scholarly journals Stakeholders’ recommendations for implementing HIV self-testing and secondary distribution of HIV self-testing for male partners of Option B+ clients in Haiti as an assisted partner service strategy: a qualitative study

2019 ◽  
Author(s):  
Donaldson Fadael Conserve ◽  
Jacob Michel ◽  
Joseph Emmanuel Adrien Demes ◽  
Jean Marxcime Chéry ◽  
Jean-Gabriel Balan ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Community Health ◽  
Health Workers ◽  
Public Information ◽  
Linkage To Care ◽  
Hiv Care ◽  
Small Scale ◽  
Male Partners ◽  
Self Testing ◽  
Secondary Distribution

Abstract Background Despite significant public health efforts, HIV testing remains low among men in Haiti. HIV self-testing (HIVST), which allows people to test in private, is an effective strategy for increasing HIV testing among men. Secondary distribution of HIVST to male partners of women living with HIV (WLWH) is one promising assisted partner services strategy to address the low HIV testing rate among men in Haiti. However, little research has been conducted on how to implement HIVST in the Caribbean. The purpose of this study was to assess stakeholders’ perspectives towards HIVST and to obtain their recommendations for how to implementing HIVST in Haiti to reach male partners of Option B+ clients. Methods Sixteen key informant interviews and nine focus groups with 44 healthcare workers (HCWs), 31 Option B+ clients, and 13 men were carried out in Haiti. Key informants were representatives of the Ministry of Health and of a non-governmental agency involved in HIV partner services. HCWs included program leads and staff members from the HIV care and treatment program, the Option B+ program, the community health service program, and the HIV counseling and testing services from 2 hospitals. Results Perceived HIVST advantages included an increase in the number of people who would learn their HIV status and start treatment. Perceived disadvantages were lack of support to ensure self-testers initiate treatment, uncertainty about male partner’s reaction, risk of violence towards a woman by a man after having received an HIVST kit from her, and the inability of a woman to counsel a man in case his self-test result is positive. Recommendations for implementing HIVST and secondary distribution of HIVST included coupling HIVST distribution with public information, education, and communication through media and social marketing; relying on community health workers to mediate the use of HIVST and ensure linkage to care; and piloting HIVST programs on a small scale. Conclusions HIVST is an appropriate and feasible HIV prevention strategy for men and women. Our findings indicate that more research is needed to determine and pilot how best to implement HIVST and secondary distribution of HIVST by Option B+ clients in Haiti.

scholarly journals Venues and methods to improve professional men’s access to HIV self-testing and linkage to HIV prevention or treatment: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Patience A. Muwanguzi ◽  
Esther M. Nasuuna ◽  
Florence Namimbi ◽  
Charles Peter Osingada ◽  
Tom Denis Ngabirano
Keyword(s):  
Qualitative Study ◽  
Hiv Testing ◽  
Underserved Populations ◽  
Linkage To Care ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
Eligibility Criteria ◽  
Prevention Services ◽  
Self Testing ◽  
Engaging Men

Abstract Background HIV testing among men in sub-Saharan Africa is sub-optimal. Despite several strategies to improve access to underserved populations, evidence regarding engaging men in professional and formal occupations in HIV testing is limited. This study explored employed professional men’s preferences for uptake of HIV self-testing, and linkage to HIV care, or prevention services. Methods This was an explorative-descriptive qualitative study where a sample of 33 men from six Ugandan urban centres. Participants were purposively selected guided by the International Standard Classification of Occupations to participate in in-depth interviews. The data were collected using an interview guide and the sample size was determined by data saturation. Eligibility criteria included fulltime formal employment for over a year at that organization. The data were analyzed manually using thematic content analysis. Results Three categories emerged: uptake of HIV self-tests, process of HIV self-testing and linkage to post-test services. The different modes of distribution of HIV self-test kits included secondary distribution, self-tests at typically male dominated spaces, delivery to workplaces and technology-based delivery. The process of HIV self-testing may be optimized by providing collection bins, and mHealth or mobile phone applications. Linkage to further care or prevention services may be enhanced using medical insurance providers, giving incentives and tele counselling. Conclusion We recommend utilization of several channels for the uptake of HIV self-tests. These include distribution of test kits both to offices and men’s leisure and recreation ‘hot spots’, Additionally, female partners, peers and established men’s group including social media groups can play a role in improving the uptake of HIV self-testing. Mobile phones and digital technology can be applied in innovative ways for the return of test results and to strengthen linkage to care or prevention services. Partnership with medical insurers may be critical in engaging men in professional employment in HIV services.

