scholarly journals "I Used to be Scared to Even Like Stand Beside Somebody Who Had It": HIV Risk Behaviours and Perceptions among Indigenous People Who Use Drugs

2021 ◽  
Vol 12 (3) ◽  
pp. 1-21
Author(s):  
Jennifer Lavalley ◽  
Western Aboriginal Harm Reduction Society ◽  
Christopher Livingstone ◽  
Melissa Steinhauer ◽  
Ashley Goodman ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Indigenous People ◽  
Hiv Risk ◽  
Risk Perceptions ◽  
Treatment Options ◽  
Hiv Treatment ◽  
Hiv Care ◽  
Hiv Knowledge ◽  
Community Based ◽  
Talking Circles

Objectives: In Canada, and elsewhere, Indigenous people who use illicit drugs and/or alcohol (WUID/A) experience a disproportionate burden of HIV-related harm. This study examined HIV risk perceptions and behaviours among Indigenous people WUID/A living in the Downtown Eastside (DTES) and the policies and practices that shape inequities and vulnerabilities for them in HIV testing and treatment. Further, we aimed to situate the vulnerabilities of Indigenous people WUID/A in HIV care within the context of wider structural inequality and generate recommendations for culturally relevant and safe HIV treatment options. Methods: This research employed an Indigenous-led community-based participatory approach using talking circles to explore experiences of Indigenous people living with HIV. Under the participatory research framework, community researchers led the study design, data collection, and analysis. Talking circles elicited participants’ experiences of HIV knowledge, testing, and treatment, and were audio-recorded and transcribed. Data were coded line-by-line and codes were organized into themes.  Results: Five key themes were identified via the talking circles: evolving HIV risk perceptions (e.g., HIV knowledge and testing, and “intentional exposure”); research as an avenue for HIV testing; HIV treatment and discussions about grief and loss; HIV-related stigma and discrimination; and the importance of culturally-relevant and safe HIV treatment options for Indigenous people WUID/A. Discussion: Our work reveals that Indigenous people WUID/A do not have adequate access to HIV knowledge and education, often limiting their ability to access HIV testing and supports. Participant stories revealed both internalized and community stigma and discrimination, which at times compromised connection with participants' home communities. Further, our findings point to a failure in the public health system to deliver accessible HIV information to Indigenous Peoples, hence, many participants have solely relied on participation in community-based research studies in the Downtown Eastside (DTES) for HIV education and knowledge. There is an urgent need for accessible, culturally safe, and community-based education and treatment options for Indigenous people WUID/A within HIV care.

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

A Qualitative Exploration of Family, Work, Community, and Health Service Influences on HIV Treatment Uptake and Adherence Among Female Sex Workers in Three Cities in Indonesia

2020 ◽  
Vol 32 (3) ◽  
pp. 243-259
Author(s):  
Elke Mitchell ◽  
Elan Lazuardi ◽  
Irma Anintya ◽  
Emily Rowe ◽  
Kate Whitford ◽  
...  
Keyword(s):  
Support Groups ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Treatment Initiation ◽  
Geographical Location ◽  
Hiv Treatment ◽  
Hiv Care ◽  
Community Based ◽  
Female Sex ◽  
Outreach Workers

Qualitative data were collected from 34 Indonesian female sex workers to understand their engagement with HIV treatment. Influences that enhanced treatment initiation and adherence included women's desires to stay healthy to continue working to provide for families; awareness of the biomedical benefits of treatment; support from bosses, outreach workers, and peer support groups; and flexible, nonjudgmental HIV service provision. Influences inhibiting treatment initiation and adherence included concerns about unwanted disclosure in the workplace and side effects of medication on women's capacity to earn money through sex work; geographical location of services; discrimination and confidentiality concerns in HIV care services. To improve HIV treatment initiation and adherence among Indonesian female sex workers, future responses should explore health promotion messages that engage with women's family and livelihood obligations; increased funding for community-based peer outreach workers; community-based treatment initiation and supply; and advocacy in work environments to secure support for treatment initiatives.

scholarly journals Challenging the HIV Epidemic in Ontario Through PrEP and HIV Testing

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Steven Winkelman
Keyword(s):  
Hiv Testing ◽  
Hiv Infections ◽  
Hiv Treatment ◽  
Annotated Bibliography ◽  
Hiv Care ◽  
Post Exposure Prophylaxis ◽  
Non Profit ◽  
Sex With Men ◽  
Exposure Prophylaxis ◽  
Priority Populations

