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Abraham SA, Cudjoe O, Nartey YA, Agyare E, Annor F, Tawiah BO, Nyampong M, Owusu KK, Abdulai M, Addo SA, Obiri-Yeboah D. Unravelling the experiences of incarcerated individuals living with HIV on ART: a qualitative study in Ghanaian prisons. INTERNATIONAL JOURNAL OF PRISON HEALTH 2024; 20:186-199. [PMID: 38984601 PMCID: PMC11342671 DOI: 10.1108/ijoph-06-2023-0031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/11/2024]
Abstract
PURPOSE The Joint United Nations Programme on HIV/AIDS (UNAIDS) goal to end the acquired immunodeficiency syndrome (AIDS) epidemic as a public health threat by 2030 emphasises the importance of leaving no one behind. To determine progress towards the elimination goal in Ghana, an in-depth understanding of human immunodeficiency virus (HIV) care from the perspective of vulnerable populations such as persons living with HIV in incarceration is necessary. This study aims to explore the experiences of incarcerated individuals living with HIV (ILHIV) and on antiretroviral therapy (ART) in selected Ghanaian prisons to help inform policy. DESIGN/METHODOLOGY/APPROACH The study adopted a qualitative approach involving in-depth interviews with 16 purposively selected ILHIV on ART from purposively selected prisons. Interviews were conducted between October and December 2022. Thematic analysis was performed using the ATLAS.Ti software. FINDINGS Three themes were generated from the analysis: waking up to a positive HIV status; living with HIV a day at a time; and being my brother's keeper: preventing HIV transmission. All participants underwent HIV screening at the various prisons. ILHIV also had access to ART although those on remand had challenges with refills. Stigma perpetuated by incarcerated individuals against those with HIV existed, and experiences of inadequate nutrition among incarcerated individuals on ART were reported. Opportunities to improve the experiences of the ILHIV are required to improve care and reduce morbidity and mortality. ORIGINALITY/VALUE Through first-hand experiences from ILHIV in prisons, this study provides the perception of incarcerated individuals on HIV care in prisons. The insights gained from this study can contribute to the development of targeted interventions and strategies to improve HIV care and support for incarcerated individuals.
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Affiliation(s)
- Susanna Aba Abraham
- Department of Adult Health, School of Nursing and Midwifery, University of Cape Coast, Cape Coast, Ghana
| | - Obed Cudjoe
- Department of Medical Laboratory Science, University of Cape Coast College of Health and Allied Sciences, Cape Coast, Ghana
| | - Yvonne Ayerki Nartey
- Department of Internal Medicine, Cape Coast Teaching Hospital, Cape Coast, Ghana
| | - Elizabeth Agyare
- Clinical Microbiology/Public Health Unit, Cape Coast Teaching Hospital, Cape Coast, Ghana and National HIV/AIDS Control Programme, Accra, Ghana
| | - Francis Annor
- Directorate of Research Innovation and Consultancy, University of Cape Coast, Cape Coast, Ghana
| | | | | | | | | | | | - Dorcas Obiri-Yeboah
- Department of Microbiology and Immunology, University of Cape Coast College of Health and Allied Sciences, Cape Coast, Ghana; Directorate of Research Innovation and Consultancy, University of Cape Coast, Cape Coast, Ghana and Clinical Microbiology/Public Health Unit, Cape Coast Teaching Hospital, Cape Coast, Ghana
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Salvi N, Itta KC, Lachyan A, Hasan AZ, Prosperi C, Kumar MS, Wesley Vivian Thangaraj J, Kaduskar O, Bhatt V, Sapkal GN, Murhekar M, Gupta N, Mehendale S, Hayford K, Moss WJ, Chauhan S, Kulkarni R. Experiences of sharing results of community based serosurvey with participants in a district of Maharashtra, India. PLoS One 2022; 17:e0271920. [PMID: 35925959 PMCID: PMC9352079 DOI: 10.1371/journal.pone.0271920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 07/10/2022] [Indexed: 11/19/2022] Open
Abstract
