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Luu M, Haardörfer R, Nehl E, Escoffery C, Sales J. Factors associated with intention of HIV testing among Asian American men: a path analysis. J Behav Med 2024; 47:849-863. [PMID: 38980458 DOI: 10.1007/s10865-024-00502-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 06/01/2024] [Indexed: 07/10/2024]
Abstract
Research has pointed to myriad cultural and socio-psychological factors associated with HIV testing, such as acculturation, social norms about HIV testing, masculinity, homonegativity, and constructs from the Theory of Planned Behavior. However, the interrelationships of these factors on the intentions of HIV testing among the population of Asian American men remains unknown. A dataset of 425 Asian American men in the U.S., collected online with convenience sampling method during 2020-2021, was analyzed to test a conceptual framework that aimed to fill this gap. Results from a path model with two endogenous variables (homonegativity and HIV testing intention) indicated that perceived social norms about HIV testing, attitude about HIV testing, and perceived HIV risk had directandindirect relationships with the intentions of HIV testing in the study population. However, social norms about HIV testing and perceived HIV risk showed stronger direct effects (standardized estimates = 0.37 and 0.34, respectively, p-value < 0.001). Additionally, we found that the relationships of these factors with HIV testing intention were also mediated by homonegativity. Findings from this study advance our understanding of pathways of associations between a host of cultural and socio-psychological factors with HIV testing intention among an understudied population - Asian American men. Our results will help inform the development of future intervention programs to increase HIV testing in this population.
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Affiliation(s)
| | - Regine Haardörfer
- Department of Behavioral, Social, and Health Education Sciences (BSHES), Rollins School of Public Health, Emory University, Atlanta, USA
| | - Eric Nehl
- Department of Behavioral, Social, and Health Education Sciences (BSHES), Rollins School of Public Health, Emory University, Atlanta, USA
| | - Cam Escoffery
- Department of Behavioral, Social, and Health Education Sciences (BSHES), Rollins School of Public Health, Emory University, Atlanta, USA
| | - Jessica Sales
- Department of Behavioral, Social, and Health Education Sciences (BSHES), Rollins School of Public Health, Emory University, Atlanta, USA
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Doughty J, Tran C, Santella AJ, Fitzgerald R, Burns F, Porter S, Watt RG. Point of care HIV testing in dental settings in high-income countries: A mixed-methods systematic review. Community Dent Oral Epidemiol 2024; 52:648-659. [PMID: 38822596 DOI: 10.1111/cdoe.12963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 03/27/2024] [Accepted: 04/12/2024] [Indexed: 06/03/2024]
Abstract
OBJECTIVES Expanding HIV testing beyond specialized services has been a key strategic approach to eliminating the transmission of HIV. In recent years, dental settings have been identified as offering an opportunity for delivering point of care HIV testing (POCT) interventions. Intervention components and implementation strategies have varied across studies and there is uncertainty about the prevalence of undiagnosed HIV in the dental patient population. Therefore, this systematic review aimed to synthesize the HIV testing outcomes of intervention studies, identify the core components of POCT interventions implemented in dental settings; and understand the barriers and facilitators to intervention implementation. METHODS A mixed-methods systematic review was undertaken. Two authors reviewed abstracts and full papers for inclusion and appraised the studies using the Mixed Methods Appraisal Tool. A convergent integrated mixed methods study design underpinned the synthesis. Outcomes were presented using descriptive statistics. Intervention components were mapped to the Template for Intervention Description and Replication (TIDieR) checklist. Barriers and facilitators were described using a narrative thematic analysis. RESULTS POCT was offered to 22 146 dental patients, 62.5% accepted POCT. Intervention studies that reported higher uptake of testing utilized a dedicated dental or researcher staff member to provide testing, integrated testing and provided results within the routine dental appointment and adopted a provider-initiated universal approach to offering testing. Six themes emerged that were pertinent to the barriers and facilitators to HIV testing in dental setting. CONCLUSIONS POCT uptake in dental settings was comparable with other non-specialized health settings. Key to the operationalization of the intervention were perceptions about its value and relevance to the dental patient population, attitudes toward the intervention, logistical barriers to its implementation, the risk of HIV testing stigma to the patient-practitioner relationship and maximising the fit of the intervention within the constraints of the dental setting.
