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Costa AB, Viscardi LH, Feijo M, Fontanari AMV. HIV Voluntary Counseling and Testing (VCT-HIV) effectiveness for sexual risk-reduction among key populations: A systematic review and meta-analysis. EClinicalMedicine 2022; 52:101612. [PMID: 36034408 PMCID: PMC9399159 DOI: 10.1016/j.eclinm.2022.101612] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 07/21/2022] [Accepted: 07/21/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND HIV disproportionately affects people who inject drugs, transgender people, sex workers, men who have sex with men, and incarcerated people. Recognized as key populations (KP), these groups face increased impact of HIV infection and reduced access to health assistance. In 1990, the Center for Disease Control and Prevention organized technical guidance on HIV Voluntary Counseling and Testing (VCT-HIV), with subsequent trials comparing intervention methodologies, no longer recommending this strategy. However, KP needs have not been explicitly considered. METHODS We assessed VCT-HIV effectiveness for sexual risk-reduction among KP (PROSPERO 2020 CRD42020088816). We searched Pubmed, EMBASE, Global Health, Scopus, PsycINFO, and Web of Science for peer-reviewed, controlled trials from February, 2020, to April, 2022. We screened the references list and contacted the main authors, extracted data through Covidence, applied the Cochrane Risk-of-Bias tool, and performed the meta-analysis using Review Manager. FINDINGS We identified 17 eligible trials, including 10,916 participants and evaluated HIV risk behaviors. When compared to baseline, VCT-HIV reduced unsafe sex frequency (Z=5.40; p<0.00001, I²=0%). INTERPRETATION While our meta-analysis identified VCT-HIV as protective for sexual risk behaviors for among KP, the results are limited to MSM and PWID, demonstrating the paucity of data on the other KP. Also, it highlights the importance of applying a clear VCT-HIV guideline as well as properly training the counselors. FUNDING Research funded by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPQ/MS-DIAHV N° 24/2019), and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior.
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Affiliation(s)
- Angelo Brandelli Costa
- Psychology Graduate Program, Pontifical Catholic University of Rio Grande do Sul (PUC-RS), Porto Alegre, Rio Grande do Sul, Brazil
- Medicine Graduate Program, Pontifical Catholic University of Rio Grande do Sul (PUC-RS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Lucas Henriques Viscardi
- Psychology Graduate Program, Pontifical Catholic University of Rio Grande do Sul (PUC-RS), Porto Alegre, Rio Grande do Sul, Brazil
- Medicine Graduate Program, Pontifical Catholic University of Rio Grande do Sul (PUC-RS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Marina Feijo
- Psychology Graduate Program, Pontifical Catholic University of Rio Grande do Sul (PUC-RS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Anna Martha Vaitses Fontanari
- Psychology Graduate Program, Pontifical Catholic University of Rio Grande do Sul (PUC-RS), Porto Alegre, Rio Grande do Sul, Brazil
- Medicine Graduate Program, Pontifical Catholic University of Rio Grande do Sul (PUC-RS), Porto Alegre, Rio Grande do Sul, Brazil
- Correspondence to: Medicine and Health Sciences Graduate Program, Pontifical Catholic University of Rio Grande do Sul (PUC-RS), Porto Alegre, Rio Grande do Sul 90619-900, Brazil.
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Parker JN, Choi SK, Bauermeister JA, Bonar EE, Carrico AW, Stephenson R. HIV and STI testing among substance-using sexual and gender minority adolescents and young adults: Results from the baseline survey of a randomized control trial (Preprint). JMIR Public Health Surveill 2021; 8:e30944. [PMID: 35776441 PMCID: PMC9288102 DOI: 10.2196/30944] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 03/01/2022] [Accepted: 05/10/2022] [Indexed: 12/28/2022] Open
Affiliation(s)
- Jayelin N Parker
- Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, United States
| | - Seul Ki Choi
- Program for Sexuality, Technology, and Action Research, University of Pennsylvania, Philadelphia, PA, United States
| | - Jose A Bauermeister
- Program for Sexuality, Technology, and Action Research, University of Pennsylvania, Philadelphia, PA, United States
| | - Erin E Bonar
- Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, United States
- Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Adam W Carrico
- School of Public Health, University of Miami, Miami, FL, United States
| | - Rob Stephenson
- Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, United States
- Department of Systems, Populations and Leadership, School of Nursing, University of Michigan, Ann Arbor, MI, United States
