scholarly journals Predictors Of Provider-Initiated Hiv Testing In Heterosexuals At Increased Risk Of Hiv (Het) In Puerto Rico: Data From Nhbs-Het Cycle 2016

2020 ◽  
Author(s):  
Maureen Marie Canario de la Torre ◽  
Ivony Yireth Agudelo Salas ◽  
Sandra Miranda de León ◽  
Yadira Rolón Colón ◽  
María Pabón Martínez ◽  
...  

Abstract The Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) have established guidelines for HIV testing in healthcare settings. The aim of this study was to identify the sociodemographic, healthcare, and sexual-behavior predictors of provider-initiated HIV testing (PIHT) using data from the Puerto Rico National HIV Behavioral Surveillance (PR-NHBS) 2016 cycle directed towards heterosexuals at increased risk of HIV infection (HET). A total sample of 531 eligible participants were recruited through respondent-driven sampling (RDS). Logistic regression models assessed the associations between sociodemographic, healthcare, and sexual-behavior predictors, whilst adjusting for sex and age. The majority of the participants were women (66.1%), with 72.7% reporting having received healthcare services in the past year. Of them, 18.7% had received an HIV-test offer from their healthcare providers. More than half of the participants (65.2%) reported a low perceived risk of getting infected with HIV in the next 12 months. Results suggest an overall low prevalence of PIHT among HET in PR who exhibited a relatively high prevalence of low perceived risk of HIV infection. Furthermore, the assessed predictors show that individuals who engaged in high-risk sexual behaviors (AOR = 0.52; 95% CI: 0.30–0.90) were less likely to receive HIV-test offers from their providers. This study further emphasizes the need for healthcare providers to follow recommended guidelines for HIV testing in healthcare settings as a means of establishing preventive measures to further counteract the HIV epidemic in Puerto Rico, specifically among HET.

2021 ◽  
Author(s):  
Vivian Colón-López ◽  
Maureen M Canario De La Torre ◽  
Nadia Centeno ◽  
Ivony Y Agudelo ◽  
Yadira Rolón Colón ◽  
...  

BACKGROUND According to CDC and WHO guidelines, all individuals from 13 to 64 years of age should get screened for HIV infection as part of their routine medical examinations, and individuals at high risk should get tested annually. OBJECTIVE This study aimed to identify sociodemographic, healthcare, and sexual behavior predictors of provider-initiated HIV testing (PIHT) using data from the Puerto Rico National HIV Behavioral Surveillance (PR-NHBS) 2016 cycle; directed towards heterosexuals at increased risk of HIV infection (HET). METHODS A total sample of 531 eligible participants were recruited through respondent-driven sampling (RDS), where sociodemographic characteristics, healthcare utilization, and HIV testing were assessed. RESULTS Despite 72% showed high-risk sexual behavioral practices and 65.2% of the HET sample interviewed reported a low perceived risk of HIV infection, only 19% reported not receiving an HIV test offered at a recent medical visit. Multivariate analysis shows that HET who engaged in high-risk sexual behaviors (AOR = 0.52; 95% CI: 0.30–0.90) were less likely to receive HIV-test offers from their providers. CONCLUSIONS This study further emphasizes the need for healthcare providers to follow recommended guidelines for HIV testing in healthcare settings as a means of establishing preventive measures to further counteract the HIV epidemic in Puerto Rico, specifically among HET.


2008 ◽  
Vol 123 (3_suppl) ◽  
pp. 115-125 ◽  
Author(s):  
Peter E. Thomas ◽  
Andrew C. Voetsch ◽  
Binwei Song ◽  
Denyce Calloway ◽  
Carolyn Goode ◽  
...  

Objectives. From 2001 through 2005, African Americans accounted for the largest percentage of new cases of human immunodeficiency virus (HIV)/ acquired immunodeficiency syndrome (AIDS) in all age categories, especially among people aged 13 to 24 years. Although students attending historically black colleges and universities (HBCUs) report many of the behaviors that promote HIV transmission, their risk behaviors and HIV testing practices have not been well-characterized. We compared the demographic and behavioral characteristics of people who have been previously tested for HIV with those of people tested for the first time in this demonstration project to increase HIV testing at HBCUs. Methods. The Centers for Disease Control and Prevention and collaborating partners conducted rapid HIV testing and behavioral surveys at HBCUs in Arkansas, Georgia, Mississippi, and Washington, D.C., from January 2005 to April 2007. We recruited a convenience sample of students and community members at different campus venues including student health centers, dormitories, and student activity centers. Results. Our analysis included 5,291 people, 42% of whom reported they had never been tested for HIV. People who had been tested in the past were more likely to be older, believe they were at high risk for infection, have visited a health-care facility, and report behaviors that increased their risk of HIV infection. Conclusion. Respondents who believed they were at increased risk for HIV infection or reported behaviors that increased their risk for infection were more likely to have been tested for HIV. Future research should compare actual vs. perceived risk for HIV infection and contrast how each impacts HIV testing.


