Improving uptake of prevention of mother-to-child HIV transmission services in Benue State, Nigeria through a faith-based congregational strategy

Background Nigeria has low antiretroviral therapy (ART) coverage among HIV-positive pregnant women. In a previous cluster-randomized trial in Nigeria, Baby Shower events resulted in higher HIV testing coverage and linkage of pregnant women to ART; here, we assess outcomes of Baby Shower events in a non-research setting. Methods Baby Shower events, including a prayer ceremony, group education, music, gifting of a “mama pack” with safe delivery supplies, and HIV testing with ART linkage support for HIV-positive pregnant women, were conducted in eighty sites in Benue State, Nigeria. Client questionnaires (including demographics, ANC attendance, and HIV testing history), HIV test results, and reported linkage to ART were analyzed. Descriptive data on HIV testing and ART linkage data for facility-based care at ANC clinics in Benue State were also analyzed for comparison. Results Between July 2016 and October 2017, 10,056 pregnant women and 6,187 male partners participated in Baby Shower events; 61.5% of women attended with a male partner. Nearly half of female participants (n = 4515, 44.9%) were not enrolled in ANC for the current pregnancy, and 22.3% (n = 2,241) of female and 24.8% (n = 1,532) of male participants reported they had never been tested for HIV. Over 99% (n = 16,240) of participants had their HIV status ascertained, with 7.2% of females (n = 724) and 4.0% of males (n = 249) testing HIV-positive, and 2.9% of females (n = 274) and 2.3% of males (n = 138) receiving new HIV-positive diagnoses. The majority of HIV-positive pregnant women (93.0%, 673/724) were linked to ART. By comparison, at health facilities in Benue State during a similar time period, 99.7% of pregnant women had HIV status ascertained, 8.4% had a HIV-positive status, 2.1% were newly diagnosed HIV-positive, and 100% were linked to ART. Conclusion Community-based programs such as the faith-based Baby Shower intervention complement facility-based approaches and can reach individuals who would not otherwise access facility-based care. Future Baby Showers implementation should incorporate enhanced support for ART linkage and retention to maximize the impact of this intervention on vertical HIV transmission.

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Low Proportion of Women who came knowing their HIV Status at First Antenatal Care Visit, Uganda, 2012-2016: A Descriptive Analysis of Surveillance Data

10.21203/rs.2.12401/v1 ◽

2019 ◽

Author(s):

Miriam Nakanwagi ◽

Lilian Bulage ◽

Benon Kwesiga ◽

Alex Riolexus Ario ◽

Doreen Agasha Birungi ◽

...

Keyword(s):

Antenatal Care ◽

Pregnant Women ◽

Hiv Testing ◽

Hiv Care ◽

Hiv Positive ◽

Hiv Status ◽

Antenatal Care Visit ◽

Care Visit ◽

Hiv Test ◽

Significant Difference

Abstract Background HIV testing is the cornerstone for all HIV care and support services, including Prevention of Mother to Child Transmission of HIV (PMTCT). The earlier women of reproductive age know their HIV status, the better informed their reproductive decisions and their infants’ outcomes may be. We analyzed trends in known current HIV status among pregnant women attending their first antenatal care visit (ANC1) in Uganda, 2012-2016. Methods We conducted secondary data analysis using District Health Information Software2 data on all pregnant women who came for ANC1 during 2012-2016. Women who brought documentation with them to ANC1 of an HIV test within the previous four weeks or an HIV care card as evidence of being in HIV care were considered as knowing their HIV status in antenatal care clinics. We calculated proportions of women with known current HIV status at ANC1, and described the linear trends both nationally and regionally. We used improved Poisson regression with generalized linear models to test the statistical significance of the trend. Results There was no significant difference in the number of women that attended ANC1 visits over the years 2012 to 2016. The proportion of women that came with known HIV status was highest at 6.9% in 2016 and this was an increasing trend (p<0.001). Most of the regions had an increase in trend except the West Nile and Mid-Eastern (p<0.001). The proportion of women that came knowing their HIV positive status at ANC1 is slightly higher than that of women that were newly tested HIV positive at ANC1 in 2015 and 2016. Conclusion Although the gap in women that come at ANC1 without knowing their HIV positive status might be reducing, still a large proportion of women who were infected with HIV did not know their status before their ANC1 HIV test, indicating a major public health gap. Therefore, more efforts are still required to achieve full PMTCT. In light of the considerable number that comes not knowing their HIV positive status at ANC1, we recommend advocacy for early ANC attendance and hence HIV testing so that timely PMTCT interventions can be made.