A growing number of organisations, including medical associations, recommend that research subjects should be given the option of being informed about the general outcome and results of the study. We recently completed a study involving nine serosurveys from 2018 to 2020 in five districts of India among three age groups (children 9 months to < 5 years; 5 to < 15 years of age, and women 15 to < 50 years of age before and after the measles and rubella (MR) vaccination campaigns). In Palghar district of Maharashtra all individuals in 30 selected clusters were enumerated, and 13 individuals per age group were randomly sampled. We established the procedures to return the results to the respondents for each stage of the survey. Of the 1,166 individuals selected for the measles and rubella serosurvey, 971 (83%) agreed to participate and were enrolled. Participants were informed that they will only be contacted if they test seronegative for measles and/or rubella antibodies. Overall, 140 individuals enrolled in the survey tested seronegative for IgG antibodies to measles and/or rubella viruses; were provided the reports and informed to seek medical advice. Upon follow up by phone, 10% (14) of the 140 participants reported to have been vaccinated. In this paper we discuss the procedures, experiences and considerations in returning results to participants in a community-based measles and rubella serosurvey. Although the lessons learned are specific to post measles-rubella vaccine campaign serosurvey in India, they might be helpful to those contemplating sharing results to participants of large scale survey settings.
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Affiliation(s)
- Neha Salvi
- Department of Health Research, Model Rural Health Research Unit, Dahanu, Maharashtra, India
| | - Krishna Chaaithanya Itta
- Department of Health Research, Model Rural Health Research Unit, Dahanu, Maharashtra, India
- ICMR- National Institute for Research in Reproductive and Child Health, Mumbai, India
| | - Abhishek Lachyan
- Department of Health Research, Model Rural Health Research Unit, Dahanu, Maharashtra, India
| | - Alvira Z. Hasan
- International Vaccine Access Center, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Christine Prosperi
- International Vaccine Access Center, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | | | | | | | | | | | | | - Nivedita Gupta
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | | | - Kyla Hayford
- International Vaccine Access Center, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - William J. Moss
- International Vaccine Access Center, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Sanjay Chauhan
- ICMR- National Institute for Research in Reproductive and Child Health, Mumbai, India
| | - Ragini Kulkarni
- ICMR- National Institute for Research in Reproductive and Child Health, Mumbai, India
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Ekholuenetale M, Nzoputam CI, Okonji OC. Association between socio-economic factors and HIV self-testing knowledge amongst South African women. South Afr J HIV Med 2022; 23:1347. [PMID: 35399747 PMCID: PMC8991179 DOI: 10.4102/sajhivmed.v23i1.1347] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 01/03/2022] [Indexed: 11/24/2022] Open
Abstract
Background Self-testing for HIV is an effective and alternative method of increasing HIV testing rates and a strategy for reaching populations that are underserved by HIV testing services. Nonetheless, many resource-constrained settings are yet to adopt HIV self-testing (HIVST) into their national HIV programmes. Objectives This study aimed to examine the association between socio-economic factors and HIVST knowledge amongst South African women. Method We used nationally representative data from the 2016 South African Demographic and Health Survey. A sample of 8182 women of reproductive age was analysed. The outcome variable was HIVST knowledge. This was measured dichotomously; know versus do not know about HIVST. The multivariable logistic model was used to examine the measures of association, with the level of significance set at P < 0.05. Results The prevalence rate of HIVST knowledge was found to be approximately 24.5% (95% confidence interval [CI]: 22.9–26.1) amongst South African women. Women with tertiary education were 3.93 times more likely to have HIVST knowledge, when compared with those with no formal education (odds ratio [OR]: 3.93; 95% CI: 1.37–11.26). Rural residents had a 33% reduction in HIVST knowledge when compared with those residing in urban areas (OR: 0.67; 95% CI: 0.51–0.89). The odds of interaction between the richer and richest women who have good knowledge of HIV infection were 1.88 and 2.24 times more likely to have HIVST knowledge, respectively, when compared with those from the poorest wealth household who have good knowledge of HIV infection. Conclusion Based on the low level of HIVST knowledge, the findings emphasise the importance of developing effective HIVST educational campaigns. Moreover, programmes should be designed to address the unique needs of the socio-economically disadvantaged women.
