Services specifically designed for key populations

: Iran has been one of the active countries fighting against HIV/AIDS in the Middle East during the last decades. Moreover, there is a strong push to strengthen the national health management system concerning HIV prevention and control. In Iran, HIV disease has its unique features, from changes in modes of transmission to improvement in treatment and care programs, which can make it a good case for closer scrutiny. The present review describes the HIV epidemic in Iran from the first case diagnosed until prevention among different groups at risk and co-infections. Not only we addressed the key populations and community-based attempts to overcome HIV-related issues in clinics, but we also elaborated on the efforts and trends in society and the actual behaviors related to HIV/AIDS. Being located in the Middle East and North Africa (MENA) region, given the countryspecific characteristics, and despite all the national efforts along with other countries in this region, Iran still needs to take extra measures to reduce HIV transmission, especially in health education. Although Iran is one of the pioneers in implementing applicable and appropriate policies in the MENA region, including harm reduction services to reduce HIV incidence, people with substance use disorder continue to be the majority of those living with HIV in the country. Similar to other countries in this region, the HIV prevention and control programs aim at 90-90-90 targets to eliminate HIV infection and reduce the transmission, especially the mother-to-child transmission and among other key populations.

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Peer assisted HIV self-testing increases positivity rates among key populations in Burundi: descriptive analysis of routine programmatic data (Preprint)

10.2196/preprints.24272 ◽

2020 ◽

Author(s):

Tiffany Lillie ◽

Dorica Boyee ◽

Gloriose Kamariza ◽

Alphonse Nkunzimana ◽

Dismas Gashobotse ◽

...

Keyword(s):

Hiv Testing ◽

Sex Workers ◽

Descriptive Analysis ◽

Case Finding ◽

Hiv Positive ◽

Key Populations ◽

Standard Testing ◽

Art Initiation ◽

Treatment Standard ◽

Self Testing

BACKGROUND In Burundi, given the low testing numbers among key populations, peer assisted HIV self-testing (HIVST) was initiated for female sex workers (FSWs), men who have sex with men (MSM), and transgender people (TG) to provide another testing option. HIVST was provided by existing peer outreach workers (POWs) who were trained to provide support before, during, and after the administration of the test. People who screened reactive were referred and actively linked to confirmatory testing, and those confirmed positive were linked to treatment. Standard testing included HIV testing by clinical staff either at mobile clinics or in facilities. OBJECTIVE The objective was to improve access to HIV testing to underserved KP members, increase HIV positivity rates, and link those who were confirmed HIV positive with life-saving treatment for epidemic control. METHODS A descriptive analysis of routine programmatic data was conducted from a nine-month implementation period (June 2018-March 2019) of peer assisted HIVST among FSWs, MSM, and TG in six provinces where the USAID- and PEPFAR-funded LINKAGES Burundi project worked. Chi-squared tests were used to compare case-finding rates among individuals tested through HIVST versus standard testing. RESULTS A total of 2,198 HIVST test kits were administered (1,791 FSWs, 363 MSM, 44 TG). Three hundred and sixty-six people (17%) were reactive to HIV screening (296 FSWs, 60 MSM, 10 TG); 314 (14%) were confirmed HIV positive (257 FSWs, 47 MSM, 10 TG); and 301 (96%) (251 FSWs, 40 MSM, 10 TG) of those confirmed were initiated on treatment. HIV case-finding rates were significantly higher with HIVST compared to standard testing for FSW and MSM but not TG: FSWs (14% vs. 9%, P < .001); MSM (13% vs. 4%, P < .001); and TG (23% vs. 17%, P > .10). ART initiation rates were significantly lower for MSM confirmed HIV positive through HIVST than through standard testing (85% vs. 99%, P < .001) but not among FSWs or TG (FSWs: 98% vs. 97%, P > .10; TG: 100% vs. 100%). CONCLUSIONS The results demonstrate the potential effectiveness of HIVST in identifying individuals who are living with HIV.

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Integrating syphilis screening in a large-scale HIV prevention program for key populations: the Avahan experience from India

The Journal of Infection in Developing Countries ◽

10.3855/jidc.2810 ◽

2013 ◽

Vol 7 (06) ◽

pp. 484-488 ◽

Cited By ~ 4

Author(s):

Mugundu Ramien Parthasarathy ◽

Prakash Narayanan ◽

Anjana Das ◽

Anup Gurung ◽

Parimi Prabhakar ◽

...

Keyword(s):

Hiv Prevention ◽

Prevention Program ◽

Large Scale ◽

Point Of Care ◽

Key Populations ◽

Immunochromatographic Strip ◽

Transmitted Infection ◽

Sexually Transmitted ◽

Syphilis Screening ◽

Strip Test

Introduction: Documented experiences from India on the implementation of syphilis screening in large-scale HIV prevention programs for “key populations at higher risk’ (KPs) are limited. Avahan is a large-scale HIV prevention program providing services to more than 300,000 KPs in six high HIV prevalence states of India since 2004. Avahan clinics provide a sexually transmitted infection service package which includes bi-annual syphilis screening. The trends in the coverage of syphilis screening among Avahan clinic attendees were studied retrospectively. Methodology: Screening was performed using either the Rapid Plasma Reagin (RPR) test or point-of-care immunochromatographic strip test (ICST). Clinic records from 2005 to 2009 were collated in an individual tracking database and analyzed with STATA-10. Results: Initially the coverage of syphilis screening (2.6% in 2005) was constrained by the availability and operational complexity of the RPR test. After its introduction in 2007, the use of ICST for screening increased from 7.4% to 77.0% and the proportion of clinic attendees screened increased from 9.0% to 21.6% during 2007-2009. The RPR reactivity rates declined from 6.6% (2006) to 4.4% (2009). Conclusion: The data showed improved rates of screening of clinic attendees and declining trends in sero-reactivity over time. The introduction of point-of-care syphilis tests may have contributed to the improved coverage of syphilis screening. The ICST may be considered for initial syphilis screening at other resource-constrained primary care sites in India such as ante-natal clinics and other KP interventions.