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Bonar EE, Walton MA, Barry KL, Bohnert AS, Chermack ST, Cunningham RM, Massey LS, Ignacio RV, Blow FC. Sexual HIV risk behavior outcomes of brief interventions for drug use in an inner-city emergency department: Secondary outcomes from a randomized controlled trial. Drug Alcohol Depend 2018; 183:217-224. [PMID: 29291549 PMCID: PMC5803438 DOI: 10.1016/j.drugalcdep.2017.10.036] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 10/23/2017] [Accepted: 10/24/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Drug use is an established risk factor for HIV. Brief Interventions (BIs) targeting reductions in both drug use and HIV risk behaviors may help curtail these related epidemics. The present study evaluates the impact of BIs for drug use and HIV risk reduction on sexual HIV risk behaviors among a primarily marijuana-using sample during a 12-month post-intervention follow-up period. METHODS We conducted a randomized controlled trial of 780 adult patients in an Emergency Department (ED) with past 3-month drug use (primarily non-injecting). This study used a 3 × 2 factorial design (3 ED-based conditions: computer-delivered brief intervention [Computer BI], therapist-delivered, computer-guided BI [Therapist BI], or enhanced usual care (EUC-ED) for drug-using adults; 2 follow-up conditions at 3 months: booster or control). This analysis examines the outcomes of the BIs on sexual HIV risk behaviors at 3-, 6-, and 12-months. RESULTS Compared to the enhanced usual care control, the combined Therapist BI with booster resulted in significant reductions in scores on the sexual risk subscale of the HIV Risk Taking Behaviour Scale over 12-months, when controlling for baseline sexual risk, gender, and drug dependency status. The baseline interventions alone, booster alone, and Computer BI plus booster did not differ from the comparison group (EUC plus control). CONCLUSIONS A therapist-delivered BI for drug use and HIV risk behaviors, combined with a follow-up therapist-delivered booster, shows promise for reducing sexual HIV risk behaviors among a primarily marijuana using, non-injecting sample.
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Affiliation(s)
- Erin E. Bonar
- Addiction Center, Department of Psychiatry, University of Michigan School of Medicine, 4250 Plymouth Road, Ann Arbor, MI 48109 USA,Injury Center, University of Michigan School of Medicine, 2800 Plymouth Road, NCRC10- G080, Ann Arbor, Michigan, 48109, USA
| | - Maureen A. Walton
- Addiction Center, Department of Psychiatry, University of Michigan School of Medicine, 4250 Plymouth Road, Ann Arbor, MI 48109 USA,Injury Center, University of Michigan School of Medicine, 2800 Plymouth Road, NCRC10- G080, Ann Arbor, Michigan, 48109, USA
| | - Kristen L. Barry
- Addiction Center, Department of Psychiatry, University of Michigan School of Medicine, 4250 Plymouth Road, Ann Arbor, MI 48109 USA
| | - Amy S.B. Bohnert
- Addiction Center, Department of Psychiatry, University of Michigan School of Medicine, 4250 Plymouth Road, Ann Arbor, MI 48109 USA,Injury Center, University of Michigan School of Medicine, 2800 Plymouth Road, NCRC10- G080, Ann Arbor, Michigan, 48109, USA,Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, 2215 Fuller Road, Ann Arbor, MI 48105, USA
| | - Stephen T. Chermack
- Addiction Center, Department of Psychiatry, University of Michigan School of Medicine, 4250 Plymouth Road, Ann Arbor, MI 48109 USA,Mental Health Service, Veterans Affairs Ann Arbor Healthcare System, 2215 Fuller Road, Ann Arbor, MI 48105, USA
| | - Rebecca M. Cunningham
- Injury Center, University of Michigan School of Medicine, 2800 Plymouth Road, NCRC10- G080, Ann Arbor, Michigan, 48109, USA,Department of Emergency Medicine, University of Michigan School of Medicine, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA,Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights 3790A SPHI, Ann Arbor, MI 48109, USA,Department of Emergency Medicine, Hurley Medical Center, 1 Hurley Place, Flint, MI 48503, USA,Institute for Healthcare Policy and Innovation, University of Michigan, 2800 Plymouth Road, Ann Arbor, MI 48109, USA
| | - Lynn S. Massey
- Addiction Center, Department of Psychiatry, University of Michigan School of Medicine, 4250 Plymouth Road, Ann Arbor, MI 48109 USA
| | - Rosalinda V. Ignacio
- Addiction Center, Department of Psychiatry, University of Michigan School of Medicine, 4250 Plymouth Road, Ann Arbor, MI 48109 USA,Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, 2215 Fuller Road, Ann Arbor, MI 48105, USA
| | - Frederic C. Blow
- Addiction Center, Department of Psychiatry, University of Michigan School of Medicine, 4250 Plymouth Road, Ann Arbor, MI 48109 USA,Injury Center, University of Michigan School of Medicine, 2800 Plymouth Road, NCRC10- G080, Ann Arbor, Michigan, 48109, USA,Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, 2215 Fuller Road, Ann Arbor, MI 48105, USA
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