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Observational study of the populations accessing rapid point-of-care HIV testing in Winnipeg, Manitoba, Canada, through a retrospective chart review of site records

Sexually Transmitted Infections ◽

10.1136/sextrans-2017-053195 ◽

2017 ◽

Vol 94 (3) ◽

pp. 194-199 ◽

Cited By ~ 4

Author(s):

James Blain Johnston ◽

Joss N Reimer ◽

John L Wylie ◽

Jared Bullard

Keyword(s):

Viral Load ◽

Hiv Testing ◽

Clinical Outcomes ◽

Point Of Care ◽

Age Groups ◽

Linkage To Care ◽

Hiv Positive ◽

Hiv Status ◽

Viral Load Suppression ◽

Hiv Test

ObjectivesHIV point-of-care testing (POCT) has been available in Manitoba since 2008. This study evaluated the effectiveness of POCT at identifying individuals with previously unknown HIV status, its effects on clinical outcomes and the characteristics of the populations reached.MethodsA retrospective database review was conducted for individuals who received HIV POCT from 2011 to 2014. Time to linkage to care and viral load suppression were compared between individuals who tested positive for HIV using POCT and controls identified as positive through standard screening. Testing outcomes for labouring women with undocumented HIV status accessing POCT during labour were also assessed.Results3204 individuals received POCT (1055 females (32.9%) and 2149 males (67.1%)), being the first recorded HIV test for 2205 (68.8%). Males were more likely to be targeted with POCT as their first recorded HIV test (adjusted OR (AOR) 1.40). Between the two main test sites (Main Street Project (MSP) and Nine Circles Community Health Centre), MSP tested relatively fewer males (AOR 0.79) but a higher proportion of members of all age groups over 30 years old (AOR 1.83, 2.51 and 3.64 for age groups 30–39, 40–49 and >50, respectively). There was no difference in time to linkage to care (p=0.345) or viral load suppression (p=0.405) between the POCT and standard screening cohorts. Of 215 women presenting in labour with unknown HIV status, one was identified as HIV positive.ConclusionsPOCT in Manitoba has been successful at identifying individuals with previously unknown HIV-positive status. Demographic differences between the two main testing sites support that this intervention is reaching unique populations. Given that we observed no significant difference in time to clinical outcomes, it is reasonable to continue using POCT as a targeted intervention.MeSH termsHIV infection; rapid HIV testing; vertical infectious disease transmission; community outreach; service delivery; marginalised populations.

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HIV testing of pregnant women—what is needed to protect positive women's needs and rights?

Sexual Health ◽

10.1071/sh04056 ◽

2005 ◽

Vol 2 (3) ◽

pp. 143 ◽

Cited By ~ 16

Author(s):

Maria de Bruyn ◽

Susan Paxton

Keyword(s):

Pregnant Women ◽

Hiv Testing ◽

Perinatal Transmission ◽

Hiv Positive ◽

Physical Assault ◽

People Living With Hiv ◽

Women's Lives ◽

Living With Hiv ◽

Voluntary Counselling And Testing ◽

The Impact

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.

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Legal Barriers to Implementing Recommendations for Universal, Routine Prenatal HIV Testing

The Journal of Law Medicine & Ethics ◽

10.1111/j.1748-720x.2004.tb00459.x ◽

2004 ◽

Vol 32 (1) ◽

pp. 137-147 ◽

Cited By ~ 5

Author(s):

Leslie E. Wolf ◽

Bernard Lo ◽

Lawrence O. Gostin

Keyword(s):

United States ◽

Antiretroviral Therapy ◽

Pregnant Women ◽

Hiv Testing ◽

Hiv Transmission ◽

Perinatal Transmission ◽

The United States ◽

Hiv Status ◽

Mother To Child ◽

Legal Barriers

Administraation of antiretroviral therapy to women during pregnancy, labor and delivery, and to infants postnatally can dramatidy reduce mother-to- child HIV transmission (MTCT). However, pregnant women need to know that they are HIV-infected to take advantage of antiretroviral therapy, and many women do not know their HIV status. One-half of HIV-infected infants in the United States were bornto women who had not been tested for HIV or for whom the time of testing was not known. Although fewer than 400infants are infected perinatally in the United States each year, that number could be reduced even further through policies aimed at HIV testing during pregnancy.The reasons toadopt such a policy are strong: the pathophysiology of perinatal transmission is clear, prophylaxis is effective and safe, and the intended beneficiaries of the intervention - babies - cannot protect themselves.

