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1.
AIDS Behav ; 24(2): 506-515, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31865516

RESUMO

Transgender female sex workers (TFSW) are highly affected by HIV, with a global prevalence of 27%. HIV self-testing (HIVST) to screen sexual partners has helped men who have sex with men and female sex workers make informed sexual decisions and avoid HIV exposure. This is the first report on TFSW's experiences screening clients using HIVST. Ten TFSW were each given ten HIVST kits and returned after 3 months to complete an online questionnaire and undergo an interview. Eight of them reported using HIVST with potential partners. Among fifty potential partners who were asked in person to test, 42 (84%) were clients. Thirty-four out of fifty (68%) accepted and 16 (32%) refused. Very few violent incidents occurred, and participants felt empowered by offering HIVST to others. Nevertheless, HIVST market cost was prohibitive for future use. HIVST use with clients could be feasible for TFSW if the cost were lowered or subsidized.


Assuntos
Sorodiagnóstico da AIDS/métodos , Infecções por HIV/diagnóstico , Programas de Rastreamento/estatística & dados numéricos , Autocuidado/métodos , Autoexame/estatística & dados numéricos , Profissionais do Sexo/psicologia , Parceiros Sexuais , Pessoas Transgênero/psicologia , Adulto , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Homossexualidade Masculina/psicologia , Homossexualidade Masculina/estatística & dados numéricos , Humanos , Masculino , New York/epidemiologia , Prevalência , Porto Rico/epidemiologia , Autocuidado/psicologia , Comportamento Sexual , Inquéritos e Questionários
2.
BMC Infect Dis ; 19(1): 807, 2019 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-31521123

RESUMO

BACKGROUND: HIV self-testing (HIVST) is a promising approach to expand HIV testing. HIVST is a process in which a person performs an HIV test and interprets the result. Negative HIVST results may encourage men who have sex with men (MSM) to use HIV prevention services. The objective of this study was to examine behaviors (e.g., facility-based HIV testing, condom use) after a negative HIVST test result among Chinese MSM. METHODS: We collected data from MSM in eight Chinese cities over a 12-month period. This is a secondary analysis of longitudinal cohort data collected as part of an intervention trial to increase HIV testing. Men completed a survey that described sociodemographic information, sexual behaviors, HIV self-testing, and facility-based HIV testing. Men who completed at least one follow-up survey were included in this analysis. Generalized linear mixed models were used to evaluate whether HIVST increased subsequent facility-based HIV testing and consistent condom use. RESULTS: We included 1219 men. Most men (78.7%) were under 30 years old and had never been married (87.0%). 755 (61.9%) men tested for HIV and 593 (49.3%) men self-tested during the study period. At baseline, among men who had never been tested for HIV, 44.9% (314/699) initiated HIVST during the study period. HIVST was associated with subsequent facility-based testing (aOR of 1.87, 95% CI: 1.47-2.37). HIVST was also associated with subsequent consistent condom use (aOR = 1.53, 95% CI: 1.13-2.06). CONCLUSION: HIVST was associated with subsequent facility-based HIV testing and consistent condom use. HIVST may enhance uptake of related HIV prevention services at facilities, suggesting the need for more implementation research.


Assuntos
Sorodiagnóstico da AIDS/métodos , Autoavaliação Diagnóstica , Infecções por HIV/diagnóstico , HIV/imunologia , Homossexualidade Masculina/psicologia , Minorias Sexuais e de Gênero/psicologia , Adulto , China , Preservativos , Seguimentos , Infecções por HIV/prevenção & controle , Humanos , Modelos Lineares , Estudos Longitudinais , Masculino , Assunção de Riscos , Sexo Seguro , Inquéritos e Questionários , Adulto Jovem
3.
Clin Lab ; 65(8)2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31414755

RESUMO

BACKGROUND: The instructions of manufacturers of methodologies for anti-HIV-1/2 antibodies screening tests re-commend avoiding analyzing blood samples with hemolysis or lipemia, but they do not mention references about scientific studies evaluating their interference. The increased need for an opportune detection of HIV infection to avoid its spread has led to public health institutions including routine HIV screening even in internal medicine and emergency rooms. Nevertheless, these blood samples are usually associated with the presence of lipemia and/ or hemolysis, leaving doubt for probable misinterpretations. This fact highlights the need for applying verification techniques, established under the internal methodological conditions of each laboratory, in order to increase the coverage of HIV screening and to ensure the reliability of their results. METHODS: Following the ethics committee approval and patient's informed consent, a confirmed anti-HIV-1 positive human serum (undetectable viral load and p24 antigen, and stable total lymphocytes > 30%) was obtained. This work describes techniques for the semiquantitative analysis of anti-HIV antibodies of three commercial HIV-screening methodologies (immunochromatography, enzyme-immunoassay and chemiluminescence) and to deter-mine the detection limit of these screening tests, as well as evaluating the maximum concentration of total lipids and of free hemoglobin that do not interfere in the detection limits. RESULTS: The highest analyzed concentration of total lipid (870 mg/dL) did not interfere with the detection limits of anti-HIV-1 antibodies in any of the evaluated methodologies. Free hemoglobin presented interference at different concentrations depending on the methodology: immunochromatography (0.57 g/dL)), enzyme-immunoassay (8.6 g/dL), and chemiluminescence (11.5 g/dL)). CONCLUSIONS: Concentrations of lipemia above postprandial levels or hemolysis induced by experimental manipulation might not interfere with HIV-serological screening. Determining the maximum permissible limits of lipemia and hemolysis by each manufacturer or laboratory based on an internal evaluation of their serological methodology would increase the reliability of HIV-diagnosis in internal medicine and emergency rooms and in patients with dyslipidemia or physiological hemolysis.


