scholarly journals Community-based HIV testing in The Netherlands: experiences of lay providers and end users at a rapid HIV test checkpoint

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Nori Krabbenborg ◽  
Ralph Spijker ◽  
Anna Maria Żakowicz ◽  
Milo de Moraes ◽  
Titia Heijman ◽  
...  
Keyword(s):  
The Netherlands ◽  
Hiv Testing ◽  
Transitional Care ◽  
End Users ◽  
Healthcare Sector ◽  
Key Populations ◽  
Structured Interviews ◽  
Test Procedures ◽  
Hiv Test ◽  
Rapid Hiv Test

Abstract Background The AIDS Healthcare Foundation (AHF-Checkpoint) in The Netherlands offers rapid HIV testing for key populations by lay providers. We explored the experiences and needs of lay providers and end users of HIV testing at AHF-Checkpoint, taking into account the WHO 5C-(consent, confidentiality, counselling, correct-results, connection-to-care) criteria for HIV test services. Methods Qualitative evaluation with 15 semi-structured interviews conducted during 2020 with ten lay providers and five gay or bisexual end users. Recorded interviews were thematically analysed, taking data triangulation into account. Results Four domains were identified: (1) accessibility of HIV testing, (2) quality of test procedures, (3) bridging (transitional care), and (4) future strategies for service delivery. AHF-Checkpoint fills a gap for key populations including LGBTQ and refugees, who experience HIV testing barriers at sexual health centres or general practices. The level of trust between lay providers and end users was highly valued by end users. They appreciated the low threshold to test at no costs, and the absence of waiting lists or triaging. Needs expressed by lay providers included more preparedness for emotionally charged situations, and extra training to improve STI knowledge. End users expressed a need for a full STI test package. Of the 5Cs, consent, counselling, and correct results were realised but confidentiality was sometimes difficult to achieve at pop-up locations, and referral barriers for confirmation testing (connection-to-care) were occasionally experienced by lay providers during weekends. Conclusion AHF-Checkpoint was described as a convenient and easily accessible service by end users and lay providers. Of the WHO 5Cs, connection-to-care could be optimised to ensure HIV confirmation and STI testing through a liaison approach with professionals from the regular healthcare sector.

scholarly journals Strengths and weaknesses of rapid hiv test implementation in a specialized center in Brazil

2018 ◽  
Vol 20 (5) ◽  
pp. 560-567
Author(s):  
Adolfo Pizzinato ◽  
Kátia Bones Rocha ◽  
Rodrigo De Oliveira-Machado ◽  
Fernanda Torres de Carvalho ◽  
Isadora Nogueira-Freire
Keyword(s):  
Health Care ◽  
Hiv Testing ◽  
Health Care Access ◽  
Health Care Professionals ◽  
Rapid Test ◽  
Service Users ◽  
Structured Interviews ◽  
Rapid Hiv Testing ◽  
Hiv Test ◽  
Rapid Hiv Test

Objective To analyze how health professionals and health service users assess counseling on Rapid HIV test, as well as its implementation, which started in Brazil in 2010, focusing on positive aspects, barriers, and limitations, and analyzing possible meanings that are given to STD and HIV/AIDS.Method Qualitative, exploratory, and descriptive research. Semi-structured interviews were administered to 27 service users and 14 health care professionals; a thematic analysis of the interviews was performed. The study was carried out in one of the first Counseling and Testing Centers (CTC) designed to implement Rapid HIV tests in Porto Alegre, Brazil.Results Positive aspects of Rapid HIV testing implementation included a reduced waiting time for obtaining the test results, better assistance provision, an increase in the number of service hours, personalized pre- and post-tests, and better prepared health care professionals regarding health care during counseling. Limitations included beliefs about the effectiveness of Rapid HIV testing, physical structure, bad publicity on this technology, and poor health care capacity. Likewise, there are some who oppose this type of test, since they believe rapid tests may not be effective.Conclusions Integrating the perspectives of health care professionals and users on this policy will favor future rapid test implementations in other CTCs, and increase health care access possibilities.

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 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 Implementation of Rapid HIV Testing Programs in Community and Outreach Settings: Perspectives from Staff at Eight Community-Based Organizations in Seven U.S. Cities

2008 ◽  
Vol 123 (3_suppl) ◽  
pp. 86-93 ◽  
Author(s):  
Hollie A. Clark ◽  
Kristina E. Bowles ◽  
Binwei Song ◽  
James D. Heffelfinger
Keyword(s):  
High Risk ◽  
Hiv Testing ◽  
Confirmatory Test ◽  
Test Results ◽  
Community Based ◽  
Hiv Counseling ◽  
Community Based Organizations ◽  
Counseling And Testing ◽  
Hiv Test ◽  
Rapid Hiv Test

