scholarly journals An Internet-Based HIV Self-Testing Program to Increase HIV Testing Uptake Among Men Who Have Sex With Men in Brazil: Descriptive Cross-Sectional Analysis

10.2196/14145 ◽  
2019 ◽  
Vol 21 (8) ◽  
pp. e14145 ◽  
Author(s):  
Raquel Brandini De Boni ◽  
Valdilea Gonçalves Veloso ◽  
Nilo Martinez Fernandes ◽  
Flavia Lessa ◽  
Renato Girade Corrêa ◽  
...  

BackgroundApproximately 30% of people living with HIV worldwide are estimated to be unaware of their infection. HIV self-testing (HIVST) is a strategy recommended by the World Health Organization to increase access to and uptake of testing among key populations who are at high risk for HIV infection.ObjectiveThis study aimed to describe the development and feasibility of a free, anonymous, internet-based HIVST strategy designed for men who have sex with men in Curitiba, Brazil (electronic testing [e-testing]).MethodsThe project was developed under the scope of the “A Hora é Agora” (The Time is Now) program. Individuals aiming to request an HIVST package (two tests each) answered an anonymous 5-minute questionnaire regarding inclusion criteria and sexual risk behavior. Eligible individuals could receive one package every 6 months for free. Website analytics, response to online questionnaires, package distribution, and return of test results were monitored via a platform-integrated system.ResultsBetween February 2015 and January 2016, the website documented 17,786 unique visitors and 3218 completed online questionnaires. Most individuals self-reported being white (77.0%), young (median age: 25 years, interquartile range: 22-31 years), educated (87.3% completed secondary education or more), and previously tested for HIV (62.5%). Overall, 2526 HIVST packages were delivered; of those, 542 (21.4%) reported a result online or by mail (23 reactive and 11 invalid). During the study period, 37 individuals who reported using e-testing visited the prespecified health facility for confirmatory testing (30 positive, 7 negative).ConclusionsE-testing proved highly feasible and acceptable in this study, thus supporting scale-up to additional centers for men who have sex with men in Brazil.

2019 ◽  
Author(s):  
Raquel Brandini De Boni ◽  
Valdilea Gonçalves Veloso ◽  
Nilo M Fernandes ◽  
Flavia Lessa ◽  
Renato Girade Correa ◽  
...  

BACKGROUND Approximately 30% of people living with HIV worldwide are estimated to be unaware of their infection. HIV self-testing (HIVST) is a strategy recommended by the World Health Organization which increases access to and uptake of testing among key populations who are at high risk for HIV infection. OBJECTIVE To describe the development and feasibility of a free, anonymous, Internet-based HIV self-testing (HIVST) strategy designed for men who have sex with men (MSM) in Curitiba, Brazil (E-testing). METHODS The project was developed under the scope of the “A Hora é Agora” (Time is now) program. Individuals aiming to request an HIVST package (2 tests each) answered an anonymous 5-minute questionnaire regarding inclusion criteria and sexual risk behavior. Eligible individuals could receive one package every 6 months for free. Website analytics, response to online questionnaires, packages distribution, and return of test results were monitored via a platform-integrated system. RESULTS Between February 2015 and January 2016, the website documented 17,786 unique visitors with 3,218 provided complete answers to the online questionnaires. Most individuals self-reported being white (77%), young (median age was 25 years, interquartile range 22-31), educated (87.3% complete secondary education or more), and had previously tested for HIV (62.5%). Overall, 2,526 HIVST packages were delivered; of those, 542 (21.4%) reported a result online or by mail (23 reactive and 11 invalid). During the study period, 37 individuals reporting to have used E-testing visited the pre-specified health facility for confirmatory testing (30 positive; 7 negative). CONCLUSIONS E-testing proved highly feasible and acceptable in this study, thus supporting scale-up to additional MSM population centers in Brazil.