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Affiliation(s)
- Michael Ekholuenetale
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Chimezie I. Nzoputam
- Department of Public Health, Center of Excellence in Reproductive Health Innovation (CERHI), College of Medical Sciences, University of Benin, Benin City, Nigeria
- Department of Medical Biochemistry, School of Basic Medical Sciences, University of Benin, Benin City, Nigeria
| | - Osaretin C. Okonji
- School of Pharmacy, Faculty of Natural Science, University of the Western Cape, Cape Town, South Africa
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Mamulwar M, Prasad VS, Nirmalkar A, Goli S, Jadhav S, Kumbhar S, Kale V, Michael E, Ford TM, Nazarov D, Honig L, Gangakhedkar R, Thakar M. Community-based point-of-care testing to identify new HIV infections: A cross-sectional study from Pune, India. Medicine (Baltimore) 2021; 100:e27817. [PMID: 34797308 PMCID: PMC8601338 DOI: 10.1097/md.0000000000027817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 08/10/2021] [Accepted: 10/29/2021] [Indexed: 01/05/2023] Open
Abstract
ABSTRACT The World Health Organization recommends point-of-care testing (POCT) to detect human immunodeficiency virus (HIV) infected individuals in the community. This will help improve treatment coverage through detection of HIV infection among those who are unaware of their status.This study was planned with an objective to investigate the feasibility and acceptability of POCT for HIV in the community.A community-based cross-sectional study was conducted in rural and peri-urban areas of Pune, India. These sites were selected based on the distance from the nearest HIV testing center. Testing locations were identified in consultation with the local stakeholders and grass-root health workers to identify and capture the priority population. The POCT was performed on blood samples collected by the finger-prick method.The proportion of participants seeking HIV tests for the first time was 79.6% that signifies the feasibility of POCT. The acceptability in the peri-urban and rural areas was 70.2% and 69.7%, respectively. POCT was performed at construction sites (24.9%), nearby industries (16.1%) and parking areas of long-distance trucks (8.1%) in the peri-urban area. Three newly diagnosed HIV-infected participants (0.1%) were detected from the peri-urban areas but none from the rural areas. Two of the newly diagnosed participants and their spouses were linked to care.There was a high acceptability of POCT and wider coverage of priority population with a strategy of testing at places preferable to the study population. Therefore, we believe that community-based POCT is a promising tool for improving HIV testing coverage even in low prevalence settings with the concentrated HIV epidemic.
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Affiliation(s)
- Megha Mamulwar
- ICMR National AIDS Research Institute, Bhosari, Pune, India
| | | | - Amit Nirmalkar
- ICMR National AIDS Research Institute, Bhosari, Pune, India
| | - Sarita Goli
- ICMR National AIDS Research Institute, Bhosari, Pune, India
| | - Sachin Jadhav
- ICMR National AIDS Research Institute, Bhosari, Pune, India
| | | | - Varsha Kale
- ICMR National AIDS Research Institute, Bhosari, Pune, India
| | | | | | | | - Lyle Honig
- AIDS Healthcare Foundation, New Delhi, India
| | | | - Madhuri Thakar
- ICMR National AIDS Research Institute, Bhosari, Pune, India