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Using routine programmatic data to measure HIV incidence among pregnant women in Botswana

10.21203/rs.3.rs-19601/v1 ◽

2020 ◽

Author(s):

Katrina Frances Ortblad ◽

Sheshth Mawandia ◽

Odirile Bakae ◽

Lenna Tau ◽

Matias Grande ◽

...

Keyword(s):

Pregnant Women ◽

Hiv Testing ◽

Real World ◽

Sub Saharan Africa ◽

Hiv Positive ◽

Surveillance Systems ◽

Hiv Incidence ◽

Art Initiation ◽

Hiv Test ◽

Hiv Negative

Abstract Introduction: Pregnant women in sub-Saharan Africa have high risk of HIV acquisition, yet approaches for measuring maternal HIV incidence using routine surveillance systems are undefined. We used programmatic data from routine antenatal care (ANC) HIV testing in Botswana to measure real-world HIV incidence during pregnancy. Methods: From January 2018 to September 2019, the Botswana Ministry of Health and Wellness implemented an HIV testing program at 139 ANC clinics. The program captured information on testers’ age, testing date and result, and antiretroviral treatment (ART) initiation. In our analysis, we excluded individuals who previously tested HIV-positive prior to their first ANC visit. We defined incident HIV infection as testing HIV-positive at an ANC visit after a prior HIV-negative result within ANC. Results: Overall, 29,570 pregnant women (median age 26 years, IQR 22-31) tested for HIV at ANC clinics: 3% (836) tested HIV-positive at their first recorded ANC visit and 97% tested HIV-negative (28,734). Of those who tested HIV-negative, 28% (7,940/28,734) had a repeat HIV test recorded at ANC. The median time to HIV re-testing was 92 days (IQR 70-112). In total, 17 previously undiagnosed HIV infections were detected (HIV incidence 8 per 1,000 person-years, 95% CI 0.5-1.3). ART initiation among women newly diagnosed with HIV at ANC (853) was 88% (671/762). Conclusions: In Botswana, real-world HIV incidence among pregnant women at ANC remains above levels of HIV epidemic control (≤1 per 1,000 person-years). This study shows how HIV programmatic data can answer timely population-level epidemiological questions and inform ongoing implementation of HIV prevention and treatment programs.

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HIV-Positive Out-of-Treatment Drug Users Who are Unaware of Their HIV Status: Predictors of Who Gets Tested and Who Returns for Test Results

Journal of Drug Issues ◽

10.1177/002204260203200401 ◽

2002 ◽

Vol 32 (4) ◽

pp. 1017-1032 ◽

Cited By ~ 1

Author(s):

Shiela M. Strauss ◽

Sherry Deren ◽

David M. Rindskopf ◽

Gregory P. Falkin

Keyword(s):

Hiv Testing ◽

Risk Behaviors ◽

Drug Users ◽

Hiv Positive ◽

Test Results ◽

Hiv Status ◽

Biological Specimen ◽

The Past ◽

Hiv Test ◽

Using Data

Many HIV positive drug users are unaware that they have the virus, either because they never obtained testing for HIV or because they submitted a biological specimen for testing but never returned to obtain the result of the test. Using data collected from a large multi-site sample of out-of-treatment HIV positive drug users (N=1,544), we identify a variety of socio-demographic characteristics and drug use and sexual risk behaviors that differentiate HIV-positive individuals who had obtained HIV testing in the past and those who had not and, among those who had been tested, what differentiates individuals who had returned to obtain their HIV test results and those who had failed to return. Results of the analyses suggest that there is a need to target different subgroups of high risk drug users for interventions to obtain HIV testing as compared with those that need encouragement to obtain the results of this testing.

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SURPRISING RESULTS: HIV TESTING AND CHANGES IN CONTRACEPTIVE PRACTICES AMONG YOUNG WOMEN IN MALAWI

Journal of Biosocial Science ◽

10.1017/s002193201500022x ◽

2015 ◽

Vol 48 (2) ◽

pp. 174-191 ◽

Cited By ~ 3

Author(s):

Christie Sennott ◽

Sara Yeatman

Keyword(s):