2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Ervan Meidan Ariatama ◽  
Titik Respati ◽  
Eka Nurhayati

Penyakit HIV/AIDS selain mengakibatkan dampak kesehatan dapat juga mengakibatkan dampak negatif terhadap psikologi, sosial, dan spiritual pada kualitas hidup orang dengan HIV/AIDS (ODHA). Antiretroviral (ARV) merupakan obat penghambat proses replikasi HIV yang merupakan solusi untuk meningkatkan kualitas hidup dan harapan hidup penderita. Tujuan penelitian ini adalah menggambarkan kondisi psikologi, sosial, dan spiritual ODHA selama menjalani pengobatan ARV di Komisi Penanggulangan AIDS (KPA) Kota Bogor periode bulan Agustus–September 2019. Penelitian ini dilakukan menggunakan metode observasi analitik dengan pendekatan cross sectional. Data diambil menggunakan kuesioner World Health Organization Quality of Life-HIV Instrument (WHOQOL-HIV Instrument) yang terdiri atas 120 pertanyaan dan terbagi menjadi 6 domain (psikologi, sosial, spiritual, fisik, lingkungan hidup, dan tingkat kebebasan). Pada penelitian ini hanya diambil 3 domain, yaitu psikologi, sosial, dan spiritual dengan jumlah pertanyaan 52 butir yang dibagikan kepada 80 responden dan dilaksanakan selama bulan Agustus sampai bulan September 2019. Teknik pengambilan sampel menggunakan non-probability sampling jenis consecutive sampling berdasar atas rumus besar estimasi proporsi dengan presisi absolut. Hasil menunjukkan mayoritas kondisi psikologi, sosial, dan spiritual ODHA selama pengobatan antiretroviral di KPA Kota Bogor tahun 2019 dalam kondisi baik dengan persentase kondisi psikologi 96%, sosial 99%, dan spiritual 70%. Simpulan penelitian ini adalah kondisi psikologi, sosial, dan spiritual pada ODHA di Komisi Penanggulangan AIDS Kota Bogor tahun 2019 mayoritas dalam kondisi baik, walaupun kondisi spiritual ODHA masih terdapat hasil kurang baik. PSYCHOLOGICAL, SOCIAL, AND SPIRITUAL CONDITIONS IN PEOPLE LIVING WITH HIV/AIDS DURING ANTIRETROVIRAL TREATMENT AT THE AIDS PREVENTION COMMISSION AT BOGOR CITY IN 2019Apart from having an impact on health, HIV/AIDS can also have a negative psychological, social, and spiritual impact on people living with HIV/AIDS (PLWHA). Antiretroviral (ARV) as drugs that inhibits the process of replication of HIV, which is a solution to improve the quality of life and life expectancy of patients. The purpose of this study was to describe the psychological, social, and spiritual conditions of PLWHA during ARV treatment at the AIDS Prevention Commission in Bogor City in August to September 2019. The study was a cross-sectional study. The research material consisted of primary data taken using the World Health Organization-Quality Instrument HIV questionnaire (WHOQOL-HIV Instrument) consisting of 120 questions and divided into six domains (psychological, social, spiritual, physical, environment, degree of freedom). However, in this study, only three domains studied, which are psychological, social, and spiritual, with 52 questions and then distributed to 80 respondents and carried out from August to September. The sampling technique uses non-probability sampling type consecutive sampling based on large formula of proportion estimation with absolute precision. Results showed the psychological, social, and spiritual condition of PLWHA during antiretroviral treatment at the Bogor City AIDS Commission in 2019 shows a good condition. The majority of good psychological, social, and spiritual domain experienced by 96%, 99%, and 70% of respondents, respectively. The conclusion of this research is the psychological, social, and spiritual conditions of PLWHA in the Bogor AIDS prevention commission in 2019 in the good conditions, even though there was a spiritual condition of ODHA that was still not good.


Author(s):  
Ishani Pathmanathan ◽  
Anand Date ◽  
William L. Coggin ◽  
John Nkengasong ◽  
Amy S. Piatek ◽  
...  