2006 ◽  
Vol 17 (3) ◽  
pp. 165-168 ◽  
Author(s):  
Tara Harris ◽  
Linda Panaro ◽  
Melissa Phypers ◽  
Yogesh Choudhri ◽  
Chris P Archibald

BACKGROUND: Recent evidence suggests a global rise in adult tuberculosis (TB) cases associated with HIV/AIDS. The World Health Organization, the United States Centers for Disease Control and Prevention, and the Public Health Agency of Canada advocate universal screening of all TB cases for HIV. The contribution of HIV to the TB burden in Canada remains unclear.METHODS: A retrospective cohort study was conducted of all TB cases reported in Canada from 1997 to 1998. The aim was to determine the proportion of patients that had an HIV test on record, and of these, the number of patients infected with HIV.RESULTS: From 1997 to 1998, 3767 TB cases were reported to the national TB surveillance system. In the present study, 3416 case records (90.7%) were included. The number of cases with a record of an HIV test was 736 (21.5%), and of these, 41.2% were tested within one month of TB diagnosis. Among the 703 cases with known HIV test results, the prevalence of HIV infection was 14.7%. Cases with an HIV test on record were more likely to have one or more risk factors for HIV, and also were more likely to be male, aged 15 to 49 years, of Aboriginal ethnicity, and to have smear-positive TB and both pulmonary and extrapulmonary disease at the time of diagnosis.DISCUSSION: These results suggest that HIV testing of TB patients is not universal, but rather selective, and is likely based on perceived risk factors for HIV as opposed to TB diagnosis alone.


The World Health Organization has set a target to achieve by 2030 that 90% of people with HIV are aware of their diagnosis, 90% of those are on treatment, and 90% of these have an undetectable viral load. People with HIV who are not aware of their diagnosis are more likely to be diagnosed late with increased morbidity and mortality, and 50% of new transmissions are from people unaware of their status. This chapter describes the challenges in increasing testing and diagnosis, recommendations for HIV testing, and initial assessment and management of those newly diagnosed with HIV infection.


Sexual Health ◽  
2005 ◽  
Vol 2 (1) ◽  
pp. 19 ◽  
Author(s):  
Richard A. Crosby ◽  
Kim H. Miller ◽  
Ruth R. Staten ◽  
Melody Noland

Objectives: Whether college students who are most at-risk of HIV infection are being tested is unknown. This exploratory study identified the prevalence and correlates of ever having an HIV test among college students. Methods: A cross-sectional survey was conducted among a probability sample of 903 college students. Measures of sexual risk behaviour were assessed. Results: Of the students surveyed, 22.5% reported they had been tested for HIV. Testing was more likely among those 20 years of age or older (27.8% v. 14.7%; P = 0.0001), females (25.4% v. 17.8%; P = 0.01), and members of racial/ethnic minorities (42.7% v. 20.3%; P = 0.0001). After adjusting for these covariates, those who reported ever having vaginal sex (AOR = 5.5; 95% CI = 3.1–9.6); anal sex (AOR = 2.4; 95% CI = 1.6–3.6), and oral sex (AOR = 6.3; 95% CI = 3.0–13.3) were significantly more likely to report being tested. Students having vaginal sex in the past 12 months were significantly more likely to report testing (AOR = 5.3; 95% CI = 3.1–9.1). Those reporting vaginal sexual debut (AOR = 1.9; 95% CI = 1.2–3.1) or oral sexual debut (AOR = 1.7; 95% CI = 1.1–2.5) ≤age 15 were significantly more likely to be tested. Students reporting four or more sex partners were significantly more likely to be tested than sexually experienced students reporting fewer partners (AOR = 3.2; 95% CI = 2.2–4.6). Finally, those reporting at least one episode of forced vaginal sex (AOR = 3.9; 95% CI = 2.1–7.2) and reporting at least one episode of any forced sex (vaginal, anal, oral) (AOR = 3.0; 95% CI = 1.8–5.0) were significantly more likely to report being tested. Conclusions: Within this population, demographically controlled findings suggest that those most at-risk of HIV infection are indeed being tested for the virus.