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Developing HIV assisted partner notification services tailored to Mexican key populations: a qualitative approach

BMC Public Health ◽

10.1186/s12889-021-10612-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Heleen Vermandere ◽

Santiago Aguilera-Mijares ◽

Liliane Martínez-Vargas ◽

M. Arantxa Colchero ◽

Sergio Bautista-Arredondo

Keyword(s):

Partner Notification ◽

Key Populations ◽

Structured Interviews ◽

Hiv Diagnosis ◽

Serostatus Disclosure ◽

Hiv Epidemic ◽

Contact Information ◽

Hiv Awareness ◽

Sex With Men ◽

The Individual

Abstract Background Assisted partner notification services (APNS) may increase HIV testing, early diagnosis, and treatment, but they are not formally implemented in Mexico, where the HIV epidemic is concentrated in men who have sex with men (MSM) and transwomen (TW). This study aimed to explore the awareness of and need for HIV partner notification, as well as to outline potential strategies for APNS based on identified barriers and facilitators. Methods We conducted semi-structured interviews to explore partner notification with MSM, TW, and counselors. Afterwards, brainstorm sessions were carried out to produce strategies for implementing APNS. Results Most participants reported experiences with informal partner notification and serostatus disclosure, but not with APNS. Only one counselor indicated assisting notification systematically. The main barriers for notifying or disclosing mentioned by both MSM and TW included fear of (violent) reactions, discrimination and lacking contact information of casual partners. Participants thought it was easier to inform a formal partner, conditional of being well informed about HIV. Given current stigma and lack of awareness, it was suggested that APNS should be preceded by HIV awareness efforts, and be provided by counselors or peers to mitigate potential rejection or violent reactions. Conclusions While APNS are not formally implemented in Mexico, all participants supported the service, indicating that APNS could potentially enhance early HIV diagnosis in Mexico. Strategies to implement such services need to be flexible addressing the individual needs of participants, guaranteeing the safety of more vulnerable participants.

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Cross-cultural adaptation of the Perceived Risk of HIV Scale in Brazilian Portuguese

Health and Quality of Life Outcomes ◽

10.1186/s12955-021-01760-6 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Thiago S. Torres ◽

Paula M. Luz ◽

Luana M. S. Marins ◽

Daniel R. B. Bezerra ◽

Celline C. Almeida-Brasil ◽

...

Keyword(s):

High Risk ◽

Risk Behaviors ◽

Cultural Adaptation ◽

Perceived Risk ◽

Brazilian Portuguese ◽

Cross Cultural ◽

Key Populations ◽

Cross Sectional ◽

High Risk Behaviors ◽

Cross Cultural Adaptation

Abstract Background Valid and reliable instruments are needed to measure the multiple dimensions of perceived risk. The Perceived Risk of HIV Scale is an 8-item measure that assesses how people think and feel about their risk of infection. We set out to perform a cross-cultural adaptation of the scale to Brazilian Portuguese among key populations (gay, bisexual and other men who have sex with men and transgender/non-binary) and other populations (cisgender heterosexual men and cisgender women). Methods Methodological study with cross-sectional design conducted online during October/2019 (key populations [sample 1] and other populations) and February–March/2020 (key populations not on pre-exposure prophylaxis [sample 2]). Cross-cultural adaptation of the Perceived Risk of HIV Scale followed Beaton et al. 2000 guidelines and included confirmatory factor analysis, differential item functioning (DIF) using the Multiple-Indicator Multiple-Cause model, and concurrent validity to verify if younger individuals, those ever testing for HIV, and engaging in high-risk behaviors had higher scores on the scale. Results 4342 participants from key populations (sample 1 = 235; sample 2 = 4107) and 155 participants from other populations completed the measure. We confirmed the single-factor structure of the original measure (fit indices for sample 1 plus other populations: CFI = 0.98, TLI = 0.98, RMSEA = 0.07; sample 2 plus other populations: CFI = 0.97, TLI = 0.95, RMSEA = 0.09). For the comparisons between key populations and other populations, three items (item 2: “I worry about getting infected with HIV”, item 4: “I am sure I will not get infected with HIV”, and item 8: “Getting HIV is something I have”) exhibited statistically significant DIF. Items 2 and 8 were endorsed at higher levels by key populations and item 4 by other populations. However, the effect of DIF on overall scores was negligible (0.10 and 0.02 standard deviations for the models with other populations plus sample 1 and 2, respectively). Those ever testing for HIV scored higher than those who never tested (p < .001); among key populations, those engaging in high-risk behaviors scored higher than those reporting low-risk. Conclusion The Perceived Risk of HIV Scale can be used among key populations and other populations from Brazil.

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