Willingness to Receive HIV Self-Testing Kits from Recent Sexual Partners Among Men in Dar Es Salam, Tanzania: Findings from the STEP Project Baseline Survey.

Globally, men are less likely to access HIV services, and addressing HIV service challenges among men is crucial to the global HIV/AIDS response. HIV self-testing (HIVST) has been shown to be a potentially effective strategy in improving HIV testing coverage among men. This study assessed and identified factors influencing willingness to receive HIVST kits from sexual partners among men in Tanzania. Data are from the baseline survey of the Self-Testing Education and Promotion (STEP) project, a five-year study comprising male participants aged 18 or older who self-reported as HIV-negative. Logistic regression models were used to assess factors associated with men's willingness to receive HIVST kits from their sexual partners. There were 505 heterosexual male participants enrolled in the study with an average age of 29 years, of whom 69% reported being willing to receive HIVST kits from their sexual partner. Logistic regression models demonstrated that willingness to receive HIVST kits from sexual partners was significantly associated with number of sexual partners within 12 months (aOR = 1.2, 95% CI [1.1-1.3]), awareness of HIVST (aOR = 5.6, 95% CI [3.2-9.5]), previous discussion of HIVST with sexual partners aOR = 14.0, 95% CI [8.0-24.6]), and previous testing for HIV with sexual partners not (aOR = 2.5, 95% CI [1.3-4.7]). These findings suggest additional promotional strategies to improve men's awareness of HIVST and support open conversations about HIVST and HIV testing with sexual partners could improve men's willingness to receive HIVST kits when distributed through their sexual partners.

Adverse Childhood Experiences and HIV-Related Stigma: A Quantitative Survey of Tanzanian Men, June 2019.

Experiencing adverse childhood experiences (ACEs) may impact personal opinions, attitudes, and judgments, which can further result in HIV-related stigma. HIV-related stigma consequentially may impact HIV preventive measures such as HIV testing, pre-exposure prophylaxis uptake, and condom use. The extent to which ACEs influence HIV-related stigma perception has not been well studied. Therefore, the study aimed to examine the association between ACEs and perceived and interpersonal HIV-related stigma among Tanzanian HIV-negative men. Quantitative survey data were obtained from the Tanzania STEP (Self-Testing Education and Promotion) project established in four wards: Mabibo, Manzese, Tandale, and Mwanyanamala. A total of 507 men responded to the ACEs and HIV-related stigma questionnaires. ACEs were operationalized as types of ACEs (environmental, physical/psychological, sexual abuse) and ACE score (0 (reference) vs. 1, 2, 3, ≥ 4). Perceived HIV-related stigma was analyzed both as a binary (HIV stigma vs. no HIV stigma) and a continuous variable. Unadjusted and adjusted multinomial logistic and linear regression models were used to assess the associations between ACEs and HIV-related stigma. ACE types were associated with HIV stigma (b = 0.237, 95% CI [0.122-0.352], p = < .0001). Findings of the adjusted multinomial logistic regression model show that experiencing one ACE (aOR = 1.9; p-value = 0.023), two ACEs (aOR = 1.8; p-value = 0.044), four or more ACEs (aOR = 4.1; p-value = < 0.0001) were associated with greater perceived HIV-related stigma. Moreover, experiencing environmental (aOR = 8.6; p-value = 0.005), physical/psychological (aOR = 2.5; p-value = 0.004), and sexual abuse (aOR = 3.4; p-value = < 0.0001) were associated with higher odds of HIV-related stigma. Our study findings suggest that those who experience childhood trauma are more likely to have a higher perception of HIV-related stigma. Intervention programs targeting HIV stigma should consider addressing ACEs entailing the behavioral and psychological impact of childhood trauma.

Efficacy of mobile phone intervention to increase male partner antenatal care attendance for HIV testing in Moshi municipal, Tanzania: a randomized controlled trial.