Background: To eliminate preventable deaths, disease and suffering due to tuberculosis ,improved diagnostic capacity is critical. The Cepheid Xpert MTB/RIF® assay is recommended by the World Health Organization as the initial diagnostic test for people with suspected HIV associatedtuberculosis. However, despite high expectations, its scale-up in real-world settings has faced challenges, often due to the systems that support it.Opportunities for System Strengthening: In this commentary, we discuss needs and opportunities for systems strengthening to support widespread scale-up of Xpert MTB/RIF as they relate to each step within the tuberculosis diagnostic cascade, from finding presumptive patients, to collecting, transporting and testing sputum specimens, to reporting and receiving results, to initiating and monitoring treatment and, ultimately, to ensuring successful and timely treatment and cure. Investments in evidence-based interventions at each step along the cascade and within the system as a whole will augment not only the utility of Xpert MTB/RIF, but also the successful implementation of future diagnostic tests.Conclusion: Xpert MTB/RIF will only improve patient outcomes if optimally implemented within the context of strong tuberculosis programmes and systems. Roll-out of this technology to people living with HIV and others in resource-limited settings offers the opportunity to leverage current tuberculosis and HIV laboratory, diagnostic and programmatic investments, while also addressing challenges and strengthening coordination between laboratory systems, laboratory-programme interfaces, and tuberculosis-HIV programme interfaces. If successful, the benefits of this tool could extend beyond progress toward global End TB Strategy goals, to improve system-wide capacity for global disease detection and control.


Author(s):  
Abdou Razak Moukaila ◽  
Edem Komi Mossi ◽  
Nouroudine Amadou ◽  
Komi Dzidzonu Nemi ◽  
Mouhaman-Inouwa Kpelafia ◽  
...  

Introduction: The objective of our study was to evaluate, in a population of Togolese People Living With HIV (PLWHIV), the agreement between three scores derived from the general population namely the Framingham score, the Systematic Coronary Risk Evaluation (SCORE), the evaluation of the cardiovascular risk (CVR) according to the World Health Organization (WHO) and the CVR evaluation equation derived from the Data collection on Adverse effects of anti-HIV Drugs (D.A.D). Methods: We conducted a descriptive and analytical cross-sectional study including 212 HIV-infected patients recruited from the day hospital of the Infectious Diseases Department of the Sylvanus Olympio University Hospital. The level of agreement between the different scores was estimated using the Pearson correlation test and the Cohen Kappa coefficient.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jill K. Gersh ◽  
Ruanne V. Barnabas ◽  
Daniel Matemo ◽  
John Kinuthia ◽  
Zachary Feldman ◽  
...  

Abstract Background People living with HIV (PLHIV) who reside in high tuberculosis burden settings remain at risk for tuberculosis disease despite treatment with anti-retroviral therapy and isoniazid preventive therapy (IPT). The performance of the World Health Organization (WHO) symptom screen for tuberculosis in PLHIV receiving anti-retroviral therapy is sub-optimal and alternative screening strategies are needed. Methods We enrolled HIV-positive adults into a prospective study in western Kenya. Individuals who were IPT-naïve or had completed IPT > 6 months prior to enrollment were eligible. We evaluated tuberculosis prevalence overall and by IPT status. We assessed the accuracy of the WHO symptom screen, GeneXpert MTB/RIF (Xpert), and candidate biomarkers including C-reactive protein (CRP), hemoglobin, erythrocyte sedimentation rate (ESR), and monocyte-to-lymphocyte ratio for identifying pulmonary tuberculosis. Some participants were evaluated at 6 months post-enrollment for tuberculosis. Results The study included 383 PLHIV, of whom > 99% were on antiretrovirals and 88% had received IPT, completed a median of 1.1 years (IQR 0.8–1.55) prior to enrollment. The prevalence of pulmonary tuberculosis at enrollment was 1.3% (n = 5, 95% CI 0.4–3.0%): 4.3% (0.5–14.5%) among IPT-naïve and 0.9% (0.2–2.6%) among IPT-treated participants. The sensitivity of the WHO symptom screen was 0% (0–52%) and specificity 87% (83–90%). Xpert and candidate biomarkers had poor to moderate sensitivity; the most accurate biomarker was CRP ≥ 3.3 mg/L (sensitivity 80% (28–100) and specificity 72% (67–77)). Six months after enrollment, the incidence rate of pulmonary tuberculosis following IPT completion was 0.84 per 100 person-years (95% CI, 0.31–2.23). Conclusions In Kenyan PLHIV treated with IPT, tuberculosis prevalence was low at a median of 1.4 years after IPT completion. WHO symptoms screening, Xpert, and candidate biomarkers were insensitive for identifying pulmonary tuberculosis in antiretroviral-treated PLHIV.