scholarly journals Pregnant women, their male partners and health care providers’ perceptions of HIV self-testing in Kampala, Uganda: Implications for integration in prevention of mother-to-child transmission programs and scale-up

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253616
Author(s):  
Joseph Rujumba ◽  
Jaco Homsy ◽  
Femke Bannink Mbazzi ◽  
Zikulah Namukwaya ◽  
Alexander Amone ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Health Care Providers ◽  
Health Workers ◽  
Scale Up ◽  
Care Providers ◽  
Male Partners ◽  
Hiv Status ◽  
Lactating Women ◽  
Self Testing ◽  
Study Participants

Background HIV status awareness is critical for HIV prevention and care but HIV testing rates remain low in Uganda, especially among men. One suggested approach to increase access and utilisation of HIV testing services is HIV self-testing. We explored perceptions of pregnant and lactating women and their male partners who attended antenatal care, and health care providers in a government hospital in Kampala, Uganda, about HIV self-testing for initial or repeat testing for women and their partners during pregnancy and postpartum We draw implications for scaling-up this new testing approach in Uganda. Methods This was a qualitative study conducted at Mulago National Referral Hospital, Kampala, Uganda, between April and December 2017. We conducted in-depth interviews with five pregnant or lactating women and their five male partners; five focus group discussions (two with women, two with health workers and one with male partners of women attending antenatal care) and five key informant interviews with health workers providing prevention of mother-to-child HIV transmission (PMTCT) services. Data were analysed using content thematic approach. Results There was limited awareness about HIV self-testing especially among pregnant or lactating women and their male partners. Study participants mentioned that HIV self-testing would enable people to know their HIV status faster, they thought the approach would be cost- and time-saving compared to health facility-based HIV testing, improve confidentiality and reduce stigma for those who test HIV positive. They expressed however, a general fear that HIV self-testing would lead to harm to self and others in case one tested HIV positive, including suicide, violence among couples, intentional transmission of HIV, and limited linkage to care due to lack of counselling. The likely misinterpretation of HIV test results especially among those with no or limited education, and possible coercion exerted by male partners on their wives were other potential concerns raised about the use of HIV self-testing. Conclusions There was limited knowledge about HIV self-testing among pregnant and lactating women, their partners and health workers. While the self-testing modality was perceived to be critical for helping people, especially those in casual and distant relationships, to know their HIV status and that of their partners, most study participants believed that HIV self-testing could potentially result in a multitude of negative outcomes in the absence of pre- and post-test counselling. Successful scale-up and integration of self-testing in HIV programs requires community education, provision of information materials and making self-test kits accessible and affordable, especially in rural areas.

scholarly journals Community-Based Interventions as Opportunities to Increase HIV Self-Testing and Linkage to Care Among Men Who Have Sex With Men – Lessons From Ghana, West Africa

2021 ◽  
Vol 9 ◽  
Author(s):  
Gamji M'Rabiu Abubakari ◽  
DeAnne Turner ◽  
Zhao Ni ◽  
Donaldson F. Conserve ◽  
Debbie Dada ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Linkage To Care ◽  
Mobile App ◽  
Sub Saharan Africa ◽  
Security And Privacy ◽  
Hiv Care ◽  
Hiv Education ◽  
Community Based Interventions ◽  
Community Based ◽  
Self Testing

MSM in Ghana encounter challenges in accessing HIV services and may experience barriers to HIV self-testing due to multiple forms of stigma present in health care settings. We worked with community-based organization partners to implement three interventions that successfully engaged and retained MSM which provides an opportunity for linkage to self-testing and medical care. These interventions were (1) Many Men Many Voices (3MV) a locally-led culturally grounded group-level HIV prevention program, (2) Auntie's Corner: a mobile-app based connecting MSM to health monitoring by a registered nurse and (3) HIV Education, Empathy, & Empowerment (HIVE3): a mobile-app based peer support intervention for MSM living with HIV. The 3MV intervention may be effective in improving HIV self-testing due to its effectiveness in engaging MSM, increasing HIV testing, and improving MSM understanding of the need for HIV testing. The utilization of apps like Auntie's Corner could positively impact HIV self-testing among MSM because it increases contact with nurses and reporting of symptoms. In HIVE3, participants expressed appreciation of the security and privacy that protects their identities as MSM and the peer mentors' abilities to make referrals to the nurses in Auntie's Corners. The confidentiality component has proven key among MSM and connecting MSM to self-testing through apps to report their process and receive care could increase utilization. Together, we show the efficacy of using the community-engaged process in reaching and engaging highly stigmatized populations like Ghana and sub-Saharan Africa, and its potential in increasing HIV self-testing and linkage to HIV care.