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Affiliation(s)
- J Doughty
- Department of Epidemiology & Public Health, Faculty of Pop Health Sciences, University College London, London, UK
- School of Dentistry, University of Liverpool
| | - C Tran
- Oral and Maxillofacial Surgery department, York and Scarborough Teaching Hospitals NHS Foundation Trust, York, UK
| | - A J Santella
- Marion Peckham Egan School of Nursing & Health Studies, Fairfield University, Fairfield, Connecticut, USA
| | - R Fitzgerald
- Department of Special Care Dentistry, Surrey and Sussex Healthcare Trust
| | - F Burns
- Institute for Global Health, University College London, London, UK
| | - Stephen Porter
- Eastman Dental Institute, Faculty of Medical Sciences, University College London, London, UK
| | - Richard G Watt
- Department of Epidemiology & Public Health, Faculty of Pop Health Sciences, University College London, London, UK
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Jiang H, He W, Pan H, Zhong X. A structural equation modeling approach to investigate HIV testing willingness for men who have sex with men in China. AIDS Res Ther 2023; 20:64. [PMID: 37661282 PMCID: PMC10476389 DOI: 10.1186/s12981-023-00561-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 08/18/2023] [Indexed: 09/05/2023] Open
Abstract
BACKGROUND A substantial risk of contracting Human immunodeficiency virus (HIV) exists among men who have sex with men (MSM), and HIV infection rates have been rising. This study aimed to analyze the factors influencing the Chinese MSM population's intention to test for HIV. METHODS Nonprobability sampling techniques were employed in June 2022 to recruit MSM in Chongqing and Sichuan, China. The data were analyzed using structural equation modeling (SEM), which is based on the knowledge-attitude-behavior (KAB) theory. RESULTS Among 1687 participants, 964 (57.1%) of the MSM were willing to have an HIV test. The results of the structural equation modeling (SEM) showed that knowledge, attitude, and behavior all influenced the testing intention, with attitude having the greatest impact (total effect of 0.22). CONCLUSION HIV testing needs to be increased among MSM as they exhibit a moderate willingness to test. Improving education on HIV knowledge and risk behavior might enhance the willingness of MSM to test for HIV in China.
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Affiliation(s)
- Han Jiang
- School of Public Health, Chongqing Medical University, Chongqing, 400016, China
| | - Wei He
- School of Public Health, Chongqing Medical University, Chongqing, 400016, China
| | - Haiying Pan
- School of Public Health, Chongqing Medical University, Chongqing, 400016, China
| | - Xiaoni Zhong
- School of Public Health, Chongqing Medical University, Chongqing, 400016, China.
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Le Bonniec A, Sun S, Andrin A, Dima AL, Letrilliart L. Barriers and Facilitators to Participation in Health Screening: an Umbrella Review Across Conditions. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2022; 23:1115-1142. [PMID: 35705780 DOI: 10.1007/s11121-022-01388-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2022] [Indexed: 11/28/2022]
Abstract
Screening is an essential prevention practice for a number of health conditions. However, screening coverage remains generally low. Studies that investigate determinants of screening participation are becoming more common, but oftentimes investigate screening for health conditions in an individualized rather than integrated fashion. In routine clinical practice, however, healthcare professionals are often confronted with situations in which several screening procedures are recommended for the same patient. The consideration of their common determinants may support a more integrated screening approach. The objectives of this umbrella review were therefore to examine: 1) the determinants (barriers and facilitators) that have been identified in relation to recommended health screening procedures; and 2) the modifiable determinants (in primary care) common across health conditions or specific to individual procedures. Results were presented through a narrative synthesis. PubMed, PsycInfo and Cochrane were searched up to January 2022. Systematic reviews reporting determinants of participation in health screening procedures with grade A or B recommendation according to the US Preventive Services Task Force were included. A total of 85 systematic reviews were included, most which contained both qualitative and quantitative studies on determinants that describe individual factors (961 occurrences), social factors (113 occurrences, healthcare professional factors (149 occurrences), health system factors (105 occurrences) and screening procedure factors (99 occurrences). The most studied screening procedures concerned cervical cancer/human papillomavirus (n = 33), breast cancer (n = 28), colorectal cancer (n = 25) and the human immunodeficiency virus (n = 12). Other conditions have been under-studied (e.g. cardiovascular problems, lung cancer, syphilis). The individual domain, including determinants such as knowledge, beliefs and emotions, was the most covered across health conditions. Healthcare professional's recommendations and the quality of patient-provider communication were identified to have a strong influence on screening participation in most conditions. The other three domains included determinants which were more specific to a condition or a population. Various determinants modifiable in primary care were found in the individual domain and in the health system, healthcare professional and screening procedure domains. Quality was assessed as low for most systematic reviews included. The identification of various modifiable determinants common across conditions highlights the potential of an integrated screening participation approach. Interventions may address common determinants in a broader person-centred framework within which tailoring to specific procedures or populations can be considered. This approach needs to be explored in intervention studies. The systematic review registration is PROSPERO CRD42019126709.