The Ontario HIV Treatment Network (OHTN) is a non-profit network which collaborates with health clinics, AIDS service and community organizations, and policy leaders in order to improve the health and wellbeing of people living with and at risk of HIV. I joined the OHTN as a member of the Collective Impact team, with a focus on examining the barriers and facilitators to Pre-Exposure Prophylaxis (PrEP) uptake in Ontario. PrEP is a once-daily pill which is highly effective in preventing HIV infections for HIV-negative people, however usage remains relatively low in Ontario. In this role, I liaised with the Knowledge Synthesis team at OHTN to collect, analyse, and synthesize recent scientific literature on Pre and Post-exposure prophylaxis (PEP) in order to create a comprehensive annotated bibliography on PrEP research. Key findings were drawn from the research to identify potential next steps to increase PrEP use for priority populations in Ontario. Findings from the annotated bibliography were presented to OHTN staff, and have been used to assist in the development of two PrEP study proposals; 1) a cisgender and transgender women-focused PrEP education package and HIV risk screening tool, and 2) a pharmacist-led PrEP delivery pilot. I also worked with the Testing and Clinical Initiatives team at the OHTN, to aid in the implementation and evaluation of two HIV-testing projects: the GetaTest pharmacy-based HIV-testing study, and the GetaKit HIV self-testing pilot program. In this role I drafted health communication materials; analysed survey data and drafted project reports for stakeholders; and provided perspectives on the HIV-care continuum, particularly on PrEP initiation, adherence, and efficacy. My work with the OHTN was important to public health because it sought to expand access to HIV testing and prevention services for priority populations in Ontario, including men who have sex with men, and cis and trans women.

scholarly journals Substance use and HIV stage at entry into care among people with HIV

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Canada Parrish ◽  
Bridget M. Whitney ◽  
Robin M. Nance ◽  
Nancy Puttkammer ◽  
Paul Fishman ◽  
...  
Keyword(s):  
Substance Use ◽  
Hiv Testing ◽  
Hiv Risk ◽  
Regression Models ◽  
Hiv Care ◽  
Hiv Disease ◽  
Methamphetamine Use ◽  
Early Entry ◽  
Timing Of Entry ◽  
The Impact

Abstract Background Information regarding the impact of substance use on the timing of entry into HIV care is lacking. Better understanding of this relationship can help guide approaches and policies to improve HIV testing and linkage. Methods We examined the effect of specific substances on stage of HIV disease at entry into care in over 5000 persons with HIV (PWH) newly enrolling in care. Substance use was obtained from the AUDIT-C and ASSIST instruments. We examined the association between early entry into care and substance use (high-risk alcohol, methamphetamine, cocaine/crack, illicit opioids, marijuana) using logistic and relative risk regression models adjusting for demographic factors, mental health symptoms and diagnoses, and clinical site. Results We found that current methamphetamine use, past and current cocaine and marijuana use was associated with earlier entry into care compared with individuals who reported no use of these substances. Conclusion Early entry into care among those with substance use suggests that HIV testing may be differentially offered to people with known HIV risk factors, and that individuals with substances use disorders may be more likely to be tested and linked to care due to increased interactions with the healthcare system.

scholarly journals 843. Targeted HIV Testing for Patients Hospitalized for COVID-19

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S512-S512
Author(s):  
Michael D Virata ◽  
Merceditas Villanueva ◽  
Janet Miceli
Keyword(s):  
Risk Factors ◽  
Hiv Testing ◽  
Hiv Risk ◽  
Treatment Algorithm ◽  
Hiv Treatment ◽  
People Living With Hiv ◽  
Hiv Patients ◽  
Entire Study ◽  
Comorbidity Scores ◽  
Hiv Risk Factors