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Gasbarrini N, Dubravić D, Combs L, Dišković A, Ankiersztejn-Bartczak M, Colaiaco F, Wawer I, Wysocki P, Rosińska M, Marzec-Boguslawska A, Collins B, Simões D, Jakobsen ML, Raben D. Increasing integrated testing in community settings through interventions for change, including the Spring European Testing Week. BMC Infect Dis 2021; 21:874. [PMID: 34517819 PMCID: PMC8438814 DOI: 10.1186/s12879-021-06555-0] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 08/06/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Maximising access to testing by targeting more than one infection is effective in identifying new infections in settings or populations. Within the EU funded Joint Action INTEGRATE, this paper examined the feasibility and impact of expanding integrated testing for HIV, hepatitis C (HCV), chlamydia, gonorrhoea and/or syphilis in four community-based pilots through targeted interventions in Croatia, Italy and Poland and the Spring European Testing Week since community settings are key in detecting new infections and reaching key populations. METHODS Pilots led by local INTEGRATE partners prioritised testing for other infections or key populations. The Croatian pilot expanded testing for men who have sex with men to syphilis, chlamydia and gonorrhoea. Italian partners implemented a HIV and HCV testing/information event at a migrant centre. A second Italian pilot tested migrants for HIV and HCV through outreach and a low-threshold service for people who use drugs. Polish partners tested for HIV, HCV and syphilis among people who inject drugs in unstable housing via a mobile van. Pilots monitored the number of individuals tested for each infection and reactive results. The pilot Spring European Testing Week from 18 to 25 May 2018 was an INTEGRATE-driven initiative to create more testing awareness and opportunities throughout Europe. RESULTS The Croatian pilot found a high prevalence for each syphilis, chlamydia and gonorrhoea respectively, 2.1%, 12.4% and 6.7%. The Italian migrant centre pilot found low proportions who were previously tested for HIV (24%) or HCV (11%) and the second Italian pilot found an HCV prevalence of 6.2%, with low proportions previously tested for HIV (33%) or HCV (31%). The Polish pilot found rates of being previously tested for HIV, HCV and syphilis at 39%, 37%, and 38%, respectively. Results from the Spring European Testing Week pilot showed it was acceptable with increased integrated testing, from 50% in 2018 to 71% in 2019 in participants. CONCLUSIONS Results show that integrated testing is feasible and effective in community settings, in reaching key populations and minimising missed testing opportunities, and the pilots made feasible because of the European collaboration and funding. For sustainability and expansion of integrated community testing across Europe, local government investment in legislation, financial and structural support are crucial.
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Affiliation(s)
| | - Davor Dubravić
- Croatian Association for HIV and Viral Hepatitis (HUHIV), Zagreb, Croatia
| | - Lauren Combs
- CHIP, Centre of Excellence for Health, Immunity and Infections,, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark
| | - Arian Dišković
- Croatian Association for HIV and Viral Hepatitis (HUHIV), Zagreb, Croatia
| | | | | | - Iwona Wawer
- National AIDS Centre, Agency of the Ministry of Health, Warsaw, Poland
| | - Piotr Wysocki
- National AIDS Centre, Agency of the Ministry of Health, Warsaw, Poland
| | - Magdalena Rosińska
- Department of Epidemiology of Infectious Diseases and Surveillance, National Institute of Public Health - National Institute of Hygiene, Warsaw, Poland
| | | | - Ben Collins
- ReShape/International HIV Partnerships, London, UK
| | - Daniel Simões
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Marie Louise Jakobsen
- CHIP, Centre of Excellence for Health, Immunity and Infections,, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark
| | - Dorthe Raben
- CHIP, Centre of Excellence for Health, Immunity and Infections,, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark.