Condom Use ◽

Hiv Testing ◽

Fixed Effects ◽

Population Based ◽

Hiv Positive ◽

Unexpected Result ◽

Hiv Status ◽

Logistic Regression Models ◽

New Information ◽

Hiv Test

SummaryThis study uses eight waves of data from the population-based Tsogolo la Thanzi study (2009–2011) in rural Malawi to examine changes in young women’s contraceptive practices, including the use of condoms, non-barrier contraceptive methods and abstinence, following positive and negative HIV tests. The analysis factors in women’s prior perceptions of their HIV status that may already be shaping their behaviour and separates surprise HIV test results from those that merely confirm what was already believed. Fixed-effects logistic regression models show that HIV testing frequently affects the contraceptive practices of young Malawian women, particularly when the test yields an unexpected result. Specifically, women who are surprised to test HIV positive increase their condom use and are more likely to use condoms consistently. Following an HIV-negative test (whether a surprise or expected), women increase their use of condoms and decrease their use of non-barrier contraceptives; the latter may be due to an increase in abstinence following a surprise negative result. Changes in condom use following HIV testing are robust to the inclusion of potential explanatory mechanisms, including fertility preferences, relationship status and the perception that a partner is HIV positive. The results demonstrate that both positive and negative tests can influence women’s sexual and reproductive behaviours, and emphasize the importance of conceptualizing of HIV testing as offering new information only insofar as results deviate from prior perceptions of HIV status.

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‘It is not fashionable to suffer nowadays’: Community motivations to repeatedly participate in outreach HIV testing indicate UHC potential in Tanzania

PLoS ONE ◽

10.1371/journal.pone.0261408 ◽

2021 ◽

Vol 16 (12) ◽

pp. e0261408

Author(s):

Josien de Klerk ◽

Arianna Bortolani ◽

Judith Meta ◽

Tusajigwe Erio ◽

Tobias Rinke de Wit ◽

...

Keyword(s):

Hiv Testing ◽

Ethnographic Study ◽

Hiv Positive ◽

Health Coverage ◽

Hiv Status ◽

Community Members ◽

Community Based ◽

Multidisciplinary Study ◽

Hiv Test ◽

Hiv Negative

Objective This study examined people’s motivations for (repeatedly) utilizing HIV testing services during community-based testing events in urban and rural Shinyanga, Tanzania and potential implications for Universal Health Coverage (UHC). Methods As part of a broader multidisciplinary study on the implementation of a HIV Test and Treat model in Shinyanga Region, Tanzania, this ethnographic study focused on community-based testing campaigns organised by the implementing partner. Between April 2018 and December 2019, we conducted structured observations (24), short questionnaires (42) and in-depth interviews with HIV-positive (23) and HIV-negative clients (8). Observations focused on motivations for (re-)testing, and the counselling and testing process. Thematic analysis based on inductive and deductive coding was completed using NVivo software. Results Regular HIV testing was encouraged by counsellors. Most participants in testing campaigns were HIV-negative; 51.1% had tested more than once over their lifetimes. Testing campaigns provided an accessible way to learn one’s HIV status. Motivations for repeat testing included: monitoring personal health to achieve (temporary) reassurance, having low levels of trust toward sexual partners, feeling at risk, seeking proof of (ill)-health, and acting responsibly. Repeat testers also associated testing with a desire to start treatment early to preserve a healthy-looking body, should they prove HIV positive. Conclusions Community-based testing campaigns serve three valuable functions related to HIV prevention and treatment: 1) enable community members to check their HIV status regularly as part of a personalized prevention strategy that reinforces responsible behaviour; 2) identify recently sero-converted clients who would not otherwise be targeted; and 3) engage community with general prevention and care messaging and services. This model could be expanded to include routine management of other (chronic) diseases and provide an entry for scaling up UHC.

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Determinan Perilaku Tes Hiv pada Ibu Hamil di Kota Padang Tahun 2019

Jurnal Endurance ◽

10.22216/jen.v5i1.4564 ◽

2020 ◽

Vol 5 (1) ◽

pp. 46

Author(s):

Hamidatul Yuni ◽

Melia Andika

Keyword(s):

