HIV testing practices among Latina women at risk of getting infected: a five-year follow-up of a community sample in South Florida

Workplace factors associated with willingness to undergo human immunodeficiency virus testing during workplace health checkups

BACKGROUND

To examine workplace factors associated with willingness to undergo human immunodeficiency virus (HIV) testing during workplace health checkups.

METHODS

This cross-sectional study used an Internet-based self-administered questionnaire to obtain data from a pool of 24,287 Japanese workers. Binary and multiple logistic regression analyses evaluated the association between workplace factors and HIV testing. Data were adjusted for sex, age, marital status, education, and history of HIV testing.

RESULTS

We gathered information from 4,143 (17.1%) respondents, of whom 1,129 (27.3%) were willing to be tested for HIV as part of a workplace health checkup. The participants were 20-59 years old. Approximately half of the participants were male (49.9%), half were married (48.9%), and half had completed higher education (47.6%). Workplace hepatitis testing was offered to 15.6% of the respondents, and most participants underwent health checkups without their colleagues (52.1%) at a medical facility (60.2%). Willingness to undergo HIV testing was positively correlated with having an increased risk of occupational blood exposure (vs. not at risk, adjusted odds ratio [OR]: 1.74, 95% confidence interval [CI]: 1.41-2.15) or working in medical and welfare roles (vs. manufacturing, OR: 1.40, 95% CI: 1.07-1.84). The presence of occupational health staff at the workplace (vs. their absence, adjusted OR: 1.35, 95% CI: 1.16-1.59) and hepatitis testing (vs. not testing, adjusted OR: 2.02, 95% CI: 1.66-2.44) increased willingness to undergo HIV testing.

CONCLUSIONS

A pilot HIV-testing program involving individuals at an increased risk of occupational blood exposure and undergoing hepatitis tests in workplaces providing occupational health staff support is recommended.

HIV testing behaviors and willingness to receive oral rapid HIV testing among dental patients in Xi'an, China

Introduction

HIV testing is an important strategy for controlling and ultimately ending the global pandemic. Oral rapid HIV testing (ORHT) is an evidence-based strategy and the evidence-based shows is favored over traditional blood tests in many key populations. The dental setting has been found to be a trusted, convenient, and yet untapped venue to conduct ORHT. This study assessed the HIV testing behaviors and willingness to receive ORHT among dental patients in Xi’an, China.

Methods

A cross-sectional survey of dental patients from Xi’an was conducted from August to September 2017. Dental patients were recruited using a stratified cluster sampling. A 44-item survey was used to measure HIV/AIDS knowledge, HIV testing behaviors, and willingness to receive ORHT.

Results

Nine hundred and nine dental patients completed the survey with a mean HIV/AIDS knowledge score of 10.7/15 (SD 2.8). Eighty-four participants (9.2%) had previously received an HIV test. Participants would have a high rate of HIV testing if they had higher monthly income (OR = 1.982, 95% CI: 1.251–3.140) and a higher HIV/AIDS knowledge score (OR = 1.137, 95% CI: 1.032–1.252). Five hundred and eighty-two participants (64.0%) were willing to receive ORHT before a dental treatment, 198 (21.8%) were not sure, and 129 (14.2%) were unwilling. Logistic regression showed that age (OR = 0.970, 95% CI: 0.959–0.982), HIV/AIDS knowledge score (OR = 1.087, 95% CI: 1.031–1.145), previous HIV test (OR = 2.057, 95% CI: 1.136–3.723), having advanced HIV testing knowledge (OR = 1.570, 95% CI: 1.158–2.128), and having advanced ORHT knowledge (OR = 2.074, 95%: CI 1.469–2.928) were the factors affecting the willingness to receive ORHT.

Conclusions

The majority of dental patients had not previously received an HIV test, although many were receptive to being tested in the dental setting. The dental setting as a venue to screen people for HIV needs further exploration, particularly because many people do not associate dentistry with chairside screenings. Increasing awareness of ORHT and reducing testing price can further improve the patient’s willingness to receive ORHT.

An Examination of Geographic Differences in Social Determinants of Health Among Women with Diagnosed HIV in the United States and Puerto Rico, 2017

Objective:

To examine differences, at the census tract level, in the distribution of human immunodeficiency virus (HIV) diagnoses and social determinants of health (SDH) among women with diagnosed HIV in 2017 in the United States and Puerto Rico.

Background:

In the United States, HIV continues to disproportionately affect women, especially minority women and women in the South.