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Nanthaprut P, Manojai N, Chanlearn P, Mattawanon N, Chiawkhun P, Homkham N, Traisathit P. Comparison of HIV-Positive Incidence Among Transgender Women and Men Who Have Sex with Men at Stand-Alone and Mobile Voluntary Counseling and Testing Facilities in Chiang Mai Province, Thailand. AIDS Patient Care STDS 2021; 35:116-125. [PMID: 33835852 DOI: 10.1089/apc.2020.0258] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Human immunodeficiency virus (HIV) infection is still a major cause of death in Thais and new cases of infection are still emerging among the key population comprising men who have sex with men (MSM), sex workers and their clients, and transgender women (TGW) and people who inject drugs. The objective of this study was to compare the incidence of HIV infection between MSM and TGW who were tested at stand-alone and mobile HIV voluntary counseling and testing (VCT) centers and to identify factors associated with HIV-positive individuals from the two services. We conducted an observational study using MSM and TGW individuals with unknown HIV status from the databases at a stand-alone center and a mobile VCT belonging to the MPlus in Chiang Mai province, Thailand. Factors associated with HIV-positive status were identified using logistic regression model. HIV VCT data were obtained for 6971 individuals at both MPlus center and mobile care unit. Among 3033 and 3938 clients tested at each facility, respectively, 168 (5.6%) and 101 (2.6%) clients were HIV positive. Individuals tested at the stand-alone centers were at a 1.91-fold higher risk of being HIV positive compared with those tested at the mobile VCT unit. Individuals who were 20-24 or >24 years old, sex workers, or sexually transmitted infection positive were more likely to be HIV positive. Our results show the beneficial effect of mobile HIV VCT facilities that enable testing of more of the at-risk population. Developing mobile VCT activities that attract a particular target population is needed to be able to reach the 90-90-90 goals. This study was approved by the Ethics Committee of the Faculty of Medicine, Chiang Mai University (0BG-2562-06418).
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Affiliation(s)
- Pimwarat Nanthaprut
- Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand
- Data Science Research Center, Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand
| | | | | | - Natnita Mattawanon
- Reproductive Medicine Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Phisanu Chiawkhun
- Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand
| | - Nontiya Homkham
- Faculty of Public Health, Thammasat University, Pathumthani, Thailand
| | - Patrinee Traisathit
- Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand
- Research Center in Bioresources for Agriculture, Industry and Medicine, Chiang Mai University, Chiang Mai, Thailand
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Chiou PY, Ko NY, Chien CY. Mobile HIV Testing Through Social Networking Platforms: Comparative Study. J Med Internet Res 2021; 23:e25031. [PMID: 33769298 PMCID: PMC8035663 DOI: 10.2196/25031] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 01/20/2021] [Accepted: 01/31/2021] [Indexed: 11/24/2022] Open
Abstract
Background Improving HIV screening in key populations is a crucial strategy to achieve the goal of eliminating AIDS in 2030. Social networking platforms can be used to recruit high risk-taking men who have sex with men (MSM) to promote the delivery of voluntary counseling and testing (VCT) as mobile HIV testing. Therefore, client recruitment and availability of mobile HIV testing through social networking platforms requires further evaluation. Objective The aim of this study is to compare the effects of targeting high risk-taking MSM and HIV case finding between two mobile HIV testing recruitment approaches: through the traditional website-based approach and through social networking platforms. Methods A comparative study design and propensity score matching was applied. The traditional VCT model, that is, the control group, recruited MSM through a website, and a trained research assistant visited the walk-in testing station at a gay village on Friday and Saturday nights. The social networking VCT model, the experimental group, recruited MSM from social networking platforms by periodically reloading into and conducting web-based discussions on dating apps and Facebook. The participants then referred to others in their social networks via a popular messenger app in Taiwan. The test was conducted at a designated time and place during weekdays by a trained research assistant. Across both modes of contact, before the mobile HIV testing, participants needed to provide demographic characteristics and respond to a questionnaire about HIV risk-taking behaviors. Results We recruited 831 MSM over 6 months, with a completion rate of 8.56% (616/7200) in the traditional VCT model and 20.71% (215/1038) in the social networking VCT model. After propensity score matching, there were 215 MSM in each group (mean age 29.97, SD 7.61 years). The social networking model was more likely to reach MSM with HIV risk-taking behaviors, that is, those seeking sexual activity through social media, having multiple sexual partners and unprotected anal intercourse, having experience of recreational drug use, and never having or not regularly having an HIV test, compared with the traditional model. HIV positive rates (incidence rate ratio 3.40, 95% CI 1.089-10.584; P=.03) and clinic referral rates (incidence rate ratio 0.03, 95% CI 0.001-0.585; P=.006) were significantly higher among those in the social networking VCT model than in the traditional VCT model. Conclusions Through effective recruitment strategies on social networking platforms, the social networking VCT mode can be smoothly promoted, as compared with the traditional VCT model, to target high risk-taking MSM and increase testing outcomes.