Author(s):  
Dharma N. Bhatta ◽  
Jennifer Hecht ◽  
Shelley N. Facente

Background: Stigma and discrimination are major challenges faced by people living with HIV (PLWH), and stigma continues to be prevalent among PLWH. We conducted a cross-sectional study of 584 men who have sex with men (MSM) living with HIV between July 2018 and December 2020, designed to better understand which demographic and behavioral characteristics of MSM living with HIV in San Francisco, California are associated with experience of stigma, so that programs and initiatives can be tailored appropriately to minimize HIV stigma’s impacts. Methods: This analysis was conducted with data from San Francisco AIDS Foundation (SFAF) encompassing services from multiple different locations in San Francisco. Data about the level of HIV-related stigma experienced were collected through a single question incorporated into programmatic data collection forms at SFAF as part of the client record stored in SFAF’s electronic health record. We performed linear regression to determine the associations between self-reported experiences of HIV stigma and other characteristics among MSM living with HIV. Results: HIV stigma was low overall among MSM living with HIV who are actively engaged in HIV care in San Francisco; however, it was significantly higher for the age groups of 13–29 years (adjusted risk difference (ARD): 0.251, 95% CI: 0.012, 0.489) and 30–49 years (ARD: 0.205, 95% CI: 0.042, 0.367) when compared to the age group of 50 years and older, as well as people who were homeless (ARD: 0.844, 95% CI: 0.120, 1.568), unstably housed (ARD: 0.326, 95% CI: 0.109, 0.543) and/or having mental health concerns (ARD: 0.309, 95% CI: 0.075, 0.544), controlling for race, injection history, and viral load. Conclusions: These findings highlight an opportunity to develop culturally, socially, and racially appropriate interventions to reduce HIV stigma among MSM living with HIV, particularly for younger men and those struggling with housing stability and/or mental health.


2020 ◽  
Author(s):  
Rewel Kariuki ◽  
Gilbert Koome Rithaa ◽  
Oyugi Elvis ◽  
Daniel Gachathi

Abstract Background: Identification of people living with HIV is key in HIV prevention and control. Partner Notification service is a World Health Organization backed strategy of reaching out to sexual partners of people diagnosed with HIV for HIV testing. However, its adoption and success rate in Kenya remains unknown.Methods: A cross sectional facility based study was undertaken in five purposively selected health facilities in Muranga County, Kenya. A retrospective review of patient medical records data for HIV positive index clients and their Sexual Partners conducted. Census approach applied to extract data for study subjects from Partner Notification Service registers for the period covering January 2017 to August 2018. Epi Info software was used for data analysis.Results: A total of 183 index clients offered Partner notification services. The mean age of the indexed clients studied was 39(SD ±13.1). Females comprised 64 % of clients studied. Of the 183 indexed clients, 89% accepted the services and elicited 216 sexual partners for tracing. The ratio of elicited sexual partners to index client was 1.3:1. Out of the 216 sexual partners, 77% were reached and tested. A total of 46 [32%] of the sexual partners elicited and traced, tested HIV positive. The most preferred approaches were provider referral (51%) and contract referral (45%). Dual referral (4%) was the least preferred approach. Conclusions: Partner notification services is acceptable and an effective strategy of increasing HIV case identification and raising awareness to exposed sexual partners in low resource countries.


