, and high self-perceived risk of HIV infection.Conclusions: We found that HIV testing uptake was similar for people from both low and high SES. However, interventions aimed at improving HIV testing in order to reach the first 90 target, should target males, all race groups, those with low education attainment, and those residing in rural formal areas. Reaching the first target will require efforts to improve community knowledge, and awareness about the negative impact of alcohol use and address HIV risk perception.

Download Full-text