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Affiliation(s)
- Piao-Yi Chiou
- Department of Nursing, National Taiwan University Hospital, Taipei City, Taiwan.,School of Nursing, College of Medicine, National Taiwan University, Taipei City, Taiwan
| | - Nai-Ying Ko
- Department of Nursing, College of Medicine, National Cheng Kung, Tainan, Taiwan
| | - Chien-Yu Chien
- School of Nursing, College of Medicine, National Taiwan University, Taipei City, Taiwan
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HIV testing in Spain: Are we doing our job? Enferm Infecc Microbiol Clin 2021; 39:1-2. [DOI: 10.1016/j.eimc.2020.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 10/20/2020] [Indexed: 11/21/2022]
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Meulbroek M, Dalmau-Bueno A, Saz J, Marazzi G, Pérez F, Coll J, Taboada H, Pujol F. Falling HIV incidence in a community clinic cohort of men who have sex with men and transgender women in Barcelona, Spain. Int J STD AIDS 2020; 31:841-848. [PMID: 32623981 DOI: 10.1177/0956462420932424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In Barcelona, Spain prior to 2006, HIV testing was mostly limited to formal healthcare facilities with no incidence data reported. A community-based organization (BCN Checkpoint) was established to increase HIV testing in a peer-led community location to generate incidence data in men who have sex with men and transgender women. Three community engagement interventions were conducted between 2009 and 2017 as follows: 2009-2011 (peer-led point-of-care testing for HIV), 2012-2014 (12-monthly HIV testing with an emphasis on testing in partnerships), 2015-2017 (three-monthly HIV testing with rapid referral for antiretroviral initiation). Between 2009 and 2017 a predominantly cisgender male (99.4%) and Spanish national (62.4%) population with mean age of 34.8 years had 49,630 visits. Mean visit number increased from 1.69 in the first to 2.07 in the last three-year period. HIV incidence fell from 4.17 (95% confidence interval [CI]: 3.53-4.93) per 100 person-years in 2009-2011 to 1.57 (95% CI: 1.30-1.89) per 100 person-years in 2015-2017. This represents a 62% reduction (incidence rate ratio: 0.38, 95% CI: 0.29-0.48) between the first and third study period (p < 0.001). These early interventions may have contributed to the reduction seen in HIV incidence in this cohort.
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Affiliation(s)
| | | | - Jorge Saz
- Projecte dels NOMS-Hispanosida, Barcelona, Spain
| | | | | | - Josep Coll
- BCN Checkpoint, Barcelona, Spain.,IrsiCaixa, Badalona, Spain
| | | | - Ferran Pujol
- Projecte dels NOMS-Hispanosida, Barcelona, Spain
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Brady M, Shanley A, Hurley C, O'Donnell K, O'Tuathail M, Fitzgerald M, Flynn C, Carson R, Igoe D. Establishment of a national surveillance system to monitor community HIV testing, Ireland, 2018. Ir J Med Sci 2020; 189:1507-1514. [PMID: 32240479 DOI: 10.1007/s11845-020-02217-3] [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: 01/02/2020] [Accepted: 03/14/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND HIV continues to be an important public health issue. Voluntary community-based HIV testing (VCBT) helps to reduce the undiagnosed population of HIV-positive individuals, enabling early diagnosis and treatment. Monitoring is essential to determine whether at-risk groups are being effectively reached. AIMS Our aim was to pilot and then introduce sustained monitoring of VCBT in Ireland, through collaboration between statutory and non-statutory organisations. METHODS The study was initiated by the Health Protection Surveillance Centre in 2018. Steps included forming a multisectoral steering group and developing a minimum standardised dataset. De-identified case-based data were requested for VCBT carried out from 1 January 2017 onwards; this paper includes data for 2018. RESULTS Six organisations participated; all four NGOs involved in VCBT, one medical charity, and the Health Service Executive National Social Inclusion Office. Methods were rapid point-of-care testing (POCT) (54%) or laboratory based (46%). Total HIV test reactivity was 1.7% (1.5% excluding persons later identified as previously diagnosed HIV positive). All POCT data were case based; the test reactivity rate was 0.8% and was higher in bar/club settings (1.2%). Most (74%) laboratory testing data were in aggregate format; the test positivity rate in one asylum centre was 5.0%. Ongoing challenges include testing among persons later identified as previously diagnosed HIV positive, monitoring case-based testing in asylum settings, and suboptimal data on confirmatory testing and linkage to care. CONCLUSIONS Sustained national monitoring in community settings will help inform HIV testing guidelines and will enable assessment of the impact of local and regional community HIV testing strategies.