BACKGROUND: HIV partner counselling and testing in antenatal care (ANC) is a crucial strategy to raise the number of males who know their HIV status. However, in many settings like Tanzania, male involvement in antenatal care remains low, and there is a definite need for innovative strategies to increase male partner involvement. This study was designed to evaluate the efficacy of mobile phone intervention increase male partner ANC attendance for HIV testing in Moshi municipal, Tanzania. METHODS: Between April and July 2022, we enrolled pregnant women presenting to a first ANC visit at Majengo and St. Joseph reproductive health facilities without their male partners. Eligible pregnant women were randomly assigned to invitation of their male partners either via phone calls, text messages from clinic staff and verbal invites from pregnant partners (intervention arm) or verbal invites only from the pregnant partners (control arm). Neither healthcare provider nor participant were blinded. The primary outcome was the proportion of male partners who attended ANC with their pregnant partners during a follow-up period of two consecutive visits. The secondary outcome measure was HIV testing among male partners following the invitation. Participants were analyzed as originally assigned (intention to treat). RESULTS: A total of 350 pregnant women presenting to ANC for the first time were enrolled, with 175 women enrolled in each arm. The efficacy of male attendance with their pregnant women following the invitations was 83.4% (147/175) in the intervention arm and 46.3% (81/175) in the control arm. Overall, the results suggest a positive and statistically significant average treatment effect among men who received mobile phone intervention on ANC attendance. For the secondary outcome, the percent of male partners who accepted HIV counselling and testing was 99.3% (146/147) in the intervention arm and 93.8% (76/81) in the control arm. Married men were having higher odds of ANC attendance compared with single men (aOR:6.40(3.26-12.56), Males with multigravida women were having lower odds of ANC attendance compared with primigravida women (aOR:0.17(0.09-0.33). CONCLUSION: The study demonstrates that supplementing verbal invitations with mobile phone calls and text messages from clinic staff can significantly increase male partner ANC attendance and HIV testing. This combined approach is recommended in improving ANC attendance and HIV testing of male partners who do not accompany their pregnant partners to antenatal clinics in the first visits. TRIAL REGISTRATION: PACTR202209769991162.

Female Circumcision and Sexual Negotiation Ability of Ethiopian Women.

The following study attempts to assess the link between the circumcision status of Ethiopian women and their ability to negotiate sex. From the 2016 Ethiopian Demographic and Health Survey, we analyzed a subsample of 3,445 women aged 15 to 49. Women's sexual negotiation ability was measured by their ability to ask for condom and their ability to refuse sex. We performed a univariate, bivariate, and multiple logistic regression analysis. In the final analysis, only education, residence, media access, and sexually transmitted infections knowledge were independently associated with the sexual negotiation ability of women. Circumcision status was not associated with sexual negotiation ability.

Conceptualizing National Advisory Boards in primary care research: application to the Two in One HIV and COVID screening and testing model.

The authors report on their development of a National Advisory Board (NAB) to guide a funded project: Two in One: HIV + COVID-19 Screening and Testing Model. This project aimed to improve primary care practitioners' capacity to routinize HIV, PrEP/PEP, and COVID-19 vaccine screenings for all their patients while relying on culturally responsive communication with their minoritized patients. To approach their monumental research and education tasks, they created a NAB, drawing from the literature on advisory boards to (a) promote board member engagement and (b) progress successfully through the six stages suggested for successful advisory boards. A midpoint survey and final focus groups with NAB members indicated mixed levels of engagement, a sense of time and work being valued, and pride in the media and academic reach of the project. The authors offer considerations for others considering forming a NAB to guide primary care research and interventions.

Men's Willingness to Receive Text Messages and Talk with an HIV counselor from the National HIV Hotline in Tanzania for Support with Linkage to Care Following HIV self-testing.