2014 ◽  
Vol 22 (6) ◽  
pp. 994-1000 ◽  
Author(s):  
Ana Cristina de Oliveira e Silva ◽  
Renata Karina Reis ◽  
Jordana Almeida Nogueira ◽  
Elucir Gir

OBJECTIVES: to assess the quality of life of people living with HIV/AIDS and verify its association with clinical characteristics and treatment adherence.METHOD: cross-sectional study conducted in a hospital in the state of Paraíba, Brazil. A questionnaire was used to collect socio-demographic and clinical data. The quality of life scale proposed by the World Health Organization and a questionnaire to measure treatment adherence were used.RESULTS: of the 314 interviewees, 190 (60.5%) were male, aged 43 years on average, 121 (38.5%) had attended up to five years of schooling, 108 (34.4%) received up to two times the minimum wage, and 112 (35.7%) were on sick leave. In regard to clinical variables, individuals with an undetectable viral load scored higher in all the domains concerning quality of life, with statistically significant differences in three domains. Regarding treatment adherence, 235 (73.8%) presented poor adherence and those who strictly adhered to treatment obtained better scores in quality of life. The results show that quality of life is better among individuals adherent to ART. Supporting people to adhere to the antiretroviral treatment should be a persistent task of healthcare workers and other people participating in the treatment, such as family members and friends.


2018 ◽  
Vol 29 (9) ◽  
pp. 873-883 ◽  
Author(s):  
Reuben Granich ◽  
Somya Gupta

The human immunodeficiency virus (HIV) and Mycobacterium tuberculosis syndemic remains a global public health threat. Separate HIV and tuberculosis (TB) global targets have been set; however, success will depend on achieving combined disease control objectives and care continua. The objective of this study was to review available policy, budgets, and data to reconceptualize TB and HIV disease control objectives by combining HIV and TB care continua. For 22 World Health Organization (WHO) TB and TB/HIV priority countries, we used 2015 data from the HIV90–90–90watch website, UNAIDS AIDSinfo, and WHO 2016 and 2017 Global TB Reports. Global resources available in TB and HIV/TB activities for 2003–2017 were collected from publicly available sources. In 22 high-burden countries, people living with HIV on antiretroviral therapy ranged from 9 to 70%; viral suppression was 38–63%. TB treatment success ranged from 71 to 94% with 14 (81% HIV/TB burden) countries above 80% TB treatment success. From 2003 to 2017, reported global international and domestic resources for HIV-associated TB and TB averaged $2.85 billion per year; the total for 2003–2017 was 43 billion dollars. Reviewing combined HIV and TB targets demonstrate disease control progress and challenges. Using an integrated HIV and TB continuum supports HIV and TB disease control efforts focused on improving both individual and public health.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Laio Magno ◽  
◽  
Andrea Fachel Leal ◽  
Daniela Knauth ◽  
Inês Dourado ◽  
...  

Abstract Background Brazil has many people living with HIV (PLWH) who are unaware of their serostatus. The public health system has recently added HIV self-testing (HIVST) for key populations such as men who have sex with men (MSM). This study estimates HIVST acceptability among Brazilian MSM and explores factors associated with acceptability among MSM who have never tested for HIV or who had a previous negative result. Methods Respondent-driven sampling (RDS) was used to recruit 4176 MSM in 12 Brazilian cities in 2016 to this biological and behavioral surveillance study. We excluded from this analysis all MSM who were aware of their positive HIV serostatus. Descriptive, bivariate and multivariate analyses were conducted. Overall proportions were weighted with Gile’s estimator in RDS Analyst software and 95% confidence intervals were calculated. The analyses of HIVST acceptability were stratified by prior HIV testing (never or one or more times). Results For this analysis, 3605 MSM were included. The acceptability of HIVST was 49.1%, lower among those who had never tested for HIV (42.7%) compared to those who had a previous HIV negative test (50.1%). In the subgroup of MSM who had never tested for HIV, those who reported discrimination or who had a medical appointment in the last 12 months reported higher HIVST acceptability. Among MSM who had a previous negative HIV test, only those reporting condomless receptive anal sex reported higher HIVST acceptability. In addition, we observed that high levels of knowledge of HIV/AIDS, taking part in lesbian, gay, bisexual, and transgender nongovernmental organizations (LGBT-NGO), or complete secondary or incomplete higher undergraduate education reported higher acceptability. Conclusions The acceptability of HIVST was low among MSM, especially among those who never tested for HIV. Given access to HIVST in Brazil, we point to the need for programs that enhance promotion of testing addressed to MSM.


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