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Affiliation(s)
- Melissa Brady
- Health Service Executive (HSE), Health Protection Surveillance Centre, Dublin, Ireland.
| | | | - Caroline Hurley
- Health Service Executive (HSE), Sexual Health and Crisis Pregnancy Programme (SHCPP), Dublin, Ireland
| | - Kate O'Donnell
- Health Service Executive (HSE), Health Protection Surveillance Centre, Dublin, Ireland
| | | | - Margaret Fitzgerald
- Health Service Executive (HSE), National Social Inclusion Office, Dublin, Ireland
| | - Cillian Flynn
- Gender, Orientation, Sexual Health and HIV (GOSHH), Limerick, Ireland
| | - Richard Carson
- AIDS Care, Education and Training (ACET) Ireland, Dublin, Ireland
| | - Derval Igoe
- Health Service Executive (HSE), Health Protection Surveillance Centre, Dublin, Ireland
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Agustí C, Muñoz R, González V, Villegas L, Fibla J, Meroño M, Capitán A, Fernàndez-López L, Platteau T, Casabona J. Outreach HIV testing using oral fluid and online consultation of the results: Pilot intervention in Catalonia. Enferm Infecc Microbiol Clin 2020; 39:3-8. [PMID: 32151468 DOI: 10.1016/j.eimc.2020.01.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 01/08/2020] [Accepted: 01/13/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION The aim of the intervention was to describe the feasibility and cost-effectiveness of offering HIV testing in outreach interventions and subsequent consultation of the results through a secure web page. METHODS The HIV test was offered "in situ" to men who have sex with men (MSM), migrant sex workers and trans women recruited in places of leisure and sex. Four collaborating NGOs recruited the participants and assisted them to register on the study website (www.swab2know.eu) through a tablet or the smartphone of the same participant. The samples were sent to the reference laboratory and the results were published on the website. RESULTS 834 participants (612 MSMs, 203 women sex workers and 19 trans women) were recruited. In total 22 reagent results (2.6%) were detected: 21 among MSMs (3.4%) and 1 in a trans women (5.3%). While 82.6% of MSMs consulted their outcome, only 39.9% and 26.3% of women sex workers and trans women respectively consulted their outcome CONCLUSIONS: Providing self-sampling in outreach activities, dispatch and analysis in a reference laboratory as well as online communication of test results is feasible. A high proportion of participants with a HIV reactive result were detected among MSMs and trans women.
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Affiliation(s)
- Cristina Agustí
- Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Departament de Salut, Generalitat de Catalunya, Badalona, Barcelona, España; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, España.
| | - Rafael Muñoz
- Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Departament de Salut, Generalitat de Catalunya, Badalona, Barcelona, España
| | - Victoria González
- Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Departament de Salut, Generalitat de Catalunya, Badalona, Barcelona, España; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, España
| | | | - Joan Fibla
- Associació Antisida Lleida, Lleida, España
| | | | | | - Laura Fernàndez-López
- Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Departament de Salut, Generalitat de Catalunya, Badalona, Barcelona, España; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, España
| | - Tom Platteau
- Institute of Tropical Medicine, Department of Clinical Sciences, Antwerp, Bélgica
| | - Jordi Casabona
- Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Departament de Salut, Generalitat de Catalunya, Badalona, Barcelona, España; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, España; Departament de Pediatria, Obstetricia i Ginecologia i de Medicina Preventiva, Universitat Autònoma de Barcelona, Badalona, Barcelona, España
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