scholarly journals Integrated home-based screening for people living with disabilities: A case study from rural Malawi

2019 ◽  
Vol 8 ◽  
Author(s):  
Elizabeth M. Petersen ◽  
Emily B. Wroe ◽  
Kondwani Nyangulu ◽  
Chisomo Kanyenda ◽  
Sam Njolomole ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Screening Programme ◽  
Health Workers ◽  
Hiv Care ◽  
Access To Health Services ◽  
Home Based ◽  
Poor Access ◽  
Access To Health ◽  
Integrated Screening

People living with disabilities (PLWDs) have poor access to health services compared to people without disabilities. As a result, PLWDs do not benefit from some of the services provided at health facilities; therefore, new methods need to be developed to deliver these services where PLWDs reside. This case study reports a household-based screening programme targeting PLWDs in a rural district in Malawi. Between March and November 2016, a household-based and integrated screening programme was conducted by community health workers, HIV testing counsellors and a clinic clerk. The programme provided integrated home-based screening for HIV, tuberculosis, hypertension and malnutrition for PLWDs. The programme was designed and implemented for a population of 37 000 people. A total of 449 PLWDs, with a median age of 26 years and about half of them women, were screened. Among the 404 PLWDs eligible for HIV testing, 399 (99%) agreed for HIV testing. Sixty-nine per cent of PLWDs tested for HIV had never previously been tested for HIV. Additionally, 14 patients self-reported to be HIV-positive and all but one were verified to be active in HIV care. A total of 192 of all eligible PLWDs above 18 years old were screened for hypertension, with 9% (n = 17) referred for further follow-up at the nearest facility. In addition, 274 and 371 PLWDs were screened for malnutrition and tuberculosis, respectively, with 6% (n = 18) of PLWDs referred for malnutrition, and 2% (n = 10) of PLWDs referred for tuberculosis testing. We successfully implemented an integrated home-based screening programme in rural Malawi.

Abstract P303: Use of Community Health Workers for Community-based Hypertension Screening in Urban Haiti

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Caleigh Smith ◽  
Vanessa Rivera ◽  
Jean Joscar Victor ◽  
Lookens Pierre ◽  
Fabyola Preval ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Linkage To Care ◽  
Median Number ◽  
Population Based ◽  
Age Group ◽  
Cvd Risk ◽  
Blood Pressure Screening

Background: Cardiovascular disease is the leading cause of mortality among Haitian adults, and hypertension (HTN) is the most important CVD risk factor, as in other resource-poor countries. The majority of Haitians have never been screened for hypertension and access to clinic-based services is limited. Methods: Twenty-eight Haitian community health workers (CHW) conducted household-based HTN screening within a population-based longitudinal cohort study of 3,000 adults in metropolitan Port-au-Prince. Randomly selected GPS locations across census blocks were selected in proportion to the estimated population of each block. One household at each waypoint was selected systematically and CHW collected household information and conducted three blood pressure measurements the same day on all adult household members (≥ 18 years) present at the time of the survey using AHA guidelines. Adults with HTN were referred to the GHESKIO clinic for repeat BP measurement and treatment. Results: Between March and September 2019, 585 households provided verbal consent for surveys and BP screening (97% response rate). These households had a total of 2542 people (1777 adults) with the median number of adults per household being 3 (IQR 2-4; range 1-9). A total of 913 adults (51%) were present at the time of survey, and all agreed to blood pressure screening. The majority were women (70%) with a median age of 36 years (IQR 27-52). Hypertension prevalence (SBP > 140 and/or DBP > 90) was 25.3% (15.5% Stage I, 9.8% Stage II). Figure 1 reports HTN prevalence by age group (18-30, 31-45, 46-60, >60) and by sex, with HTN increasing by age group but without significant variation by sex. Conclusion: Community blood pressure screening is feasible and highly acceptable in Port-au-Prince, Haiti. Preliminary results show high rates of HTN among a population with limited access to screening, diagnosis and treatment. Further research is urgently needed to design linkage to care strategies and effective treatment interventions to curb the HTN epidemic in Haiti.