Assuntos
Anticorpos Anti-HIV/imunologia , Infecções por HIV/diagnóstico , Soropositividade para HIV/diagnóstico , HIV-1/imunologia , Sorodiagnóstico da AIDS/métodos , Anticorpos Anti-HIV/sangue , Infecções por HIV/sangue , Infecções por HIV/virologia , Soropositividade para HIV/sangue , Soropositividade para HIV/virologia , HIV-1/fisiologia , Hemoglobinas/imunologia , Hemoglobinas/metabolismo , Hemólise/imunologia , Humanos , Hiperlipidemias/sangue , Hiperlipidemias/imunologia , Limite de Detecção , Lipídeos/sangue , Lipídeos/imunologia , Sensibilidade e Especificidade
4.
PLoS One ; 14(7): e0218795, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31260480

RESUMO

BACKGROUND: Adolescents living in sub-Saharan Africa constitute a vulnerable population at significant risk of HIV infection. This study aims to evaluate the acceptability, feasibility, and accuracy of home-based, supervised HIV self-testing (HIVST) as well as their predictors among adolescents living in Kisangani, Democratic Republic of the Congo (DRC). METHODS: A cross-sectional, door-to-door survey using a blood-based HIV self-test and a peer-based supervised HIVST approach was conducted from July to August 2018 in Kisangani, DRC. The acceptability and feasibility of HIVST were assessed among adolescents' consenting to use and interpret HIV self-test. The accuracy of HIVST was estimated by the sensibility and specificity of adolescent-interpreted HIV self-test. Factors associated with acceptability and feasibility of HIVST were analyzed with logistic regression. RESULTS: A total of 628 adolescents (including 369 [58.8%] females) aged between 15 and 19 years were enrolled. Acceptability of HIVST was high (95.1%); 96.1% of participants correctly used the self-test, and 65.2% asked for verbal instructions. The majority of adolescents (93.5%) correctly interpreted their self-test results. The Cohen's κ coefficient between the results read by adolescents and by supervisors was 0.62. The correct interpretation decreased significantly when adolescents had no formal education or attended primary school as compared to those currently attending university (37.0% versus 100%; adjusted OR: 0.01 [95% CI: 0.004-0.03]). In the hands of adolescents at home, the sensitivity of the Exacto Test HIV Self-test was estimated at 100%, while its specificity was 96.0%. The majority of participants (68.0%) affirmed that post-test counseling was essential, and that face-to-face counseling (78.9%) was greatly preferred. CONCLUSIONS: Home-based, supervised HIVST using a blood-based self-test and peer-based approach can be used with a high degree of acceptability and feasibility by adolescents living in Kisangani, DRC. Misinterpretation of test results is challenging to obtaining good feasibility of HIVST among adolescents with poor educational level. Face-to-face post-test counseling seems to be preferred among Kisangani's adolescents.


Assuntos
Infecções por HIV/diagnóstico , HIV-1/imunologia , HIV-2/imunologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Preferência do Paciente/psicologia , Autogestão/psicologia , Sorodiagnóstico da AIDS/métodos , Adolescente , Aconselhamento/métodos , Estudos Transversais , República Democrática do Congo , Estudos de Viabilidade , Feminino , Antígenos HIV/sangue , Infecções por HIV/imunologia , Infecções por HIV/virologia , Humanos , Modelos Logísticos , Masculino , Programas de Rastreamento/métodos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Preferência do Paciente/estatística & dados numéricos , Kit de Reagentes para Diagnóstico , Autogestão/educação , Autogestão/estatística & dados numéricos , Sensibilidade e Especificidade , Adulto Jovem
6.
BMC Res Notes ; 12(1): 238, 2019 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-31023349

RESUMO

OBJECTIVE: Efforts to dual eradication of mother-to-child transmission of human immune deficiency virus (HIV) and syphilis have improved in the previous decades. This has however been hindered by limited validation studies. A cross-sectional study was conducted among adult pregnant women attending antenatal care clinic at Mayuge Health Center III. Two milliliters of venous blood were collected into Ethylene di-amine tetra acetic acid vacutainers, and tested for HIV and syphilis using the SD Bioline HIV/Syphilis Duo assay, and the national HIV and syphilis testing algorithm. Sensitivity and specificity were calculated for the Duo Kit against the gold standards within 95% confidence intervals. RESULTS: Three hundred and eighty-two (382) participants were enrolled. Their mean age was 25.8 years. The prevalence of HIV was 1.8% (95% confidence interval 1.23-2.41); while that of syphilis was 2.1% (95% confidence interval 1.81-2.54), and the dual infection was 0.52% (95% confidence interval 0.37-0.92). The sensitivity and specificity of the SD Bioline HIV/Syphilis Duo assay were all 100.0% (95% confidence interval 99.5 to 100.0 and 98.6 to 100.0, respectively). The performance of the SD Bioline HIV/Syphilis Duo Kit was optimal, reassuring its aptness for use, and favorable qualities to a limited resource setting.