Public Health ◽

Health Care ◽

Pregnant Women ◽

Hiv Testing ◽

Reproductive Age ◽

Public Health Care ◽

Hiv Positive ◽

Cross Sectional ◽

Hiv Test ◽

The City

Women are a population prone to contracting and transmitting, the number of women suffering from HIV as much as 36.4%. In 2017 as many as 73 new cases of HIV positive women in the city of Padang, almost half were women of reproductive age, including 2 cases of HIV positive pregnant women. Integrated antenal service for pregnant women, one of which is by carrying out laboratory tests of HIV testing that are required for all pregnant women. Padang City has 20 HIV counseling and testing services and 18 of them are Public Health Care. The purpose of this study was to determine of HIV test behavior in pregnant women viewed from the level of knowledge, patients' perceptions of HIV, social and psychological support of patients. Research with a quantitative approach with cross sectional design, conducted in several Padang city health centers with the lowest coverage of HIV testing in pregnant women in the city of Padang. The sample of the study was 100 pregnant women who visited the Public Health Care in May 2019. The research instrument by the questionnaire method. Data analysis used univariate, bivariate and multivariate. The results showed there was social support is the most dominant variable influencing HIV testing in pregnant women. Perempuan merupakan populasi rawan tertular dan menularkan, jumlah perempuan yang menderita HIV sebanyak 36,4% . Tahun 2017 sebanyak 73 kasus baru wanita positif HIV di Kota Padang, hampir separoh merupakan wanita usia reproduksi, diantaranya 2 kasus ibu hamil positif HIV. Layanan antenal terpadu pada ibu hamil salah satunya dengan melaksanakan pemeriksaan laboratorium tes HIV yang diwajibkan bagi seluruh Ibu hamil. Kota Padang memiliki layanan konseling dan tes HIV sebanyak 20 dan 18 diantaranya adalah puskesmas. Tujuan penelitian ini Untuk mengetahui determinan perilaku tes HIV pada Ibu hamil dilihat dari tingkat pengetahuan, persepsi pasien terhadap HIV, dukungan sosial dan psikologis pasien. Penelitian dengan pendekatan kuantitatif dengan desain cross sectional, yang dilakukan di beberapa puskesmas kota Padang dengan cakupan pemeriksaan HIV terendah pada Ibu hamil di Kota Padang. Sampel penelitian adalah Ibu hamil yang berkunjung ke puskesmas pada bulan Mei 2019 sebanyak 100 orang. Instrumen penelitian dikumpulkan dengan metode angket. Analisis data menggunakan univariat, bivariat dan multivariat. Hasil penelitian menunjukkan Dukungan sosial merupakan variabel yang paling dominan mempengaruhi pemeriksaan HIV pada Ibu hamil.

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Low Proportion of Women who came knowing their HIV Status at First Antenatal Care Visit, Uganda, 2012-2016: A Descriptive Analysis of Surveillance Data

10.21203/rs.2.12401/v2 ◽

2020 ◽

Author(s):

Miriam Nakanwagi ◽

Lilian Bulage ◽

Benon Kwesiga ◽

Alex Riolexus Ario ◽

Doreen Agasha Birungi ◽

...

Keyword(s):

Antenatal Care ◽

Pregnant Women ◽

Hiv Testing ◽

Statistical Significance ◽

Reproductive Age ◽

Hiv Care ◽

Hiv Positive ◽

Hiv Status ◽

Significant Difference ◽

Test Result

Abstract Background: HIV testing is the cornerstone for HIV care and support services, including Prevention of Mother to Child Transmission of HIV (PMTCT). Knowledge of HIV status is associated with better reproductive health choices and outcomes for the infant’s HIV status. We analyzed trends in known current HIV status among pregnant women attending the first antenatal care (ANC) visit in Uganda, 2012-2016. Methods: We conducted secondary data analysis using District Health Information Software2 data on all pregnant women who came for ANC visit during 2012-2016. Women who brought documented HIV negative test result within the previous four weeks at the first ANC visit or an HIV positive test result and/or own HIV care card were considered as knowing their HIV status. We calculated proportions of women with known current HIV status at first ANC visit, and described linear trends both nationally and regionally. We tested statistical significance of the trend using modified Poisson regression with generalized linear models. For known HIV positive status, we only analyzed data for years 2015-2016 because this is when this data became available. Results: There was no significant difference in the number of women that attended first ANC visits over years 2012-2016. The proportion of women that came with known HIV status increased from 4.4% in 2012 to 6.9% in 2016 and this increase was statistically significant (p<0.001). Most regions had an increase in trend except the West Nile and Mid-Eastern (p<0.001). The proportion of women that came knowing their HIV positive status at first ANC visit was slightly higher than that of women that were newly tested HIV positive at first ANC visit in 2015 and 2016. Conclusion: Although the gap in women that come at first ANC visit without knowing their HIV positive status might be reducing, a large proportion of women who were infected with HIV did not know their status before the first ANC visit indicating a major public health gap. We recommend advocacy for early ANC attendance and hence timely HIV testing and innovations to promptly identify HIV positive women of reproductive age so that timely PMTCT interventions can be made.

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