Survey of the Level of HIV Testing in State and Territorial Public Health Laboratories

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.

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P006: Time for a national conversation: Practices and perspectives on HIV testing in Canadian emergency departments

CJEM ◽

10.1017/cem.2020.214 ◽

2020 ◽

Vol 22 (S1) ◽

pp. S66-S66

Author(s):

D. Wiercigroch ◽

E. Xie ◽

J. Hulme ◽

M. Landes

Keyword(s):

Public Health ◽

High Risk ◽

Hiv Testing ◽

Emergency Departments ◽

Theory Approach ◽

Catchment Areas ◽

Health Practitioners ◽

Time Required ◽

Public Health Practitioners

Introduction: Improved access to HIV testing would benefit the one in six Canadians living with undiagnosed HIV, and potentially reduce transmission. Emergency departments may be the first or only point of contact with the healthcare system for people exposed to HIV; however, HIV testing remains inaccessible in many EDs in Canada. Methods: We used a grounded theory approach to characterize the experiences and context of HIV testing in Canadian EDs. We conducted semi-structured phone interviews with ED and public health practitioners from a purposive sample of urban, rural, academic, and community ED catchment areas. Thematic analysis was performed through iterative readings by two authors. Results were triangulated through consultation with public health and HIV experts. Results: Data were obtained from 16 ED physicians and 8 public health practitioners. HIV tests were infrequently performed in the EDs of our sample. Informants from higher incidence regions believed that greater availability of HIV tests in the ED would benefit the populations they serve. In half of the sample, rapid HIV tests were available. However, indications for testing were most often occupational or known high-risk exposure. Notably, two urban EDs in British Columbia screened all patients who otherwise needed blood tests (opt-out), but had shifted to opt-in testing at the time of this study. Consent practices and perceived requirements varied widely between sites; this confused or frustrated physicians. Most EDs were unable to offer a test result to patients during their visit as results were not available until days to weeks later. Commonly, the ordering physician was responsible for communicating results. Some EDs had an assigned physician managing all results on a given day while others relied on public health units for follow-up. All EDs reported access to public health clinics for ongoing care. Barriers to offering a test in the ED included time required for consent, discomfort with pre-test counselling, delay in results availability and unclear processes for follow-up. Conclusion: We describe substantial regional and within-site variation in HIV testing practices across a diverse sample of EDs across Canada. These findings highlight disparities in access to HIV testing and warrant a national discussion on best practices for testing in EDs with an emphasis on reducing barriers for high-risk populations and addressing unmet needs.

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HIV Testing Updates and Challenges: When Regulatory Caution and Public Health Imperatives Collide

Current HIV/AIDS Reports ◽

10.1007/s11904-014-0251-7 ◽

2015 ◽

Vol 12 (1) ◽

pp. 117-126 ◽

Cited By ~ 18

Author(s):

Bernard M. Branson

Keyword(s):

Public Health ◽

Hiv Testing

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HIV Testing Of Infants: Privacy And Public Health

Health Affairs ◽

10.1377/hlthaff.17.4.170 ◽

1998 ◽

Vol 17 (4) ◽

pp. 170-183 ◽

Cited By ~ 5

Author(s):

Amitai Etzioni

Keyword(s):

Public Health ◽

Hiv Testing

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New law on HIV testing in Botswana: The implications for healthcare professionals

Southern African Journal of HIV Medicine ◽

10.4102/sajhivmed.v16i1.337 ◽

2015 ◽

Vol 16 (1) ◽

Cited By ~ 4

Author(s):

Rofiah O. Sarumi ◽

Ann E. Strode

Keyword(s):

Public Health ◽

Human Rights ◽

Hiv Testing ◽

Healthcare Professionals ◽

International Human Rights ◽

New Public Health ◽

Testing Strategies ◽

New Public ◽

Human Rights Norms ◽

Public Health Act

Background: Botswana is one of the countries with the highest HIV prevalence rates in the world. Innovative HIV testing strategies are required to ensure that those infected or at risk of infection become aware of their HIV status and are able to access treatment, care and support. Despite this public health imperative, HIV testing strategies in Botswana will in future be based around the principles in the new Public Health Act (2013). The present article describes the HIV testing norms in the Act, and sets out the strengths and weaknesses of this approach and its implications for healthcare professionals in Botswana.Objectives: To compare international norms on HIV testing with the provisions governing such testing in the new Botswana Public Health Act and to assess the extent to which the new Act meets international human rights norms on HIV testing.Method: A ‘desktop’ review of international human rights norms and those in the Botswana Public Health Act.Conclusion: HIV testing norms in the new Public Health Act in Botswana violate individual rights and will place healthcare workers in a position where they will have to elect between acting lawfully or ethically. Law reform is required in order to ensure that HIV testing achieves the joint goals of public health and human rights.

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Evaluation of HIV screening at antenatal care settings in Denpasar City

Public Health and Preventive Medicine Archive ◽

10.15562/phpma.v5i1.39 ◽

2017 ◽

Vol 5 (1) ◽

pp. 33

Author(s):

Putu Cintya Denny Yuliyatni ◽

Wayan Pujana ◽

Citra Indriani

Keyword(s):

Public Health ◽

Pregnant Women ◽

Hiv Testing ◽

Health Centre ◽

Secondary Data ◽

Performance Outcomes ◽

Hiv Screening ◽

Public Health Centre ◽

Key Informants ◽

Hiv Test

Background and purpose: National strategy to increase the coverage of prevention of mother to child transmission (PMTCT) program in Indonesia is integrating the service into public health centres (puskesmas). In Bali, the integration has been started since 2014. After one year of program implementation, an evaluation was conducted in order to provide input and feedback for program improvement.Methods: Secondary data analysis and indepth interview with 13 key informants in Denpasar City were conducted to assess input, process and output of the integration implementation. Results: Of the 11,719 pregnant women targeted within the program, 43% were offered to undergo HIV testing and 98% of these agreed to have HIV test with 17 were found HIV positive. Interviews with key informants found that there were adequate resources both in terms of manpower, funds and equipment. Obstacles found in the implementation include different site of ANC and HIV testing facility. The other barrier was high number of pregnant mother who conducted ANC at private obstetrician which not yet included in the program.Conclusions: Integration of PMTCT into ANC services at public health centre (PHC) is an effective way to improve the uptake of HIV screening among pregnant women. However, there is a need of effective of referral systems from private midwives and PHC satellite services. The expansion of networks into private midwives and obstetrician will be instrumental in improving performance outcomes.

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