Abstract Background SARS-CoV-2 causes a severe respiratory illness known as COVID-19. Treatment options in the early portion of the COVID-19 pandemic included the use of antiretroviral agents i.e. protease inhibitors (PIs) such as lopinavir (LPV) that had been shown to have activity against the main proteases of SARS-CoV-2 in vitro but with very limited clinical data. Prior to the use of PIs, HIV testing would be indicated to ensure that patients who were not previously diagnosed with HIV would start appropriate HIV treatment. In this unique situation, HIV testing would be utilized not based on traditional HIV risk factors. Methods We performed a retrospective search from a specific systems database of patients admitted to Yale-New Haven Health System (YNHHS) with a diagnosis of COVID-19 infection. We identified a subset of patients who were HIV tested. Most were done prior to initiating PI treatment. Demographics, comorbidity scores and specific underlying conditions were also tabulated. We performed Kruskal Wallis and Chi-Squared analysis to test for significance between HIV- and HIV+ patients. Results The total no. of patients admitted to the YNHHS with COVID-19 infection between the period from January 6, 2020 to January 6, 2021 was 5776. A cohort 964 (16.7%) patients were screened for HIV. Much of the testing occurred in the early COVID periods (Figure 1) when PIs were considered as part of the treatment algorithm. Sixty-seven (0.07%) patients tested HIV+ with 3 (0.003%) being newly diagnosed (Fig 2). Compared to HIV- patients, HIV+ were more likely to be identified as Black, with higher mean Elixhauser Comorbidity scores and significant associations with conditions such as hypertension, pulmonary disease, complicated diabetes, liver disease, renal failure and depression (Table 1). These co-morbidities have been correlated with higher risk of hospitalization for people living with HIV (PWH). Figure 2. COVID Admission and HIV Status The graph represents HIV testing results over the entire study period. Table 1. Demographics and Comorbidites Represents demographics and comorbidities of HIV- & HIV+ patients Figure 1. COVID Admissions and HIV Testing COVID admissions over time and the performance of HIV testing Conclusion This is one of the first reports on targeted HIV testing for patients not using identifiable traditional HIV risk factors who were admitted to a large healthcare system for COVID19 infections. The percentage of newly HIV diagnosed patients from this cohort was considered to be < known HIV infection rates for our population. The majority of PWH were already established in care prior to their COVID19 diagnosis. Disclosures All Authors: No reported disclosures

scholarly journals Addressing the Challenges and Relational Aspects of Index-Linked HIV Testing for Children and Adolescents: Insights from the B-GAP Study in Zimbabwe

2020 ◽  
Author(s):  
Chido Dziva Chikwari ◽  
Sarah Bernays ◽  
Stefanie Dringus ◽  
Victoria Simms ◽  
Helen A Weiss ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Children And Adolescents ◽  
Discrete Event ◽  
World Health ◽  
Hiv Care ◽  
Community Based ◽  
Paediatric Hiv ◽  
Adequate Knowledge ◽  
Testing Uptake ◽  
Health Organization

Abstract Introduction Index-linked HIV testing, targeted at sexual contacts or children of individuals with HIV, may improve yield and efficiency. The B-GAP study evaluated index-linked testing approaches in health facility and community-based settings. This paper reports on a qualitative study to understand factors that affect index-linked HIV testing for children and adolescents. Methods We conducted four focus group discussions (FGDs) with caregivers who had their children tested through B-GAP and one FGD with providers who offered index-linked HIV testing to indexes. We aimed to understand enabling and inhibiting factors in the decision-making process. Translated and transcribed transcripts were read for familiarisation. Following initial coding, analytical memos were written to identify emerging key themes across the data.Results Caregivers did not have adequate knowledge about the need for, and importance of, paediatric HIV testing. Once the decision to test had been made, access to facilities was sometimes challenging, and alleviated by community-based testing. A key finding was that HIV testing is not a discrete event but a process that was influenced by relationships with other family members and children themselves. These relationships raised complex issues that could prevent or delay the testing process. Conclusion There is a need to improve paediatric HIV literacy and to provide support to caregivers and their families in order to improve testing uptake. Addressing access barriers through the provision of community-based testing and implementing a family centred approach can optimize index-linked testing. Contributions to the literature • Although promoted and recommended by the World Health Organization; index-linked HIV testing for children has not been standard practice in routine HIV care for many countries including Zimbabwe.• Prior this study, no study has evaluated the factors that influence and affect uptake of index-linked HIV testing for children and adolescents as reported in our manuscript. • Our findings have the potential to bridge the HIV testing gap for children and optimize index-linked testing, a strategy that has been shown to result in higher yield of HIV when compared to universal testing but where uptake remains suboptimal.

scholarly journals COVID/HIV Co-Infection: A Syndemic Perspective on What to Ask and How to Answer

2021 ◽  
Vol 9 ◽  
Author(s):  
Hailay Abrha Gesesew ◽  
Lillian Mwanri ◽  
Jacqueline H. Stephens ◽  
Kifle Woldemichael ◽  
Paul Ward
Keyword(s):  
Hiv Testing ◽  
Research Agenda ◽  
Digital Health ◽  
Hiv Treatment ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Medical Mistrust ◽  
Theoretical Frameworks ◽  
The Impact