Methods:

Data reported in the National HIV Surveillance System (NHSS) of the Centers for Disease Control and Prevention were used to determine census tract-level HIV diagnosis rates and percentages among adult women (aged ≥18 years) in 2017. Data from the American Community Survey were combined with NHSS data to examine regional differences in federal poverty status, education level, income level, employment status, and health insurance coverage among adult women with diagnosed HIV infection in the United States and Puerto Rico.

Results:

In the United States and Puerto Rico, among 6,054 women who received an HIV diagnosis in 2017, the highest rates of HIV diagnoses generally were among those who lived in census tracts where the median household income was less than $40,000; at least 19% lived below the federal poverty level, at least 18% had less than a high school diploma, and at least 16% were without health insurance.

Conclusion:

This study is the first of its kind and gives insight into how subpopulations of women are affected differently by the likelihood of an HIV diagnosis. The findings show that rates of HIV diagnosis were highest among women who lived in census tracts having the lowest income and least health coverage.

HIV Testing Among Muslim Women in the United States: Results of a National Sample Study

Purpose: More than one million Americans are living with human immunodeficiency virus (HIV), and less than half of Americans have ever accepted an HIV test. There are no national HIV testing estimates for Muslim Americans, an underserved and often stigmatized population. Considering the lack of HIV testing estimates for this population, we conducted an exploratory study on HIV testing and potential associates in American Muslim women from across the United States. Methods: We applied logistic regression models to examine the Muslim Women's Health Project data, collected in 2015 (N=218). Results: Health care engagement and intimate partner violence were significantly associated with having been tested for HIV. Respondents using contraceptives received an influenza vaccination, and received an abnormal pap test had more than two times higher odds of having been tested for HIV (odds ratio [OR]=2.56, OR=2.43, OR=2.93, respectively; p<0.05 all). Having been sexually abused was associated with more than two times higher odds of having been tested for HIV (OR=2.49; p<0.05). Conclusion: Respondents reported higher rates of HIV testing as compared with the general public, signaling HIV knowledge, engagement in preventative health care, and possibly HIV risk. Scholars and practitioners should not assume that Muslim patients are at low risk for HIV and do not engage in HIV-risk behaviors. Thus, assumptions about Muslims women's willingness to accept HIV testing should be further examined to elucidate HIV risk among this population.

Exploring HIV concern in a population of Dominican American women midlife and older

BACKGROUND

The feminization and ethnic diversification of HIV infection, has resulted in a call for gender- and culture-specific prevention strategies for at-risk groups including Latinos in the United States. The steadily changing demographic profile of the AIDS epidemic challenges prevention strategies to remain relevant and up-to-date, particularly in populations of women midlife and older where an understanding of risk remains under explored. As the CDC requests country-specific HIV risk profiles for Latino communities in the US, understanding the socio-economic, behavioral and personal risk reasons of HIV risk for older Dominican women is critical for prevention.

METHODS

We conducted focus group discussions informed by the Theory of Gender and Power (TGP). The three constructs of the TGP: 1) Affective influences/social norms; 2) Gender-specific norms and. 3) Power and Authority guided the thematic analysis and identified themes that described the socio-cultural and contextual reasons that that contribute to perceptions of HIV risk.

RESULTS

Sixty Dominican American women ages 57-73 participated in our focus group discussions. Sexual Division of Labour: 1) Economic Dependence; 2) Financial Need and 3) Education and Empowerment. Sexual Division of Power: 4) HIV Risk and 5) Relationship Dynamics. Cathexis: Affective Influences/Social Norms: 6) HIV/AIDS Knowledge and 7) Prevention and Testing. Importantly, participants were concerned about partner fidelity when visiting the Dominican Republic, as the country accounts for the second highest HIV rates in the Caribbean.

CONCLUSIONS

Our results confirm previous findings about perceptions of HIV risk and provide additional insight into aging-related aspects of HIV risk for Latino women midlife and older.

HIV Testing Among Heterosexual Hispanic Women in South Florida

PURPOSE

The purpose of this study was to examine the influence of selected facilitators, barriers, beliefs, and knowledge suggested by the literature to be associated with human immunodeficiency virus (HIV) testing among heterosexual Hispanic women.

DESIGN

This study utilizes a cross-sectional design to analyze secondary data from SEPA III: The Effectiveness Trial. SEPA stands for Salud, Educacion, Prevencion y Autocuidado, which translates to Health, Education, Prevention, and Self-Care. The Social Cognitive Model (SCM) guided this study.

METHODS

Three hundred twenty heterosexual Hispanic women 18 to 50 years of age participated in this study. Data were analyzed using descriptive statistics and logistic regression.