2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S595-S595
Author(s):  
Hampton Ocon ◽  
Samir Sabbag

Abstract Background According to the Centers for Disease Control and Prevention, Miami-Dade County has the highest rate of new HIV diagnoses in the Nation. So far, a large focus of public health initiatives has been spreading awareness of HIV testing locations, but this form of voluntary testing relies on individuals realizing that they are at risk of HIV infection in the first place. Consequently, a major obstacle to encouraging young men-who-have-sex-with-men (YMSM) to test themselves for HIV is their own self-perceived risk of having an undetected infection. Methods In an effort to better understand the discordance between high-risk sexual behavior and HIV testing among this high-risk population, YMSM (18–24) were surveyed through smartphone applications that facilitate sexual encounters in the Miami-Dade area (eg Grindr, Scruff). Users were asked about their history of condomless anal intercourse (CAI), their HIV testing habits, and whether or not they believe it possible that they are currently infected with HIV. An analysis of the relationship between CAI and self-perception of possible HIV infection was performed using Cochran-Mantel–Haenszel testing. Results Of the 843 eligible responses, 667 reported a history of voluntary HIV testing while 176 had never voluntarily tested. 726 respondents reported a history of CAI and 131 of these have never voluntarily tested. Of the 843 total participants, 1.6% were in the highest HIV risk group, which is those who have engaged in CAI with an exchange/casual partner, have never voluntarily tested for HIV, and have no self-perceived risk of being currently infected. According to data analysis, YMSM who have engaged in CAI but have never been tested for HIV were not more likely to have a self-perceived possibility of infection when compared with those who have voluntarily tested (P < 0.595). Conclusion This suggests that many high-risk YMSM are not voluntarily testing themselves for HIV not because they do not have access to testing, but rather because they do not perceive themselves as being possibly infected in the first place. Therefore, in addition to increasing access to HIV testing, new public health initiatives must be designed to facilitate YMSM understanding their own personal HIV risk. Disclosures All authors: No reported disclosures.


2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S425-S426
Author(s):  
Moira C McNulty ◽  
Ellen Almirol ◽  
Jessica P Ridgway ◽  
Jessica Schmitt ◽  
Rebecca Eavou ◽  
...  

Abstract Background Women account for 25 % of HIV infections nationally, and African American (AA) women are disproportionately affected. We report important gender differences observed in an expanded HIV testing and linkage to care (X-TLC) program conducted on the South and West Sides of Chicago. Methods X-TLC is funded by CDPH with CDC prevention B funds. X-TLC has expanded from 3 sites to 14 sites, including acute care hospitals (academic, community), community health centers (CHCs), and family planning clinics. We report descriptive stats, group comparisons by Chi-square, and multivariate analyses adjusted for demographics. Results Since 2011, X-TLC has conducted 308,038 HIV screens, and 63.7 % of those tested were women. Overall seroprevalence for HIV was 0.56 %, and 30.5 % of HIV patients identified were cis-gender women (seroprevalence 0.15 %). The seroprevalence for women testing in EDs was higher (0.44 %). Similar to men, only 52.9 % of HIV positive women were new diagnoses. Women accounted for 28.5 % of all new diagnoses, compared with 15.4 % for Chicago overall. In 2016 X-TLC screened 91,865 persons for HIV, and 65.2 % of those tested were women. There were 193 new diagnosis and 32.1 % (62) were women, 85.7 % AA. In comparison, in 2015 there were 139 women with a new HIV diagnosis for all of Chicago. Women newly diagnosed were less likely to be linked to care (adjusted odds ratio, aOR, 0.54, 0.35–0.85). Linkage was lower for women diagnosed at CHCs (84.6 % vs. 76.3 %, P = 0.02). Most CHCs did not have on site HIV providers. At our site, however, women linked to care were more likely to be retained in care (aOR 0.58, 0.43–0.78). We also conduct targeted outreach testing, partner services (PS) testing, and social network strategy (SNS) testing, but women are not identified by these programs (16/171 tested women, 8 new diagnoses were men for PS; 507 tested, 471 men and 36 trans-gender women, 38 new positives, 0 cis-gender women for SNS). Conclusion More women than men were offered and/or accept HIV screening in healthcare settings. The proportion of seropositive women identified was higher than the national average. X-TLC is reaching a large proportional of AA women with HIV unaware of their status. Other testing strategies will rarely identify cis-gender women with HIV infection. Gender differences in linkage to and retention in care will require strategies targeted at women. Disclosures J. P. Ridgway, Gilead FOCUS: Grant Investigator, Grant recipient; N. Glick, Gilead FOCUS: Grant Investigator, Grant recipient; D. Pitrak, Gilead Sciences FOCUS: Grant Investigator, Grant recipient


1995 ◽  
Vol 6 (5) ◽  
pp. 348-350 ◽  
Author(s):  
A G Wardropper ◽  
R S Pattman

Summary: It has been proposed that changes in sexual behaviour arising out of concerns regarding HIV infection can be inferred by changes in the incidence of gonorrhoea. We have reviewed data on gonococcal isolates in Newcastle over the last 13 years and looked at changes in relation to HIV test requests, new cases of HIV infection and media campaigns. HIV testing has been available in the clinic since late 1985. There was a steady decline in cases of gonorrhoea from 1985–1991 and then as in other areas an increase in incidence was seen among homosexual and bisexual men. The majority of this recent increase was due to pharyngeal infection. Sexual behaviour may have changed but this cannot be purely attributed to HIV concerns. HIV testing began after the incidence of gonorrhoea in England was already falling and we found no relationship between trends in gonorrhoea, HIV test requests and new cases of HIV infection.