Background: Tanzania faces a significant burden of HIV, with particular challenges in reaching men and ensuring timely linkage to care. To address these issues, HIV self-testing (HIVST) has been implemented to increase HIV testing and the National HIV Hotlines are being considered as a strategy to facilitate linkage to care. This study aimed to assess the willingness of Tanzanian men to receive support from use the National HIV Hotline via mobile phones for HIVST and linkage to care. Methods: Data from 505 men from the baseline survey of a cluster-randomized controlled trial conducted in June 2019 with 18 social networks or "camps" in Dar es Salaam, Tanzania. Participants were 18-year-old or older male camp members who were HIV-negative at the time of enrolment. Logistic regression models were used to assess factors associated with men's comfort with talking with an HIV counselor over the phone. Results: There were 505 heterosexual male participants enrolled in the study with an average age of 29 years. Logistic regression demonstrated that comfortability texting a friend about HIV self-testing (OR =3.37, 95% CI [1.97 - 5.76], being comfortable texting a friend about HIV (OR = 3.84, 95% CI [2.20 - 6.72], previous history of receiving HIV related text messages (aOR = 0.55, 95% CI [0.31 - 0.99] were significantly associated with men's s comfortability talking to a HIV counselor on the National HIV Hotline following HIVST. The factors such as participants' comfortability texting friend about HIVST (OR = 2.52, 95% CI [1.49 - 4.25]) and comfortability texting friend about HIV (OR = 2.96, 95% CI [1.83 - 4.80] were significantly associated with the probability of participant's comfortability receiving text message from HIV counselor following HIVST. Conclusion: These findings suggest an effort to develop and implement a user-friendly digital health intervention that promote comfortability, address private concerns, and deliver tailored support and information to individuals following HIV self-testing.

Digital Intervention Services to Promote HIV Self-Testing and Linkage to Care Services: A Bibliometric and Content Analysis-Global Trends and Future Directions.

Objective: The global burden of HIV remains a critical public health challenge, particularly in sub-Saharan Africa, home to over two-thirds of individuals living with HIV. HIV self-testing (HIVST) has emerged as a promising strategy endorsed by the World Health Organization to achieve UNAIDS targets. Despite its potential, challenges persist in linking self-testers to care post a positive result. Digital health interventions, including chatbots and mobile applications, offer innovative solutions to address this gap. However, a comprehensive bibliometric analysis of the collaboration and growth in the literature at the intersection of HIVST and digital interventions is lacking. Methods: The study employs a bibliometric approach, leveraging data from the Web of Science, to analyze the characteristics, citation pattern and content of 289 articles spanning 1992-2023. The analysis involves performance assessment, scientific collaboration analysis, science mapping, and content analysis. Key bibliometric indicators, such as annual growth rate, citation impact, and authorship patterns, are explored. Collaboration patterns among countries, institutions, and authors are elucidated, and thematic mapping provides insight into the key research themes. Results: The analysis reveals a dynamic and expanding field, with an annual scientific growth rate of 12.25%. Notable contributions come from diverse sources, including North America, Europe, and Africa. High-impact journals such as JMIR mHealth and uHealth play a crucial role in disseminating research findings. African authors, including Lebelonyane R, Ford N, and Lockman S, feature prominently, reflecting a positive trend in diverse authorship. Co-citation analysis highlights influential manuscripts, with systematic reviews dominating the top-cited articles. Collaboration analysis underscores strategic partnerships globally, particularly involving the United States, Australia, South Africa, and the United Kingdom. Conclusion: This bibliometrics analysis provides a comprehensive overview of the digital health landscape in HIVST and linkage to care. It identifies key contributors, high-impact journals, and collaborative networks. The thematic map reveals nuanced research domains, including alcohol dependence, men's health, outcomes, and user acceptance. The findings offer insights for researchers, policymakers, and practitioners, guiding future directions in the evolving intersection of HIVST and digital health interventions.

Corrigendum: Digital Intervention Services to Promote HIV Self-Testing and Linkage to Care Services: A Bibliometric and Content Analysis-Global Trends and Future Directions.

[This corrects the article DOI: 10.3389/phrs.2024.1606354.].