Assuntos
Sorodiagnóstico da AIDS/métodos , Infecções por HIV/diagnóstico , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Kit de Reagentes para Diagnóstico/provisão & distribução , Sorodiagnóstico da Sífilis/métodos , Sífilis/diagnóstico , Adolescente , Adulto , Centros Comunitários de Saúde , Estudos Transversais , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/virologia , Humanos , Pessoa de Meia-Idade , Gravidez , Cuidado Pré-Natal/métodos , Prevalência , Kit de Reagentes para Diagnóstico/economia , Sensibilidade e Especificidade , Sífilis/epidemiologia , Sífilis/virologia , Uganda/epidemiologia
7.
PLoS One ; 14(4): e0215353, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30986228

RESUMO

BACKGROUND: HIV-self-testing (HIVST) could be a strategy to get more people tested for HIV in resource limited settings. One of the prerequisites of a successful HIVST programme is the availability of an easy to use, valid HIV-test which is robust against field conditions and procedural errors by untrained lay users. METHODS AND FINDINGS: The primary objective of this study was to evaluate the ability of untrained persons to correctly interpret the OraQuick HIV Self-Test results with oral fluid compared with results obtained by trained users using the matched lot OraQuick Rapid HIV-1/2 Antibody Test and blinded to the results of the Self-Test. Sensitivity of the OraQuick HIV Self-Test in untrained users was 101 in 102 (99.02%; 95%CI = 93.88-99.95%)-and specificity- 1,241 in 1,241 (100.0%; 95%CI = 99.62-100.0%). Forty-eight Self-Tests were excluded in the accuracy analysis (due to a result read as invalid, not sure or ambiguous) resulting in a test system failure rate of 3.45% (95% CI 2.56%-4.55%). At least one observation of difficulty or error with one or more of the test steps were seen in 1,193 (84.6%) participants. Age, education and health literacy were independently associated with the sum score of procedural errors and difficulties. Four tests did not provide a valid result as determined by the trained user's interpretation of the Self-Test. CONCLUSIONS: The OraQuick HIV Self-Test provides reliable and repeatable results in a rural field environment in spite of procedural errors.


Assuntos
Sorodiagnóstico da AIDS/métodos , Anticorpos Anti-HIV/metabolismo , Infecções por HIV , HIV-1/metabolismo , HIV-2/metabolismo , Saliva/metabolismo , Autocuidado , Adolescente , Adulto , Feminino , Infecções por HIV/diagnóstico , Infecções por HIV/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , População Rural , África do Sul
8.
Cent Eur J Public Health ; 27(1): 50-53, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30927397

RESUMO

OBJECTIVE: HIV testing among people who inject drugs (PWID) in Russia has been documented to be low; however, few studies have been conducted outside of the major metropolitan cities. The aim of this study was to determine how many PWID were aware of their HIV serostatus and what motivators were associated with getting tested for HIV. METHODS: Our analysis describes HIV testing behaviours among 593 PWID in Ivanovo and Novosibirsk, Russia. Participants completed a questionnaire and consented to HIV testing. We used logistic regression modelling to determine demographic and behavioural correlates of HIV testing. RESULTS: Self-reported history of HIV testing was 52% in Ivanovo and 54% in Novosibirsk. Prior knowledge of serostatus was very low among PWID who tested positive (3 of 102 in Ivanovo and 0 of 11 in Novosibirsk). The most common reason for testing was doctor referral, and the most common locations were government HIV/AIDS centres and prisons. HIV testing was rarely client initiated or led by a personal motivation for being tested. CONCLUSIONS: HIV testing in Ivanovo and Novosibirsk is suboptimal, resulting in poor knowledge of HIV serostatus. More programmes to promote HIV testing among PWID are urgently needed in both cities.


Assuntos
Sorodiagnóstico da AIDS/métodos , Usuários de Drogas/estatística & dados numéricos , Infecções por HIV/diagnóstico , Infecções por HIV/prevenção & controle , Abuso de Substâncias por Via Intravenosa/complicações , Abuso de Substâncias por Via Intravenosa/psicologia , Cidades , Usuários de Drogas/psicologia , HIV , Infecções por HIV/etnologia , Infecções por HIV/psicologia , Humanos , Masculino , Programas de Rastreamento , Federação Russa/epidemiologia
9.
PLoS One ; 14(1): e0210866, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30682062

