Evaluatiing the Effects of HIV Self-testing used Professional Rapid Test Kits among MSM in Some Areas of China.

With rapid expanding of HIV self-testing (HIVST) among unprofessional people has many unknown hidden dangers. This research for the first to survey the feasibility of urine, oral mucosal transudate (OMT) and finger blood rapid HIV testing kits were used for HIVST by non-professionals MSM in China. Total 274 valid questionnaires were received from 313 MSM participants, including 263 completed urine HIVST, 61 completed OMT HIVST and 17 completed blood HIVST. The average age of participants was under 30, about 80% were unmarried, more than 80% with an education level above Grade 9 but more than 50% people had never heard of the rapid HIV test. There were significant differences in the key information understanding accuracy between HIVST. The accuracy rates were 18.0–80.6%. When the HIVST result was positive, more than 80% chose to seek confirmation. When the test was negative, 60.5% (159/263) participants of urine self-test and 32.8% (20/61) of OMT self-test chose regular retesting. When the test was ineffective, more than 80% chose to retest. In addition, 54.1% of the 146 voluntary participants to accept blood HIVST, followed by 15.8% accept blood and urine HIVST and 14.4% accept only urine HIVST. The main reason for choosing blood HIVST was "accuracy", while the main reason for choosing urine HIVST was "convenience". This findings lays a scientific theoretical basis for further carring out HIVST in China.

Varicella Zoster Virus Meningitis with Absence of Rash in an Immunocompetent Child

Only a few cases in the literature have ever reported the reactivation of the varicella zoster virus (VZV) in children especially in the case of immunocompetent patients. It is an uncommon situation that may lead to several neurological complications. We report varicella zoster virus (VZV) meningitis in a 14-year-old healthy boy with no antecedent of rash. On his cerebrospinal fluid (CSF) examination, VZV DNA was detected. The rapid HIV test was negative. The treatment using acyclovir (20 mg/kg/8h) was effective, and the child’s clinical condition rapidly improved.

Community-based HIV testing in The Netherlands: experiences of lay providers and end users at a rapid HIV test checkpoint

Background The AIDS Healthcare Foundation (AHF-Checkpoint) in The Netherlands offers rapid HIV testing for key populations by lay providers. We explored the experiences and needs of lay providers and end users of HIV testing at AHF-Checkpoint, taking into account the WHO 5C-(consent, confidentiality, counselling, correct-results, connection-to-care) criteria for HIV test services. Methods Qualitative evaluation with 15 semi-structured interviews conducted during 2020 with ten lay providers and five gay or bisexual end users. Recorded interviews were thematically analysed, taking data triangulation into account. Results Four domains were identified: (1) accessibility of HIV testing, (2) quality of test procedures, (3) bridging (transitional care), and (4) future strategies for service delivery. AHF-Checkpoint fills a gap for key populations including LGBTQ and refugees, who experience HIV testing barriers at sexual health centres or general practices. The level of trust between lay providers and end users was highly valued by end users. They appreciated the low threshold to test at no costs, and the absence of waiting lists or triaging. Needs expressed by lay providers included more preparedness for emotionally charged situations, and extra training to improve STI knowledge. End users expressed a need for a full STI test package. Of the 5Cs, consent, counselling, and correct results were realised but confidentiality was sometimes difficult to achieve at pop-up locations, and referral barriers for confirmation testing (connection-to-care) were occasionally experienced by lay providers during weekends. Conclusion AHF-Checkpoint was described as a convenient and easily accessible service by end users and lay providers. Of the WHO 5Cs, connection-to-care could be optimised to ensure HIV confirmation and STI testing through a liaison approach with professionals from the regular healthcare sector.