2019 ◽  
Author(s):  
Joanne D Stekler ◽  
Lauren R Violette ◽  
Hollie A Clark ◽  
Sarah J McDougal ◽  
Lisa A Niemann ◽  
...  

BACKGROUND HIV testing guidelines provided by the Centers for Disease Control and Prevention (CDC) are continually changing to reflect advancements in new testing technology. Evaluation of existing and new point-of-care (POC) HIV tests is crucial to inform testing guidelines and provide information to clinicians and other HIV test providers. Characterizing the performance of POC HIV tests using unprocessed specimens can provide estimates for the window period of detection, or the time from HIV acquisition to test positivity, which allows clinicians and other HIV providers to select the appropriate POC HIV tests for persons who may be recently infected with HIV. OBJECTIVE This paper describes the protocols and procedures used to evaluate the performance of the newest POC tests and determine their sensitivity during early HIV infection. METHODS Project DETECT is a CDC-funded study that is evaluating POC HIV test performance. Part 1 is a cross-sectional, retrospective study comparing behavioral characteristics and HIV prevalence of the overall population of the Public Health–Seattle &amp; King County (PHSKC) Sexually Transmitted Disease (STD) Clinic to Project DETECT participants enrolled in part 2. Part 2 is a cross-sectional, prospective study evaluating POC HIV tests in real time using unprocessed whole blood and oral fluid specimens. A POC nucleic acid test (NAT) was added to the panel of HIV tests in June 2018. Part 3 is a longitudinal, prospective study evaluating seroconversion sensitivity of POC HIV tests through serial follow-up testing. For comparison, HIV-1 RNA and HIV-1/HIV-2 antigen/antibody tests are also performed for participants enrolled in part 2 or 3. A behavioral survey that collects information about demographics, history of HIV testing, STD history, symptoms of acute HIV infection, substance use, sexual behaviors in the aggregate and with recent partners, and use of pre-exposure prophylaxis and antiretroviral therapy is completed at each part 2 or 3 visit. RESULTS Between September 2015 and March 2019, there were 14,990 Project DETECT–eligible visits (part 1) to the PHSKC STD Clinic resulting in 1819 part 2 Project DETECT study visits. The longitudinal study within Project DETECT (part 3) enrolled 27 participants with discordant POC test results from their part 2 visit, and 10 (37%) were followed until they had fully seroconverted with concordant positive POC test results. Behavioral survey data and HIV test results, sensitivity, and specificity will be presented elsewhere. CONCLUSIONS Studies such as Project DETECT are critical for evaluating POC HIV test devices as well as describing characteristics of persons at risk for HIV acquisition in the United States. HIV tests in development, including POC NATs, will provide new opportunities for HIV testing programs. INTERNATIONAL REGISTERED REPORT RR1-10.2196/16332


2019 ◽  
Vol 73 ◽  
pp. 294-302
Author(s):  
Kamila Wójcik-Cichy ◽  
Anna Piekarska ◽  
Elżbieta Jabłonowska

Early diagnosis increases life expectancy in HIV-infected patients. Aim: The aim of this study was to determine the reasons for HIV testing in newly-diagnosed patients with HIV registered in Lodz, Poland in years 2009-2017. The study examines also whether HIV testing was performed following the recommendation of physicians or at the request of patients. Results: The study group consisted of 401 (83.72%) males and 78 (16.28%) females. The median age at the moment of diagnosis was 33 years (LQ 27-UQ 40). In total, 285 (62.91%) patients were late presenters. Clinical indications constituted the main reason for undergoing HIV testing and were reported in 228 out of 479 patients (47.59%) including AIDS-defining diseases were a reason for HIV testing in 105 patients. Thirty-four patients underwent HIV testing following diagnosis of sexually-transmitted diseases (STDs); in 91.18% of these cases the STDs was syphilis. However, high-risk sexual contact was the main reason for HIV testing in asymptomatic patients (160 of 257 cases; 62.27%). Patients in the non-AIDS group were significantly more likely to take the initiative to order an HIV test than patients in the AIDS group (p<0.0001). Conclusions: In conclusion, in the Lodz region, patients with HIV infection are most commonly diagnosed at an advanced stage of infection. This may be associated with the low number of HIV tests performed following the doctors recommendation.


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