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Affiliation(s)
- Alice Le Bonniec
- Research On Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France.
- Groupe de Recherche en Psychologie Sociale (GRePS) EA4163, Université Lumière Lyon 2, Lyon, France.
| | - Sophie Sun
- Research On Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France
- Collège Universitaire de Médecine Générale, Université Claude Bernard Lyon 1, Lyon, France
| | - Amandine Andrin
- Research On Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France
- Groupe de Recherche en Psychologie Sociale (GRePS) EA4163, Université Lumière Lyon 2, Lyon, France
| | - Alexandra L Dima
- Research On Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France
| | - Laurent Letrilliart
- Research On Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France
- Collège Universitaire de Médecine Générale, Université Claude Bernard Lyon 1, Lyon, France
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Hempel S, Ferguson L, Bolshakova M, Yagyu S, Fu N, Motala A, Gruskin S. Frameworks, measures, and interventions for HIV-related internalised stigma and stigma in healthcare and laws and policies: systematic review protocol. BMJ Open 2021; 11:e053608. [PMID: 34887280 PMCID: PMC8663079 DOI: 10.1136/bmjopen-2021-053608] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION There is strong global commitment to eliminate HIV-related stigma. Wide variation exists in frameworks and measures, and many strategies to prevent, reduce or mitigate stigma have been proposed but critical factors determining success or failure remain elusive. METHODS AND ANALYSIS Building on existing knowledge syntheses, we designed a systematic review to identify frameworks, measures and intervention evaluations aiming to address internalised stigma, stigma and discrimination in healthcare, and stigma and discrimination at the legal or policy level. The review addresses four key questions (KQ): KQ1: Which conceptual frameworks have been proposed to assess internal stigma, stigma and discrimination experienced in healthcare settings, and stigma and discrimination entrenched in national laws and policies? KQ2: Which measures of stigma have been proposed and what are their descriptive properties? KQ3: Which interventions have been evaluated that aimed to reduce these types of stigma and discrimination or mitigate their adverse effects and what are the effectiveness and unintended consequences? KQ4: What common 'critical factors for success or failure' can be identified across interventions that have been evaluated? We will search PubMed, PsycINFO, Web of Science, Universal Human Rights Index, HeinOnline, PAIS, HIV Legal Network, CDSR, Campbell Collaboration, PROSPERO and Open Science Framework. Critical appraisal will assess the source, processes and consensus finding for frameworks; COnsensus-based Standards for the selection of health Measurement Instruments criteria for measures; and risk of bias for interventions. Quality of evidence grading will apply . A gap analysis will provide targeted recommendations for future research. We will establish a compendium of frameworks, a comprehensive catalogue of available measures, and a synthesis of intervention characteristics to advance the science of HIV-related stigma. PROSPERO REGISTRATION NUMBER CRD42021249348.
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Affiliation(s)
- Susanne Hempel
- Southern California Evidence Review Center, University of Southern California, Los Angeles, California, USA
| | - Laura Ferguson
- Institute on Inequalities in Global Health, University of Southern California, Los Angeles, California, USA
| | - Maria Bolshakova
- Southern California Evidence Review Center, University of Southern California, Los Angeles, California, USA
| | - Sachi Yagyu
- Southern California Evidence Review Center, University of Southern California, Los Angeles, California, USA
| | - Ning Fu
- Department of Economics, Shanghai University of Finance and Economics, Shanghai, China
| | - Aneesa Motala
- Southern California Evidence Review Center, University of Southern California, Los Angeles, California, USA
| | - Sofia Gruskin
- Institute on Inequalities in Global Health, University of Southern California, Los Angeles, California, USA
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Ramírez-Ortiz D, Sheehan DM, Ibañez GE, Ibrahimou B, De La Rosa M, Cano MÁ. HIV testing intentions and cognitive reappraisal among Latino emerging adults. AIDS Care 2020; 33:548-552. [PMID: 32408760 DOI: 10.1080/09540121.2020.1763905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Negative emotions related to HIV testing may influence an individual's intentions to test for HIV. However, emotion regulation strategies such as cognitive reappraisal which involves reframing the meaning of an event to modify one's emotional response to it may potentially help to regulate these emotions and facilitate decisions to get tested for HIV. In this exploratory study, we examined the association between cognitive reappraisal and HIV testing intentions and whether this association differs by gender. Cross-sectional data were collected from a convenience sample of 157 Latino emerging adults aged 18-25 years living in Arizona and Florida through an online survey. Hierarchical logistic regression models were used to analyze the data. Results indicated that cognitive reappraisal was significantly associated with HIV testing intentions (aOR: 1.44, 95% CI:1.04-1.99) and that this association was specific to females (aOR: 2.48, 95% CI: 1.39-4.43). Our results demonstrate the potential of cognitive reappraisal to facilitate HIV testing intentions among females. HIV prevention interventions should incorporate cognitive reappraisal training to regulate and adapt to the negative emotions associated with HIV testing in efforts to increase HIV testing.