Performance of the nursing team in the rapid HIV tes

Objetivo: identificar potencialidades e fragilidades da equipe de enfermagem no manejo de pacientes no teste rápido anti-HIV. Método: trata-se de um estudo quantitativo, descritivo, exploratório, com a equipe de enfermagem que atua na execução do teste rápido anti-HIV. Levantou-se amostragem censitária, totalizando seis enfermeiros e seis técnicos de enfermagem os quais responderam ao questionário sociodemográfico e sobre a realização do teste rápido. Resultados: observaram-se, como potencialidades, a realização de grupos educativos, a realização do aconselhamento pós-teste e a entrega de resultados de forma individual. Verificaram-se as seguintes fragilidades: ficha imprópria para a coleta de dados; execução de etapas do teste rápido por profissionais distintos; ambiguidade na execução do protocolo de recrutamento de parceiros e notificação compulsória; sentir-se inseguro para a realização do procedimento; sobrecarga de trabalho; restrição de horários de funcionamento das Unidades Básicas de Saúde. Conclusão: ressalta-se que as fragilidades visualizadas demonstram que não se trata de uma problemática exclusiva à atenção PVHA na perspectiva da Atenção Primária à Saúde, mas, também, a outras ações programáticas no âmbito da Política Nacional da Atenção Básica. Descritores: HIV; Infecções por HIV; Síndrome da Imunodeficiência Adquirida; Equipe de Enfermagem; Atenção Primária à Saúde; Diagnóstico Precoce.AbstractObjective: to identify the nursing team's strengths and weaknesses in the management of patients in the rapid HIV test. Method: this is a quantitative, descriptive, exploratory study, with the nursing team that works on the rapid HIV test. A census sampling was carried out, totaling six nurses and six nursing technicians who answered the sociodemographic questionnaire and the performance of the rapid test. Results: it was observed, as potentialities, the realization of educational groups, the realization of post-test counseling and the delivery of results individually. The following weaknesses were found: improper form for data collection; execution of rapid test steps by different professionals; ambiguity in the execution of the partner recruitment protocol and mandatory notification; feeling insecure to perform the procedure; work overload; restriction of opening hours of the Basic Health Units. Conclusion: it is emphasized that the weaknesses seen demonstrate that this is not an exclusive problem to PLWHA care from the perspective of Primary Health Care, but also to other programmatic actions within the scope of the National Primary Care Policy. Descriptors: HIV; HIV Infections; Acquired Immunodeficiency Syndrome; Nursing, Team; Primary Health Care; Early Diagnosis.ResumenObjetivo: identificar las fortalezas y debilidades del equipo de enfermería en el manejo de pacientes en la prueba rápida de VIH. Método: es un estudio cuantitativo, descriptivo, exploratorio, con el equipo de enfermería que trabaja en la prueba rápida de VIH. Se realizó un muestreo censal, con un total de seis enfermeros y seis técnicos de enfermería que respondieron el cuestionario sociodemográfico y el desempeño de la prueba rápida. Resultados: se observó, como potencialidades, la realización de grupos educativos, la consejería posterior a la prueba y la entrega de resultados individualmente. Se encontraron las siguientes debilidades: forma incorrecta para la recopilación de datos; ejecución de pasos de prueba rápidos por diferentes profesionales; ambigüedad en la ejecución del protocolo de reclutamiento de socios y notificación obligatoria; sentirse inseguro para realizar el procedimiento; sobrecarga de trabajo; restricción de los horarios de atención de las Unidades Básicas de Salud. Conclusión: se enfatiza que las debilidades observadas demuestran que este no es un problema exclusivo para la atención de las PVVS desde la perspectiva de la Atención Primaria de Salud, sino también para otras acciones programáticas dentro del alcance de la Política Nacional de Atención Primaria. Descriptores: VIH; Infecciones por VIH; Síndrome de Inmunodeficiencia Adquirida; Grupo de Enfermeira; Atención Primaria de Salud; Diagnóstico Precoz.

HIV Screening During Pregnancy in a U.S. HIV Epicenter

Background. The CDC and ACOG have issued guidelines for HIV screening in pregnancy for patients living in areas with high prevalence of HIV in order to minimize perinatal vertical transmission. There is a lack of data examining providers’ compliance with these guidelines in at-risk patient populations in the United States. Objective. To evaluate if HIV screening in pregnant women was performed according to guidelines at a large, urban, tertiary care medical center in South Florida. Study Design. A retrospective review was performed on 1270 prenatal and intrapartum records from women who delivered a live infant in 2015 at a single institution. Demographic and outcome data were chart abstracted and analyzed using arithmetic means and standard deviations. Results. Of the 1270 patients who met inclusion criteria, 1090 patients initiated prenatal care in the first or second trimester and delivered in the third trimester. 1000 (91.7%) patients were screened in the first or second trimester; however, only 822 (82.2%) of these were retested in the third trimester during prenatal care. Among the 178 patients lacking a third trimester test, 159 (89.3%) received rapid HIV testing upon admission for delivery. Of the 1090 patients who initiated prenatal care in the first or second trimester and delivered in the third trimester, 982 (90.1%) were screened in accordance with recommended guidelines. Of the 1270 patients initiating care in any trimester, 24 (1.9%) had no documented prenatal HIV test during prenatal care, however 22 (91.7%) had a rapid HIV test on admission for delivery. Two (0.16%) patients were not tested prenatally or prior to delivery. Conclusion. Despite 99.8% of women having at least one HIV screening test during pregnancy, there is room for improvement in routine prenatal screening in both early pregnancy and third trimester prior to onset of labor in this high-risk population.