FINDINGS

The most common facilitators for HIV testing were receiving recommendations from a healthcare provider (HCP) and the test is offered by an HCP rather than women asking for it. The most common barrier to testing was having no reason to believe they were infected. Most women believed a positive test result would encourage them to take better care of themselves. However, as much as 15% of women reported desires to kill or hurt themselves if they test positive. On the other hand, a negative result would make them assume their partners are negative and thus do not need to be tested. Significantly, explanatory variables related to HIV testing were knowledge and the HIV test is offered by an HCP instead of women asking for it.

CONCLUSIONS

Strengthening HIV knowledge and offering HIV tests are significant contributions that nurses make to the health of Hispanic women. The SCM can be used to design programs to increase HIV testing among Hispanic women.

CLINICAL RELEVANCE

Nurses are encouraged to offer testing and provide culturally competent HIV prevention education to increase HIV testing among Hispanic women.

Factors associated with condom use inyoung people-A population-based survey

INTRODUCTION

This study aimed to identify the factors associated with condom use in the last sexual intercourse.

METHODS

A population-based survey with young people aged 15-24, in the city of São Paulo, which collected sociodemographic data referring to knowledge about sex and sexual behavior.

RESULTS

Among 821 sexually active young people interviewed in the last year, condom use in their last sexual intercourse was positively associated with: 1) not being married; 2) use of condom at sexual onset; and 3) receiving free condoms; additionally, among men: 4) casual partners in the previous year; and 5) partner of the same sex; and, amongwomen: 6) sexual onset after the age of 15. Having been tested for HIV was a negative association among women. Condoms are widely acknowledged, and there is a pattern of use for the first and last sexual intercourse. Access to free condoms is an important factor for use, and people use condoms according to standards that configure risk management.

CONCLUSIONS

The strategy of primary prevention with the use of condoms is not yet exhausted. Based on this study, the city of São Paulo takes prevention as a public policy and allocates large condoms dispensers in 26 urban bus terminals, where 6million people circulate daily. In 2016, 75,546,720 free condoms were distributed, 30% in bus terminals alone.

Acceptability of Rapid HIV Testing Among Latinos in Washington Heights, New York City, New York, USA

In the United States, human immunodeficiency virus (HIV) has a disproportionately large impact on Latino Americans. This study assessed the acceptability of rapid HIV testing among a sample of Latinos from New York City. A cross-sectional study was conducted with 192 participants from The Washington Heights/Inwood Informatics Infrastructure for Community-Centered Comparative Effectiveness Research (WICER) study. Participants were interviewed and offered rapid HIV testing and post-test counseling. Seventy-five percent (n = 143) accepted rapid HIV testing when offered. More religious participants were less likely than less religious participants to undergo testing (RR = 0.73; 95% CI 0.54-0.99). Participants tested for HIV within the past year were less likely than those who had not been tested within the past year to agree to undergo testing (RR = 0.27; 95% CI 0.11-0.66). Community-based rapid HIV testing is feasible among Latinos in urban environments. Outreach efforts to engage religious individuals and encouraging routine testing should be reinforced.

Missed Opportunities for Repeat HIV Testing in Pregnancy: Implications for Elimination of Mother-to-Child Transmission in the United States

HIV testing is an effective intervention that is used for reducing perinatal HIV transmission. Centers for Disease Control and Prevention recommends a second HIV test during the third trimester of pregnancy for women in settings with an elevated HIV incidence (≥17 cases per 100,000 person-years). We conducted a retrospective cohort study at a single hospital in Baltimore, Maryland, to determine whether a second HIV test was done and to compare HIV retesting with mandated syphilis retesting. Of women who delivered at this hospital, 98.8% received prenatal care. Descriptive, bivariate, and multivariable analyses were performed. Among 1632 women, mean age was 27.6 years (standard deviation: 6.3), 59.6% were black, and 55.5% were single. HIV retesting was done in 28.4% of women, which was significantly less often compared with the state-mandated syphilis retesting (78.7%, p < 0.001). The odds of having an HIV retest were 15 times higher among women who received prenatal care at a teaching clinic [adjusted odds ratio (aOR): 15.58; 95% confidence interval (CI): 11.12-21.81], and they were lower among women with private insurance (aOR: 0.54, 95% CI: 0.34-0.86). The odds of having a syphilis retest were twice as high among women who received prenatal care at a faculty practice (aOR: 2.17; 95% CI: 1.53-3.09), and they were lower among women with private insurance (aOR: 0.61, 95% CI: 0.43-0.88). Emphasizing an "opt-out" HIV retesting approach through state laws may minimize risk perception, and this is one strategy that can be considered in areas of high HIV incidence to reach the goal of eliminating perinatal HIV transmission in the United States.