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Affiliation(s)
- Daisy Ramírez-Ortiz
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami
| | - Diana M Sheehan
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami.,Center for Research on U.S. Latino HIV/AIDS and Drug Abuse, Florida International University, Miami, Florida.,Research Center in Minority Institutions, Florida International University, Miami
| | - Gladys E Ibañez
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami
| | - Boubakari Ibrahimou
- Department of Biostatistics, Robert Stempel College of Public Health and Social Work, Florida International University, Miami
| | - Mario De La Rosa
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse, Florida International University, Miami, Florida.,Department of Social Work, Robert Stempel College of Public Health and Social Work, Florida International University, Miami
| | - Miguel Ángel Cano
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami.,Center for Research on U.S. Latino HIV/AIDS and Drug Abuse, Florida International University, Miami, Florida
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Hoyos J, Koutentakis K, Maté T, Pulido J, Sordo L, Guerras JM, Belza MJ. High risk men who have sex with men in Spain are reporting low intentions of actively seeking HIV testing: results from a cross-sectional study. BMC Public Health 2020; 20:398. [PMID: 32216783 PMCID: PMC7099777 DOI: 10.1186/s12889-020-8440-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 03/02/2020] [Indexed: 11/12/2022] Open
Abstract
Background We analyse unprotected anal intercourses (UAI) self-reported by a sample of men who have sex with men (MSM), by their future testing intentions and past testing history to identify undertested subpopulations that could be contributing to onward transmission. Methods We recruited MSM through gay dating websites in Spain from September 2012 to April 2013. For MSM at risk of acquiring or unknowingly transmitting HIV (at risk hereafter) we calculate time at risk, number of UAI in the last 12 months and last 5 years by testing intention (low intention (LI), Medium intention (MI), high intention (HI)) and past testing history. For never testers we analyse the reasons for not having been tested. Results Of 3272 MSM at risk, 19.8% reported LI of testing. MSM with LI reported the longest period at risk (8.49 years (p < 0.001)) and reported 3.20 UAI/person in the last 12 months (vs. 3.23 and 2.56 in MSM with HI and MI (p < 0.001)) and 12.90 UAI/person in the last 5 years (vs. 8.07 and 9.82 in MSM with HI and MI (p < 0.001)). Those with LI accounted for 21 and 27% of all the UA acts occurring in the last 12 months and the last 5 years. Among never testers (40.6%), those with LI reported lower risk perception (p = 0.006). Conclusion We identified a group of high risk and undertested MSM that could be behind a substantial proportion of the UAIs with potential of transmission/acquisition of HIV. Given their low willingness to seek an HIV test and low risk perception, they constitute a population that will probably require approaches other than client initiated strategies.
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Affiliation(s)
- Juan Hoyos
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Madrid, Spain.,Department of Public Health and Maternal and Child Health, Madrid Complutense University, Madrid, Spain
| | - Kostas Koutentakis
- Carlos III Health Institute, National Center of epidemiology, Madrid, Spain
| | - Tomás Maté
- Primary Health Care Management of East Valladolid, Valladolid, Spain
| | - Jose Pulido
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Madrid, Spain. .,Department of Public Health and Maternal and Child Health, Madrid Complutense University, Madrid, Spain. .,Department of Health Programs, Carlos III Health Institute, National School of Health, Madrid, Spain.
| | - Luis Sordo
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Madrid, Spain.,Department of Public Health and Maternal and Child Health, Madrid Complutense University, Madrid, Spain
| | | | - María-José Belza
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Madrid, Spain.,Department of Biostatistics and Epidemiology, Carlos III Health Institute, National School of Health, Madrid, Spain
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Bovbjerg ML. Current Resources for Evidence-Based Practice, January 2019. J Obstet Gynecol Neonatal Nurs 2019; 48:99-111. [DOI: 10.1016/j.jogn.2018.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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