Objectives. The goals of this research were to evaluate perceptions of staff about the effectiveness of methods used by eight community-based organizations (CBOs) to implement human immunodeficiency virus (HIV) counseling and rapid testing in community and outreach settings in seven U.S. cities, and to identify operational challenges. Methods. A survey was administered to CBO staff to determine their perceptions about the effectiveness of methods used to select testing venues, promote their testing programs, recruit people for testing, provide test results, and link HIV-positive people to health care. Using a Likert scale, respondents rated the effectiveness of methods, their agreement with statements about using mobile testing units (MTUs) and rapid HIV test kits, and operational challenges. Results. Most respondents perceived the methods they used for selecting testing venues, and particularly using recommendations from people receiving testing, to be effective. Most respondents also thought their promotional activities were effective. Respondents believed that using MTUs improved their capacity to reach high-risk individuals, but that MTUs were associated with substantial challenges (e.g., costs to purchase and maintain them). Programmatic challenges included training staff to provide counseling and testing, locating and providing confirmatory test results to people with reactive rapid tests, and sustaining testing programs. Conclusions. CBO staff thought the methods used to select venues for HIV testing were effective and that using MTUs increased their ability to provide testing to high-risk individuals. However, using MTUs was expensive and posed logistical difficulties. CBOs planning to implement similar programs should take these findings into consideration and pay particular attention to training needs and program sustainability.

HIV testing in an urgent-care clinic

Sexual Health ◽  
2005 ◽  
Vol 2 (4) ◽  
pp. 245 ◽  
Author(s):  
Keith Murphy ◽  
Oscar Grusky ◽  
Kathleen Johnston Roberts ◽  
Aimee-Noelle Swanson
Keyword(s):  
Hiv Prevention ◽  
Hiv Testing ◽  
Urgent Care ◽  
Medical Setting ◽  
Structured Interviews ◽  
Care Clinic ◽  
Health Maintenance ◽  
Hiv Test ◽  
Study Results ◽  
Urgent Care Clinic

Background: Early detection of HIV is increasingly important in light of advances in HIV research and treatment. Although treatment advances offer the potential to curtail HIV incidence and seroprevalence, the full benefits remain unrealised because many infected individuals remain unaware of their serostatus. An intensive observational study of HIV testing and counselling was undertaken in a large health maintenance organisation’s urgent-care clinic (UCC) for non-threatening illnesses and non-traumatic injuries in order to better understand the HIV testing process in a medical setting. Methods: Multiple data collection strategies, including observation, semi-structured interviews and document and policy analyses, were used in order to identify key factors influencing HIV testing. The study examined physicians’, nurses’ and physician’s assistants’ relationships with patients in the UCC. Results: It was found that HIV testing in the UCC is highly variable because some patients are asked about their sexual risk histories and given HIV prevention education materials and others are not. Moreover, for those patients who do receive these components of testing, the content of both the risk assessments and HIV prevention counselling varies from patient to patient. Findings also highlight the problematic nature of providing HIV test results in an UCC. Conclusions: A number of implementation issues were found to be relevant to the new US Centers for Disease Control and Prevention (CDC) policy of making HIV testing a routine feature of medical care. The study results suggest the need for organisationally fine-tuned interventions designed to improve the process of testing patients for HIV in medical settings.

scholarly journals Implementing a Novel Citywide Rapid HIV Testing Campaign in Washington, D.C.: Findings and Lessons Learned

2012 ◽  
Vol 127 (4) ◽  
pp. 422-431 ◽  
Author(s):  
Amanda D. Castel ◽  
Manya Magnus ◽  
James Peterson ◽  
Karishma Anand ◽  
Charles Wu ◽  
...  
Keyword(s):  
Focus Groups ◽  
Hiv Testing ◽  
Black People ◽  
Scale Up ◽  
Qualitative Evaluation ◽  
Lessons Learned ◽  
Hiv Care ◽  
Hiv Screening ◽  
Hiv Test ◽  
Rapid Hiv Test

Objectives. In June 2006, the District of Columbia (DC) Department of Health launched a citywide rapid HIV screening campaign. Goals included raising HIV awareness, routinizing rapid HIV screening, identifying previously unrecognized infections, and linking positives to care. We describe findings from this seminal campaign and identify lessons learned. Methods. We applied a mixed-methods approach using quantitative analysis of client data forms (CDFs) and qualitative evaluation of focus groups with DC residents. We measured characteristics and factors associated with client demographics, test results, and community perceptions regarding the campaign. Results. Data were available on 38,586 participants tested from July 2006 to September 2007. Of those, 68% had previously tested for HIV (44% within the last 12 months) and 23% would not have sought testing had it not been offered. Overall, 662 (1.7%) participants screened positive on the OraQuick® Advance™ rapid HIV test, with non-Hispanic black people, transgenders, and first-time testers being significantly more likely to screen positive for HIV than white people, males, and those tested within the last year, respectively. Of those screening positive for HIV, 47% had documented referrals for HIV care and treatment services. Focus groups reported continued stigma regarding HIV and minimal community saturation of the campaign. Conclusions. This widespread campaign tested thousands of people and identified hundreds of HIV-infected individuals; however, referrals to care were lower than anticipated, and awareness of the campaign was limited. Lessons learned through this scale-up of population-based HIV screening resulted in establishing citywide HIV testing processes that laid the foundation for the implementation of test-and-treat activities in DC.