RESUMO

BACKGROUND: Human immunodeficiency virus (HIV) testing is critical for early linkage to treatment and care services. However, there is a substantial gap in HIV testing, particularly in resource limited settings due to low accessibility of HIV testing sites, inconvenient testing hours, and concerns about loss of confidentiality. Thus, adopting new strategies such as HIV self-testing (HIVST) could overcome these barriers and increases HIV testing uptake. OBJECTIVE: The aim of this study was to evaluate the diagnostic performance of non-invasive HIVST kit using oral fluid for HIV diagnosis. This study also aimed to assess the ability of clients in interpretation of OraQuick HIVST results. METHOD: Between December 2017 and February 2018, a total of 400 study participants were enrolled into the study to assess a diagnostic accuracy of Oral fluid-based HIVST kit (OraQuick) in 15 public health facilities in Addis Ababa, Ethiopia. Participants were provided with instructions and visual aids on how to perform HIVST and interpret results. They also underwent a blood-based rapid HIV antibody test as per the current national algorithm. The results of HIVST were interpreted independently by the participants and respective health care workers (HCWs). The sensitivity, specificity, positive predictive value (PPV), Negative predictive value (NPV) and inter-rater agreement of the test were computed. RESULTS: Out of 200 participants who tested positive on the national algorithm testing, oral fluid-based self-testing was positive in 199 (99.5%), false negative in 1 (0.5%). Of 200 participants who tested negative on the national algorithm testing, self-testing was negative in 200 (100%). There were no false positive and invalid tests. The sensitivity and specificity of the OraQuick HIVST were 99.5% (95%CI: 97.26-99.99) and 100% (95%CI: 98.18-100.0), respectively. The overall agreement between the two tests was high (κ value = 0.995). The PPV and NPV of OraQuick test were 100% and 99.5% (95%CI: 96.59-99.93) respectively. CONCLUSION: This study showed a high diagnostic performance of OraQuick HIV self-test and suggests that OraQuick HIVST kit has a potential to be used for HIV testing in Ethiopia along with the national algorithm.


Assuntos
Sorodiagnóstico da AIDS/métodos , Infecções por HIV/diagnóstico , Kit de Reagentes para Diagnóstico , Sorodiagnóstico da AIDS/estatística & dados numéricos , Adolescente , Adulto , Algoritmos , Estudos Transversais , Etiópia , Feminino , HIV-1 , HIV-2 , Humanos , Masculino , Valor Preditivo dos Testes , Kit de Reagentes para Diagnóstico/estatística & dados numéricos , Autocuidado , Sensibilidade e Especificidade , Adulto Jovem
10.
AIDS Behav ; 23(4): 883-892, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30661215

RESUMO

Annual HIV testing is recommended for individuals at high risk of infection, specifically incarcerated populations. Incarcerated men carry a higher lifetime risk of acquiring HIV than the general population, yet little is known about their HIV testing behaviors. We collected Audio Computer Assisted Self Interview data for 819 men entering a state prison in North Carolina. We assessed correlates of previous HIV testing, including stigmatizing attitudes and beliefs, and explored two outcomes: (1) ever HIV tested before current incarceration, and (2) recency of last HIV test. Eighty percent had been HIV tested before; of those, 36% reported testing within the last year. Being African American, having education beyond high school, prior incarceration, and higher HIV knowledge increased odds of ever having tested. Results of this study highlight the need to expand HIV testing and education specific to incarcerated populations. Additionally, efforts should be made to monitor and encourage repeat screening.


Assuntos
Sorodiagnóstico da AIDS/estatística & dados numéricos , Afro-Americanos/psicologia , Infecções por HIV/diagnóstico , Conhecimentos, Atitudes e Prática em Saúde , Mau Uso de Serviços de Saúde/estatística & dados numéricos , Prisioneiros/estatística & dados numéricos , Prisões , Estereotipagem , Sorodiagnóstico da AIDS/métodos , Adolescente , Adulto , Estudos Transversais , Infecções por HIV/epidemiologia , Humanos , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , North Carolina/epidemiologia , Assunção de Riscos , Testes Sorológicos , Adulto Jovem
11.
PLoS Med ; 16(1): e1002719, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30601823