HIV seroconversion among female sex workers: retrospective cohort study from a large-scale HIV prevention and sexual and reproductive health program in Tanzania.

Introduction: In 2016, UNAIDS set ambitious targets to reduce global HIV infections by 75% by 2020 and 90% by 2030, based on the 2.1 million new infections reported in 2010. However, by 2022, new HIV infections had only decreased by 38%, from 2.1 million in 2010 to 1.3 million in 2022, raising concerns about reaching the 2030 goal. Female sex workers (FSWs) in sub-Saharan Africa face a disproportionately high risk of HIV acquisition, contributing 5%-20% of all new infections in several countries in the region. This analysis investigates HIV seroconversion and associated factors among FSWs, offering insights into critical interventions for preventing HIV transmission in this population and advancing the goal of ending the HIV pandemic by 2030. Methods: We conducted a retrospective cohort study involving 17,977 FSWs who initially tested HIV negative upon enrollment in the Sauti project between October 2016 and September 2018. HIV incidence rates were calculated by dividing the number of new HIV cases by observed person-time within the cohort. Cox regression analysis identified factors associated with seroconversion. Results: The study revealed an HIV incidence rate of 8.6 per 100 person-years among FSWs [95% confidence interval (CI): 8.1-9.1]. Factors independently associated with HIV seroconversion included age 35 years or older [adjusted hazard ratio (aHR): 2.53; 95% CI: 2.03-3.14], unprotected sex (aHR: 1.27; 95% CI: 1.13-1.42), STI symptoms (aHR: 1.99; 95% CI: 1.67-2.38), and alcohol consumption before sex (aHR: 1.20; 95% CI: 1.07-1.34). Conclusion: Targeted interventions are vital in curbing HIV transmission among FSWs, with a focus on expanding access to primary HIV prevention services, particularly for older FSWs who face heightened risk. Tailored sexual health education programs are imperative to encourage consistent condom use and enable informed decision-making. Accessible and timely STI screening and treatment services are crucial to mitigate HIV transmission risk. Collaborative partnerships between healthcare providers, community organizations, and government agencies are essential in implementing these interventions among FSWs.

Residential and inpatient treatment of substance use disorders in Sub-Saharan Africa: a scoping review.

BACKGROUND: With substance use rates increasing in Sub-Saharan Africa (SSA), an understanding of the accessibility and effectiveness of rehabilitative services for people who use alcohol and other drugs (AOD) is critical in the global efforts to diagnose and treat substance use disorders (SUD). This scoping review seeks to address the gaps in knowledge related to the types of research that have been conducted regarding inpatient or residential SUD treatment in SSA, the settings in which the research was conducted, and the study countries. METHODS: A search of three databases, PubMED, Scopus, and African Index Medicus, was conducted for publications related to the treatment of SUD in inpatient or residential settings in SSA. Articles were screened at the title/abstract level and at full text by two reviewers. Articles eligible for inclusion were original research, conducted in SSA, published in English, included populations who received or were currently receiving treatment for SUD in inpatient or residential settings, or documented demand for SUD services. RESULTS: This scoping review included 82 studies originating from 6 countries in SSA. Three themes emerged within the literature: access and demand for inpatient and residential SUD treatment, quality and outcomes of SUD treatment, and descriptions of the services offered and staffing of these facilities. Barriers to access include financial barriers, limited availability of services, and geographic concentration in cities. Women were shown to access residential and inpatient SUD treatment at lower rates than men, and certain racial groups face unique language and financial barriers in accessing services. Studies indicate mixed success of inpatient and residential SUD treatment in sustained SUD remission for patients. CONCLUSION: There are significant gaps in the literature, driven by a lack of longitudinal studies focused on patient outcomes following treatment and the use of a narrow definition of treatment success. Both structural and non-structural barriers, such as stigma and discrimination, are barriers to access. Further research is needed to evaluate approaches to mitigate these barriers and expand access to residential and inpatient SUD treatment.