Integrating community health workers into HIV care teams: Impact on HIV care outcomes

2020 ◽  
Vol 19 (3) ◽  
pp. 204-219
Author(s):  
Mari-Lynn Drainoni ◽  
Allyson L. Baughman ◽  
Sara S. Bachman ◽  
Rachel Bowers-Sword ◽  
Melissa Davoust ◽  
...  
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Hiv Care ◽  
Care Outcomes

scholarly journals Improving the UNAIDS 90-90-90 Treatment Targets: Solutions Suggested from a Qualitative Study of HIV Patients, Community Advocates, Health Workers and Program Managers in Jimma, Southwest Ethiopia

2020 ◽  
Vol 17 (1) ◽  
pp. 378
Author(s):  
Hailay Gesesew ◽  
Paul Ward ◽  
Kifle Woldemichael ◽  
Lillian Mwanri
Keyword(s):  
Hiv Testing ◽  
Health Workers ◽  
Hiv Care ◽  
Religious Leaders ◽  
Hiv Patients ◽  
Immunological Failure ◽  
Program Managers ◽  
Care Services ◽  
Hiv Status Disclosure ◽  
Status Disclosure

Ethiopia’s performance toward the UNAIDS 90-90-90 targets is low. The present study explored interventions to improve delayed HIV care presentation (first 90), poor retention (second 90) and clinical and immunological failure (third 90). We employed a qualitative approach using in-depth interviews with 10 HIV patients, nine health workers, 11 community advocates and five HIV program managers. Ethical approvals were obtained from Australia and Ethiopia. The following were suggested solutions to improve HIV care and treatment to meet the three 90s: (i) strengthening existing programs including collaboration with religious leaders; (ii) implementing new programs such as self-HIV testing, house-to-house HIV testing, community antiretroviral therapy (ART) distribution and teach-test-treat-link strategy; (iii) decentralizing and integrating services such as ART in health post and in private clinics, and integrating HIV care services with mental illness and other non-communicable diseases; and (iv) filling gaps in legislation in issues related with HIV status disclosure and traditional healing practices. In conclusion, the study suggested important solutions for improving delayed HIV care presentation, attrition, and clinical and immunological failure. A program such as the teach-test-treat-link strategy was found to be a cross-cutting intervention to enhance the three 90s. We recommend further nationwide research before implementing the interventions.

scholarly journals Barriers and facilitators associated with HIV testing uptake in South African health facilities offering HIV Counselling and Testing

2016 ◽  
Vol 21 ◽  
pp. 86-95 ◽  
Author(s):  
Neo Mohlabane ◽  
Bomkazi Tutshana ◽  
Karl Peltzer ◽  
Aziza Mwisongo
Keyword(s):  
Hiv Testing ◽  
South African ◽  
Health Workers ◽  
Scale Up ◽  
Health Facilities ◽  
Barriers And Facilitators ◽  
Hiv Care ◽  
Treatment Needs ◽  
Hiv Test ◽  
Hiv Counselling And Testing

Background: The scale-up of HIV Counselling and Testing (HCT) in South Africa to 4500 public health facilities and the service's provision in mobile and non-medical sites was aimed at increasing HCT uptake. However, some people still have never had an HIV test.Objective: An HCT survey was carried out to ascertain barriers and facilitators for HIV testing in South Africa.Methods: A cross-sectional survey of 67 HCT-offering health facilities in 8 South African provinces was undertaken. Individuals (n = 489) who had not tested for HIV on the day of the site visit were interviewed on awareness of HCT services, HIV testing history and barriers to HIV testing. Frequencies were run to describe the sample characteristics, barriers and facilitators to HIV testing. Bivariate and multivariate logistic regression was usedt o identify the association between never tested for HIV with socio-demographics, awareness of HCT services and type of HCT facilities.Results: In all 18.1% participants never had an HIV test. Major barriers to HCT uptake comprise being scared of finding out one's HIV test result or what people may say, shyness or embarrassment, avoidance of divulging personal information to health workers and fear of death. In multivariate analysis the age group 55 years and older, and not being recommended to have an HIV test were associated with never had an HIV test. Potential facilitators for HIV testing include community or household HIV testing, providing incentives for those who test for HIV, mandatory HIV testing and disclosure of HIV status by those who test HIV positive.Conclusion: The benefits of HCT which include the reduction of HIV transmission, the availability of HIV care and treatment needs to be emphasized to enhance HCT uptake.

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