RESUMO

BACKGROUND: Conventional HIV testing services have been less comprehensive in reaching men than in reaching women globally, but HIV self-testing (HIVST) appears to be an acceptable alternative. Measurement of linkage to post-test services following HIVST remains the biggest challenge, yet is the biggest driver of cost-effectiveness. We investigated the impact of HIVST alone or with additional interventions on the uptake of testing and linkage to care or prevention among male partners of antenatal care clinic attendees in a novel adaptive trial. METHODS AND FINDINGS: An adaptive multi-arm, 2-stage cluster randomised trial was conducted between 8 August 2016 and 30 June 2017, with antenatal care clinic (ANC) days (i.e., clusters of women attending on a single day) as the unit of randomisation. Recruitment was from Ndirande, Bangwe, and Zingwangwa primary health clinics in urban Blantyre, Malawi. Women attending an ANC for the first time for their current pregnancy (regardless of trimester), 18 years and older, with a primary male partner not known to be on ART were enrolled in the trial after giving consent. Randomisation was to either the standard of care (SOC; with a clinic invitation letter to the male partner) or 1 of 5 intervention arms: the first arm provided women with 2 HIVST kits for their partners; the second and third arms provided 2 HIVST kits along with a conditional fixed financial incentive of $3 or $10; the fourth arm provided 2 HIVST kits and a 10% chance of receiving $30 in a lottery; and the fifth arm provided 2 HIVST kits and a phone call reminder for the women's partners. The primary outcome was the proportion of male partners who were reported to have tested for HIV and linked into care or prevention within 28 days, with referral for antiretroviral therapy (ART) or circumcision accordingly. Women were interviewed at 28 days about partner testing and adverse events. Cluster-level summaries compared each intervention versus SOC using eligible women as the denominator (intention-to-treat). Risk ratios were adjusted for male partner testing history and recruitment clinic. A total of 2,349/3,137 (74.9%) women participated (71 ANC days), with a mean age of 24.8 years (SD: 5.4). The majority (2,201/2,233; 98.6%) of women were married, 254/2,107 (12.3%) were unable to read and write, and 1,505/2,247 (67.0%) were not employed. The mean age for male partners was 29.6 years (SD: 7.5), only 88/2,200 (4.0%) were unemployed, and 966/2,210 (43.7%) had never tested for HIV before. Women in the SOC arm reported that 17.4% (71/408) of their partners tested for HIV, whereas a much higher proportion of partners were reported to have tested for HIV in all intervention arms (87.0%-95.4%, p < 0.001 in all 5 intervention arms). As compared with those who tested in the SOC arm (geometric mean 13.0%), higher proportions of partners met the primary endpoint in the HIVST + $3 (geometric mean 40.9%, adjusted risk ratio [aRR] 3.01 [95% CI 1.63-5.57], p < 0.001), HIVST + $10 (51.7%, aRR 3.72 [95% CI 1.85-7.48], p < 0.001), and phone reminder (22.3%, aRR 1.58 [95% CI 1.07-2.33], p = 0.021) arms. In contrast, there was no significant increase in partners meeting the primary endpoint in the HIVST alone (geometric mean 17.5%, aRR 1.45 [95% CI 0.99-2.13], p = 0.130) or lottery (18.6%, aRR 1.43 [95% CI 0.96-2.13], p = 0.211) arms. The lottery arm was dropped at interim analysis. Overall, 46 male partners were confirmed to be HIV positive, 42 (91.3%) of whom initiated ART within 28 days; 222 tested HIV negative and were not already circumcised, of whom 135 (60.8%) were circumcised as part of the trial. No serious adverse events were reported. Costs per male partner who attended the clinic with a confirmed HIV test result were $23.73 and $28.08 for the HIVST + $3 and HIVST + $10 arms, respectively. Notable limitations of the trial included the relatively small number of clusters randomised to each arm, proxy reporting of the male partner testing outcome, and being unable to evaluate retention in care. CONCLUSIONS: In this study, the odds of men's linkage to care or prevention increased substantially using conditional fixed financial incentives plus partner-delivered HIVST; combinations were potentially affordable. TRIAL REGISTRATION: ISRCTN 18421340.


Assuntos
Sorodiagnóstico da AIDS/métodos , Continuidade da Assistência ao Paciente , Infecções por HIV/diagnóstico , Motivação , Cuidado Pré-Natal , Autocuidado , Adulto , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Infecções por HIV/terapia , Humanos , Malaui/epidemiologia , Masculino , Gravidez , Cuidado Pré-Natal/métodos , Autocuidado/métodos , Autocuidado/psicologia , Adulto Jovem
12.
Int J STD AIDS ; 30(2): 173-180, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30348065

RESUMO

The SD BIOLINE HIV/Syphilis Duo (SD BIOLINE DUO) rapid test is a dual rapid lateral flow immunoassay that detects antibodies to both human immunodeficiency virus (HIV) and Treponema pallidum (TP) 'syphilis' via fingerprick whole blood. We evaluated the field performance of the SD BIOLINE HIV/Syphilis Duo test among two populations in Hanoi, Vietnam - men who have sex with men (MSM) and pregnant women. We also surveyed factors that influence participants' willingness to test for HIV and syphilis. This test has the potential to increase HIV and syphilis screening in low-resource settings. Patients who received healthcare services at a sexual health clinic for MSM and a district antenatal care center in Hanoi, Vietnam were recruited for the study. Participants with HIV and syphilis were intentionally recruited for adequate test performance evaluation via convenience sampling. At each facility, venipuncture blood specimens were obtained for reference testing for HIV and TP using SD BIOLINE HIV 1/2 3.0 and TP particle agglutination, respectively. SD BIOLINE DUO was compared to the standard reference tests and sensitivity and specificity were calculated. We calculated 95% confidence interval (CI) using the exact binomial method. We used conjoint analysis to identify test attributes that are associated with participant likelihood to seek HIV and syphilis testing. Of 280 participants, 100 (35.7%) were MSM and 180 (64.3%) were pregnant women. Of MSM, 17 (17.0%) were HIV positive and 49 (49.0%) were TP seropositive. All women were negative for both HIV and syphilis antibodies. For HIV antibody testing, sensitivity and specificity were 100.0% (95% CI: 80.5-100.0%) and 100.0% (95% CI: 98.6-100.0%), respectively. For the syphilis antibody testing, sensitivity and specificity were 83.1% (95% CI: 71.0-91.6%) and 100.0% (95% CI: 98.3-100.0%), respectively. Potential for false positives, preference for one blood draw over two, and shorter wait time for testing results were the highest ranked attributes by participants according to their willingness to test. The SD BIOLINE HIV/Syphilis Duo rapid test demonstrated very good performance in this field setting and participants preferred attributes that aligned well with this test.


