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.

Treatment as prevention: arriving at community consensus.

At a satellite meeting preceding the 2013 Controlling the HIV Epidemic With Antiretrovirals evidence summit in London, England, a group of organizations and advocates discussed and formulated the final draft of a document, the Community Consensus Statement on the Use of Antiretroviral Therapy in Preventing HIV Transmission, that succinctly outlines a set of principles that should be followed in the provision of antiretroviral therapy to people with living with human immunodeficiency virus (HIV) for the purposes of preventing HIV, particularly as a public health measure. The satellite meeting's conclusions were subsequently outlined in a presentation and panel discussion at the evidence summit.

Stiffness of Experimentally Tested Horizontally Loaded Walls and Timber-Framed Modular Building.

This paper presents an overview of representative up-to-date research and the authors' own experimental results from tests of wall elements and a horizontally loaded timber-framed modular building. The research has been conducted in connection with the development of timber-based structures in recent years. In the present research, wall elements and modules of timber-frame construction with life-size dimensions were used. So far, these types of structures have mainly been tested in laboratories-especially with regard to anchoring and cyclic loading. An experimental testing was carried out on a natural scale in two stages based on the standard procedure described in EN 594. In the first stage, wall panels were tested. In the second stage, tests were carried out on a complete four-storey building. Dowel fasteners were used to fix the sheathing to the load-bearing wall structures. Additionally, the sheathing was glued to the timber frame of the walls. The same type of wall element was used for the construction of the tested building. Horizontal loads were applied at the height of the top of the walls in both stages. The building loads were applied in a direction perpendicular to the longitudinal axis of the modules. Based on test data, the stiffnesses of the wall panels and the whole building were derived, as well as the type of interaction between the modules and the influence of the walls on the spatial work of the building. On the basis of the conducted studies, both the stiffness of the walls in different configurations and the stiffness of the complete building were determined, as well as the nature of the interaction of neighbouring modules and the influence of wall connections on the 3D working of the building. The results show that the stiffness of the building in the horizontal plane in the direction of the applied load is almost twice as high as the sum of the stiffnesses of the building walls in the same direction.

Safeguarding HIV prevention and care services amidst military conflict: experiences from Ukraine.

Ukraine stands out among European countries concerning HIV epidemiological data. Since February 2022, the military conflict with Russian forces has posed unprecedented challenges to HIV prevention and care. AIDS Healthcare Foundation (AHF), a global non-profit organisation with operations in Ukraine since 2009, implemented a preparedness plan to protect staff members and support local facilities in the continuity of care throughout the war. In this manuscript, we describe the strategies adopted by AHF to anticipate the risk of military conflict, steps to implement a preparedness plan, main challenges faced by local staff members and managers, adaptations needed as the conflict evolved, and indicators of HIV care 1 year before and 1 year after the onset of the conflict. Our experience shows that safeguarding the organisation's human resources has been a prerequisite to sustain services throughout the war.

COVID-19 pandemic and the great impulse to telemedicine: the basis of the WONCA Europe Statement on Telemedicine at the WHO Europe 70th Regional Meeting September 2020.

Telemedicine is the use of telecommunication and information technologies to support the delivery of healthcare at a distance, guaranteeing patients healthcare by facilitating access where barriers exist; the COVID-19 pandemic has attracted worldwide interest in this field.The purpose of this paper is to highlight the main pros and cons of telemedicine, which serve as the basis of the WONCA Europe Statement at the WHO Europe 70th Regional Meeting on 14 September 2020.Pros of telemedicine include virtual healthcare at home, where patients receive support in certain conditions without leaving their houses. During a pandemic, it can be adopted to limit physical human interaction. Unfortunately, it can negatively affect the quality of the doctor-patient relationship, the quality of the physical examination, and the quality of care. Telemedicine requires effective infrastructure and robust investments to be feasible and effective.

Policy advocacy for female injecting drug users in eastern and central Europe.

A key reason for hosting AIDS 2010 in Vienna was to highlight the spread of HIV through injecting drug use, something that has reached crisis proportions in many parts of Eastern Europe and the former Soviet Union. In this article, based on a presentation at the conference, Anna Zakowicz discusses the options for promoting policy advocacy for female injecting drug users (IDUs) in Central and Eastern Europe.