Análise da operacionalização da testagem rápida para o HIV realizada pelo enfermeiro

O estudo objetivou analisar os modos de operacionalização da testagem rápida para o HIV realizada pelo Enfermeiro na Estratégia Saúde da Família. Trata-se de estudo qualitativo com 13 Enfermeiros da Estratégia Saúde da Família da Paraíba. Os dados foram coletados de abril a junho de 2017 por meio de entrevista semiestruturada e analisados pela análise temática de Bardin e o fluxograma descritor. As categorias que emergiram a partir das entrevistas e agrupadas em etapas no fluxograma descritor foram: oferta do teste rápido anti-HIV; entrega do resultado e aconselhamento pré-teste; execução do teste rápido anti-HIV; aconselhamento pós-teste; e encaminhamento do paciente. Conclui-se que a necessidade da identificação do fornecimento adequado de kits de testagem, da ampliação da oferta do teste para a população em geral, e da interação entre as unidades e Rede de referência no Estado.Descritores: Enfermagem, Testes Sorológicos, Síndrome de Imunodeficiência Adquirida. Analysis of the operationalization of the rapid test for HIV carried out by the nurseAbstract: The aim of this study was to analyze the ways in which the nurse performed rapid testing for HIV in the Family Health Strategy. This is a qualitative study with 13 Nurses of the Paraíba Family Health Strategy. The data were collected from April to June 2017 through a semi-structured interview and analyzed by the thematic analysis of Bardin and the flowchart descriptor. The categories that emerged from the interviews and were grouped in stages in the flowchart descriptor were: rapid HIV test offer, delivery of the result and pre-test counseling; implementation of the rapid HIV test; post-test counseling; and patient referral. It is concluded that the need to identify the adequate supply of test kits, the expansion of the test offer to the general population, and the interaction between the units and reference network in the State.Descriptors: Nursing, Serologic Tests, Acquired Immunodeficiency Syndrome. Análisis de la operacionalización de la prueba rápida para el HIV realizado por el enfermeroResumen: El estudio objetivó analizar las formas de operacionalización de las pruebas rápidas para el HIV realizada por el enfermero en la Estrategia de Salud Familiar. Este es un estudio cualitativo con 13 enfermeras de la Estrategia de Salud Familiar de Paraíba. Los datos se recopilaron de abril a junio de 2017 a través de una entrevista semiestructurada y se analizaron mediante el análisis temático de Bardin y el flujograma descriptor. Las categorías que surgieron de las entrevistas y se agruparon en etapas en el flujograma descriptor fueron: oferta de prueba rápida de anti-HIV, entrega del resultado y asesoramiento previo a la prueba; ejecución de la prueba rápida de HIV; asesoramiento posterior a la prueba; y encaminamiento del paciente. Se concluye que la necesidad de identificar el suministro adecuado de kits de prueba, la expansión de la oferta de prueba a la población general y la interacción entre las unidades y la Red de referencia en el Estado.Descriptores: Enfermería, Pruebas Serológicas, Síndrome de Inmunodeficiencia Adquirida.

1661. Using Social Media to Enhance an STI Screening Program in Wuhan, China

Background 357 million people between the ages of 19 and 49 are infected each year with a sexually transmitted infection (STI). Wuhan, China is a unique setting for STI intervention as it has over 900,000 college students, a population at high risk for contracting HIV. Cultural attitudes toward premarital sex and homosexuality and poor sexual education are barriers to lowering STI rates. Additionally, 90% of Chinese healthcare is provided at large public hospitals with minimal privacy. Anonymous STI screening outside of the public hospital setting is highly desired by young adults and MSM populations. Methods Study investigators partnered with dating app Blued to advertise a nontraditional testing site where high-risk individuals were offered anonymous STI/HIV screening. With the assistance of the regional CDC and a community-based organization (CBO), rapid STI results were provided in a convenient and nonjudgmental setting. Information on sexual behavior and knowledge of STIs was surveyed for future public health interventions. Results Of 200 individuals screened for HIV, syphilis, gonorrhea, and chlamydia, 51 (25.5%) had a positive test result. Over 10% of rectal and pharyngeal tests were positive, compared with 1% of urine tests. 3/200 (1.5%) of had positive rapid HIV test results; all were connected to treatment. Among 41 (20.5%) who learned about the study through Blued, STI prevalence was higher (31.7% vs. 23.9%, P = 0.3), compared with participants recruited through advertisement by the CBO. Most (67.5%) identified as MSM. Survey data confirmed low underlying knowledge of STI transmission and risk factors, especially regarding pre-exposure prophylaxis (PrEP). Conclusion A discreet screening service at a nontraditional site, facilitated through dating application and social media advertisement, was well received by young adult and MSM communities in Wuhan, China. Triple-site STI screening found a significant number of infections among this population and should be routinely offered by public health services. The use of real-time, convenient diagnostic testing presents an opportunity to lower HIV incidence in Wuhan, a city with a large at-risk population. Disclosures All authors: No reported disclosures.