Assuntos
Sorodiagnóstico da AIDS/métodos , Anticorpos Antibacterianos/imunologia , Anticorpos Antivirais/imunologia , Infecções por HIV/diagnóstico , HIV/imunologia , Programas de Rastreamento/métodos , Aceitação pelo Paciente de Cuidados de Saúde , Sorodiagnóstico da Sífilis/métodos , Sífilis/diagnóstico , Adolescente , Adulto , Anticorpos Antibacterianos/sangue , Anticorpos Antivirais/sangue , Feminino , Infecções por HIV/sangue , Infecções por HIV/virologia , Homossexualidade Masculina , Humanos , Masculino , Pessoa de Meia-Idade , Sistemas Automatizados de Assistência Junto ao Leito , Testes Imediatos , Gravidez , Gestantes , Cuidado Pré-Natal , Sensibilidade e Especificidade , Sífilis/sangue , Sífilis/imunologia , Treponema pallidum/imunologia , Vietnã
13.
AIDS Behav ; 23(4): 893-899, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30264206

RESUMO

HIV-positive men who have sex with men (MSM) were recruited on www.Facebook.com and www.Poz.com to give HIV self-tests to their contacts. Study participants completed a baseline survey, were given two self-tests, and completed a survey 2 months later. Of 133 eligible men, 40 (30%) completed both surveys. Most participants were 30-54 years old and non-Hispanic white. Some had a detectable viral load (n = 4), had condomless anal sex with male partners of negative or unknown status (n = 17), and had met anal sex partners at gay dating websites (n = 23). Of 80 self-tests given to participants, 59 (74%) were distributed, primarily to non-Hispanic white MSM, 30-54 years old who were friends. Participants reported results from 31 distributed tests; 2 sex partners of participants had positive results. Participants indicated these two persons were unaware of their infections. Expanding recruitment websites might reach non-white MSM. Unrecognized infections were identified through online recruitment and self-test distribution via HIV-positive persons.


Assuntos
Sorodiagnóstico da AIDS/estatística & dados numéricos , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Infecções por HIV/diagnóstico , Soropositividade para HIV , Homossexualidade Masculina , Programas de Rastreamento/métodos , Autocuidado/métodos , Parceiros Sexuais , Sorodiagnóstico da AIDS/métodos , Adulto , Infecções por HIV/prevenção & controle , Humanos , Relações Interpessoais , Masculino , Programas de Rastreamento/organização & administração , Pessoa de Meia-Idade , Autocuidado/psicologia , Doenças Sexualmente Transmissíveis/prevenção & controle , Inquéritos e Questionários
14.
Int J STD AIDS ; 30(4): 323-328, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30472926

RESUMO

This cross-sectional study of 3212 pregnant women assessed the field performance, acceptability, and feasibility of two dual HIV/syphilis rapid diagnostic tests, the Chembio DPP HIV-syphilis Assay and the SD Bioline HIV/syphilis Duo in antenatal clinics. Sensitivity and specificity for HIV and syphilis were calculated compared to the rapid Determine HIV-1/2 with Uni-Gold to confirm positive results for HIV and the Treponema pallidum particle agglutination assay for syphilis. RPR titers ≥1:4 were used to define active syphilis detection. Acceptability and feasibility were assessed using self-reported questionnaires. For Chembio, the HIV sensitivity was 90.6% (95%CI = 87.4, 93.0) and specificity was 97.2% (95%CI = 96.2, 97.8); syphilis sensitivity was 68.6% (95%CI = 61.9, 74.6) and specificity was 98.5% (95%CI = 97.8, 98.9). For SD Bioline, HIV sensitivity was 89.4% (95%CI = 86.1, 92.0) and specificity was 96.3% (95%CI = 95.3, 97.1); syphilis sensitivity was 66.2% (95%CI = 59.4, 72.4) and specificity was 97.2% (95%CI = 96.4, 97.9). Using the reference for active syphilis, syphilis sensitivity was 84.7% (95%CI = 76.1, 90.6) for Chembio and 81.6% (95%CI = 72.7, 88.1) for SD Bioline. Both rapid diagnostic tests were assessed as highly acceptable and feasible. In a field setting, the performance of both rapid diagnostic tests was comparable to other published field evaluations and each was rated highly acceptable and feasible. These findings can be used to guide further research and proposed scale up in antenatal clinic settings.