The present commentary explored the intersecting nature of the COVID-19 and HIV pandemics to identify a shared research agenda using a syndemic approach. The research agenda posits the following questions. Questions around HIV infection, transmission, and diagnosis include: (i) molecular, genetic, clinical, and environmental assessments of COVID-19 in people living with HIV, (ii) alternative options for facility-based HIV testing services such as self- and home-based HIV testing, and (iii) COVID-19 related sexual violence and mental health on HIV transmission and early diagnosis. These and related questions could be assessed using Biopsychosocial and socio-ecological models. Questions around HIV treatment include: (i) the effect of COVID-19 on HIV treatment services, (ii) alternative options for facility-based treatment provision such as community-based antiretroviral therapy groups, and (iii) equitable distribution of treatment and vaccines for COVID-19, if successful. Bickman's logic model and the social determinants of health framework could guide these issues. The impact of stigma, the role of leveraging lessons on sustained intra-behavioral change, the role of medical mistrust and conspiracy beliefs, and the role of digital health on integrated management of HIV care and spectrum of care of COVID-19 need assessment using several frameworks including Goffman's stigma framework, Luhmann's Trust theory, and Gidden's theory of structuration. In conclusion, the potential research agenda of this commentary encompasses a variety of research fields and disciplinary areas—clinicians, laboratory scientists, public health practitioners, health economists, and psychologists—, and suggests several theoretical frameworks to guide examination of complex issues comprehensively.

scholarly journals Achieving the first of the Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 targets: understanding the influence of HIV risk perceptions, knowing one’s partner’s status and discussion of HIV/sexually transmitted infections with a sexual partner on uptake of HIV testing

2019 ◽  
Vol 11 (6) ◽  
pp. 425-431 ◽  
Author(s):  
A I Ajayi ◽  
E Mudefi ◽  
O V Adeniyi ◽  
D T Goon
Keyword(s):  
United Nations ◽  
Hiv Testing ◽  
Sexually Transmitted Infections ◽  
Hiv Risk ◽  
Sexual Partner ◽  
Risk Perceptions ◽  
Sexually Transmitted ◽  
Nations Programme ◽  
United Nations Programme ◽  
Hiv Test

Abstract This study assessed how HIV risk perceptions, knowledge of one’s partner’s status and discussion of HIV/sexually transmitted infections (STIs) with one’s sexual partner influence the uptake of HIV testing. Data were obtained from 833 young adults, selected using stratified random sampling in a South African university in 2018. Adjusted and unadjusted logistic regression models were employed to examine determinants of HIV testing uptake. The majority of students (69.9%) had previously tested for HIV, but only 58.4% tested for HIV in the last year. Being highly concerned about contracting HIV/STIs was positively associated with having tested for HIV (adjusted OR [AOR]: 4.28; CI: 2.50 to 7.34) and getting an HIV test in the past year (AOR: 1.83; CI: 1.20 to 2.80). Knowing one’s partner’s status was associated with a higher probability of ever having been tested for HIV (AOR: 3.07; CI: 1.89 to 4.97) or having received an HIV test in the previous year (AOR: 2.66; CI: 1.77 to 3.99). Discussion of HIV/STIs was associated with higher odds of having ever been tested for HIV (AOR: 3.81; CI: 2.44 to 5.96) and recent HIV testing (AOR: 3.22; CI: 2.17 to 4.77). HIV testing was below the Joint United Nations Programme on HIV/AIDS UNAIDS 90-90-90 target. Being concerned about contracting HIV, discussion of HIV/STIs with a sexual partner and knowing one’s partner’s HIV status were associated with the uptake of HIV testing.

scholarly journals Perceptions of HIV Risk Among Internet-Using, HIV-Negative Barebacking Men

2012 ◽  
Vol 6 (4) ◽  
pp. 280-293 ◽  
Author(s):  
Hugh Klein ◽  
David L. Tilley
Keyword(s):  
Hiv Risk ◽  
Perceived Risk ◽  
Risk Perceptions ◽  
Unprotected Sex ◽  
Hiv Knowledge ◽  
Self Identity ◽  
Younger Age ◽  
Risk Practices ◽  
Sex With Men ◽  
Hiv Negative

The current study examines the risk perceptions of HIV-negative men who have sex with men (MSM) who use the Internet to seek unprotected sex. The research questions include the following: How great do these men perceive their HIV risk to be? Are their perceptions based on HIV knowledge or related to their risk behaviors? What factors are associated with greater/lesser perceived risk? Results revealed that more than half of the men believed that they had no or only a slight chance of contracting HIV. Risk perceptions were not related to HIV knowledge or to involvement in HIV risk practices. Four factors were identified as being associated with greater perception of HIV risk: self-identity as a sexual “bottom,” having sex while high, greater use of bareback-focused websites, and younger age. Internet-using HIV-negative men who have sex with men tend to underestimate their risk for acquiring HIV, and interventions need to help them accurately assess their risk.

Sign in / Sign up

Export Citation Format

Share Document