scholarly journals Men’s use of sexual health and HIV services in Swaziland: a mixed methods study

Sexual Health ◽  
2016 ◽  
Vol 13 (3) ◽  
pp. 265 ◽  
Author(s):  
Joelle Mak ◽  
Susannah H. Mayhew ◽  
Ariane von Maercker ◽  
Integra Research Team ◽  
Manuela Colombini
Keyword(s):  
Sexual Health ◽  
Hiv Testing ◽  
Adult Population ◽  
Healthcare Services ◽  
Traditional Healers ◽  
Service Users ◽  
Structured Interviews ◽  
Health Seeking ◽  
Hiv Services ◽  
Hiv Test

Background: Over one-quarter of the adult population in Swaziland is estimated to be HIV positive. Men’s use of sexual health (SH) services has significant implications for HIV prevention. This study aimed to understand Swazi men’s health-seeking behaviours in relation to SH and HIV services. Methods: A household survey was conducted in Manzini (n = 503), complemented by 23 semi-structured interviews and two focus group discussions (with a total of 10 participants). Results: One-third of male survey participants used SH services in the past year, most commonly HIV testing (28%). Service users were more likely to be sexually active (aOR 3.21, 95% CI: 1.81–5.68 for those with one partner; and aOR 2.35, 95% CI: 1.25–4.41 for those with multiple partners) compared with service non-users. Service users were less likely to prefer HIV services to be separated from other healthcare services (aOR 0.50, 95% CI: 0.35–0.71), or to agree with travelling further for their HIV test (aOR 0.52, 95% CI: 0.33–0.82) compared with non-users, after controlling for age-group and education. Men avoided SH services because they feared being stigmatised by STI/HIV testing, are uncomfortable disclosing SH problems to female healthcare providers, and avoided HIV testing by relying on their wife’s results as a proxy for their own status. Informal providers, such as traditional healers, were often preferred because practitioners were more often male, physical exams were not required and appointments and payment options were flexible. Conclusion: To improve men’s uptake of SH services, providers and services need to be more sensitive to men’s privacy concerns, time restrictions and the potential stigma associated with STI/HIV testing.

A novel time-limited pop-up HIV testing service for gay men in Sydney, Australia, attracts high-risk men

Sexual Health ◽  
2014 ◽  
Vol 11 (4) ◽  
pp. 345 ◽  
Author(s):  
Vickie Knight ◽  
Marianne Gale ◽  
Rebecca Guy ◽  
Nicolas Parkhill ◽  
Jo Holden ◽  
...  
Keyword(s):  
High Risk ◽  
Confidence Interval ◽  
Sexual Health ◽  
Hiv Testing ◽  
Fast Track ◽  
Health Clinic ◽  
Screening Service ◽  
Testing Service ◽  
Hiv Test ◽  
Rapid Hiv Test

Background HIV diagnoses have been increasing steadily in Australia and are concentrated among gay, bisexual and other men who have sex with men (GBM). HIV testing is a key control strategy, and in 2013, a novel time-limited pop-up community HIV testing service (Pop-up) was introduced to raise awareness and increase testing options for GBM. The Pop-up service offered rapid HIV tests only. We compared uptake and outcomes of the Pop-up service to an established clinical model [a fast-track screening service in a sexual health clinic offering rapid and/or conventional HIV tests and sexually transmissible infection (STI) tests]. Methods: Service delivery data was collated and analysed from the HIV Pop-up (25 November to 1 December 2013) and the fast-track HIV/STI screening service (Xpress) in a sexual health clinic immediately before the Pop-up (1 August to 22 November 2013). A comparison of all the HIV tests and results, tests per hour and characteristics of new clients (demographics, risk behaviour, testing history) was conducted using χ2, Poisson distribution and Ranksum tests. Results: At the Pop-up service, 182 GBM had a rapid HIV test conducted over the 5-day period (average: seven HIV tests per hour) and no HIV tests were reactive (0%, 95% confidence interval: 0–1.8%). At the Xpress service, 1075 asymptomatic GBM had at least one STI test and 957 GMB had a HIV test (rapid or conventional) conducted over the 3-month period (average: four HIV tests per hour), with two positive HIV tests (0.2%, 95% confidence interval: 0.02–0.7) and 151 positive STI tests (14%, 95% confidence interval: 12–16.2). Compared with new patients at the Xpress service, GBM attending the Pop-up service were older (median of 39 vs 29 years, P < 0.01); more likely to report ≥5 sexual partners in the past 3 months (P = 0.02); more likely to reside in ‘Gay Sydney’ (P < 0.01); and more likely to be tested for HIV (P < 0.01). Conclusions: Time-limited Pop-up community HIV testing is feasible and reached high-risk GBM, but compared with a clinic-based model, it only reached a smaller proportion of GBM who test infrequently or who have never been tested and are unaware of their HIV status. No STI testing was conducted through the Pop-up service, which allowed a higher throughput of HIV tests; however, a significant number of STIs may have been missed.

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