Assuntos
Sorodiagnóstico da AIDS/métodos , Anticorpos Antivirais/imunologia , Infecções por HIV/diagnóstico , HIV/imunologia , Aceitação pelo Paciente de Cuidados de Saúde , Complicações Infecciosas na Gravidez/diagnóstico , Cuidado Pré-Natal/métodos , Sorodiagnóstico da Sífilis/métodos , Sífilis/diagnóstico , Adolescente , Adulto , Instituições de Assistência Ambulatorial , Anticorpos Antibacterianos/sangue , Anticorpos Antibacterianos/imunologia , Anticorpos Antivirais/sangue , Estudos de Viabilidade , Feminino , Infecções por HIV/sangue , Infecções por HIV/virologia , Humanos , Programas de Rastreamento/métodos , Gravidez , Sensibilidade e Especificidade , Sífilis/sangue , Sífilis/microbiologia , Treponema pallidum/imunologia , Treponema pallidum/isolamento & purificação , Zâmbia
15.
AIDS Behav ; 23(4): 847-859, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30565095

RESUMO

In China, some health departments and gay community-based organizations have begun to offer home-based HIV testing kits in order to augment test uptake among men who have sex with men (MSM). However, HIV test preferences and motivations for home-testing among MSM in China are not well understood. The HIV testing preferences of 803 MSM throughout China were evaluated using single-item assessment and a discrete choice experiment (DCE). In both the single-item assessment and DCE, participants expressed strong preference for free and anonymous testing by health professionals. Both approaches also indicated that naïve testers most prefer home testing. However, among previous testers, the single-item assessment indicated that "home" was the most preferred testing location (vs. hospital or clinic), while the DCE indicated that "home" was the least preferred testing location after controlling for anonymity. HIV home-testing may have limited appeal to previously tested Chinese MSM if anonymity is not maintained.


Assuntos
Sorodiagnóstico da AIDS/estatística & dados numéricos , Assistência à Saúde/organização & administração , Infecções por HIV/diagnóstico , Infecções por HIV/psicologia , Homossexualidade Masculina/psicologia , Programas de Rastreamento/métodos , Preferência do Paciente , Sorodiagnóstico da AIDS/métodos , Adolescente , Adulto , China/epidemiologia , Infecções por HIV/etnologia , Infecções por HIV/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Homossexualidade Masculina/etnologia , Humanos , Masculino , Motivação , Minorias Sexuais e de Gênero , Adulto Jovem
16.
AIDS Behav ; 23(4): 813-819, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30506350

RESUMO

Venue-based testing may improve screening efforts for HIV and syphilis, thereby reducing transmission. We offered onsite rapid dual HIV and syphilis testing at venues popular among MSM and/or transgender women in Lima, Peru. We used Poisson regression to calculate adjusted prevalence ratios (aPRs) for factors associated with each infection. Most (90.4%) of the 303 participants would test more frequently if testing was available at alternative venues. New cases of HIV (69) and syphilis infection (84) were identified. HIV was associated with recent sex work (aPR 1.11; 95% CI 1.02-1.22), sex with a partner of unknown serostatus (aPR 1.18; 95% CI 1.09-1.27), exclusively receptive anal sex role (aPR 1.16; 95% CI 1.03-1.30) or versatile sex role (aPR 1.17; 95% CI 1.06-1.30) compared to insertive. Syphilis was associated with reporting role versatility (aPR = 2.69; 95% CI 1.52-5.74). Sex work venues had higher syphilis prevalence 47% versus 28% in other venues, p value = 0.012. Venue-based testing may improve case finding.


Assuntos
Sorodiagnóstico da AIDS/estatística & dados numéricos , Infecções por HIV/diagnóstico , Homossexualidade Masculina , Doenças Sexualmente Transmissíveis/prevenção & controle , Sífilis/diagnóstico , Pessoas Transgênero , Sorodiagnóstico da AIDS/métodos , Adulto , Feminino , Infecções por HIV/epidemiologia , Humanos , Masculino , Programas de Rastreamento/métodos , Peru/epidemiologia , Prevalência , Fatores de Risco , Trabalho Sexual , Parceiros Sexuais , Minorias Sexuais e de Gênero , Sífilis/epidemiologia , Sorodiagnóstico da Sífilis , Sexo sem Proteção
17.
BMC Med Ethics ; 19(1): 92, 2018 11 21.
Artigo em Inglês | MEDLINE | ID: mdl-30463559

RESUMO

BACKGROUND: Mother-to-child transmission (MTCT) of the Human Immunodeficiency -Virus (HIV) is a serious public health problem, contributing up to 90% of childhood HIV infections. In Tanzania, the prevention-of-mother-to-child-transmission (PMTCT) feature of the HIV programme was rolled out in 2000. The components of PMTCT include counselling and HIV testing directed at antenatal clinic attendees. It is through the process of Provider Initiated Counseling and Testing (PITC) that counselling is offered participant confidentiality and voluntariness are upheld and valid consent obtained. The objective of the study was to explore antenatal clinic attendees' experiences of the concept of voluntariness vis- a- vis the implementation of prior counseling and subsequent testing for HIV under the PITC as part of their antenatal care. METHODS: In-depth interviews were conducted with17 antenatal clinic attendees and 6 nursing officers working at the Muhimbili National Hospital (MNH) antenatal clinic. The study data were analyzed using qualitative content analysis. RESULTS: Antenatal clinic attendees' accounts suggested that counselling and testing for HIV during pregnancy was voluntary, and that knowledge of their HIV status led them to access appropriate treatment for both mother and her newborn baby. They reported feeling no pressure from nursing officers, and gave verbal consent to undergo the HIV test. However, some antenatal clinic attendees reported pressure from their partners to test for HIV. Healthcare providers were thus faced with a dilemma of disclosure/ nondisclosure when dealing with discordant couples. CONCLUSION: Antenatal clinic attendees at MNH undertook the PITC for HIV voluntarily. This was enhanced by their prior knowledge of HIV, the need to prevent mother- to- child transmission of HIV, and the effectiveness of the voluntary policy implemented by nursing officers.


Assuntos
Sorodiagnóstico da AIDS/ética , Aconselhamento/ética , Cuidado Pré-Natal/ética , Sorodiagnóstico da AIDS/métodos , Adulto , Confidencialidade/ética , Feminino , Humanos , Transmissão Vertical de Doença Infecciosa/ética , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Consentimento Livre e Esclarecido/ética , Entrevistas como Assunto , Gravidez , Cuidado Pré-Natal/métodos , Diagnóstico Pré-Natal/ética , Diagnóstico Pré-Natal/métodos , Tanzânia
19.
Sci Rep ; 8(1): 15297, 2018 10 17.
Artigo em Inglês | MEDLINE | ID: mdl-30333568

RESUMO

Eliminating hepatitis C as a public health threat requires an improved understanding of how to increase testing uptake. We piloted point-of-care testing (POCT) for a current HCV infection in an inner-city Emergency Department (ED) and assessed the influence on uptake of offering concomitant screening for HIV. Over four months, all adults attending ED with minor injuries were first invited to complete an anonymous questionnaire then invited to test in alternating cycles offering HCV POCT or HCV+HIV POCT. Viral RNA was detected in finger-prick blood by GeneXpert. 814/859 (94.8%) questionnaires were returned and 324/814 (39.8%) tests were accepted, comprising 211 HCV tests and 113 HCV+HIV tests. Offering concomitant HIV screening reduced uptake after adjusting for age and previous HCV testing (odds ratio 0.51; 95% confidence interval [CI] 0.38-0.68; p < 0.001). HCV prevalence was 1/324 (0.31%; 95% CI 0.05-1.73); no participant tested positive for HIV. 167/297 (56.2%) POCT participants lived in the most deprived neighbourhoods in England. HCV RNA testing using finger-prick blood was technically feasible. Uptake was moderate and the offer of concomitant HIV screening showed a detrimental impact on acceptability in this low prevalence population. The findings should be confirmed in a variety of other community settings.


Assuntos
Sorodiagnóstico da AIDS/métodos , Infecções por HIV/diagnóstico , Hepatite C/diagnóstico , Testes Imediatos , Adolescente , Adulto , Idoso , Feminino , HIV/fisiologia , Infecções por HIV/sangue , Infecções por HIV/virologia , Hepacivirus/fisiologia , Hepatite C/sangue , Hepatite C/virologia , Humanos , Masculino , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Inquéritos e Questionários , Adulto Jovem
20.
AIDS Patient Care STDS ; 32(10): 399-407, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30277816

RESUMO

Women account for 25% of all people living with HIV and 19% of new diagnoses in the United States. African American (AA) women are disproportionately affected. Yet, differences in the care continuum entry are not well understood between patient populations and healthcare sites. We aim to examine gender differences in diagnosis and linkage to care (LTC) in the Expanded HIV Testing and Linkage to Care (X-TLC) program within healthcare settings. Data were collected from 14 sites on the South and West sides of Chicago. Multivariate logistic regression analysis was used to determine the differences in HIV diagnoses and LTC by gender and HIV status. From 2011 to 2016, X-TLC performed 281,017 HIV tests; 63.7% of those tested were women. Overall HIV seroprevalence was 0.57%, and nearly one third (29.4%) of HIV-positive patients identified were cisgender women. Of newly diagnosed HIV-positive women, 89% were AA. 58.5% of new diagnoses in women were made at acute care hospitals, with the remainder at community health centers. Women who were newly diagnosed had a higher baseline CD4 count at diagnosis compared with men. Overall, women had lower odds of LTC compared with men (adjusted odds ratio = 0.58, 95% confidence interval 0.44-0.78) when controlling for patient demographics and newly versus previously diagnosed HIV status. Thus, interventions that focus on optimizing entry into the care continuum for AA women need to be explored.


Assuntos
Sorodiagnóstico da AIDS/estatística & dados numéricos , Afro-Americanos/estatística & dados numéricos , Continuidade da Assistência ao Paciente/organização & administração , Infecções por HIV/diagnóstico , Infecções por HIV/terapia , Sorodiagnóstico da AIDS/métodos , Adulto , Contagem de Linfócito CD4 , Chicago/epidemiologia , Continuidade da Assistência ao Paciente/estatística & dados numéricos , Assistência à Saúde , Feminino , Infecções por HIV/etnologia , Soroprevalência de HIV , Humanos , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Estudos Soroepidemiológicos , Fatores Sexuais
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