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Article

Zoe Edelstein, Michael Kharfen, Michelle Kim, Benjamin Tsoi, Paul M. Salcuni, Theresa Gamble, Blayne Cutler, Bernard Branson and Wafaa M. El-Sadr

Awareness raising campaigns have been used to promote HIV prevention messages, including the expansion of HIV testing, but initiating such campaigns de novo can be costly…

Abstract

Purpose

Awareness raising campaigns have been used to promote HIV prevention messages, including the expansion of HIV testing, but initiating such campaigns de novo can be costly. Both the Bronx, New York and Washington, DC have significant local HIV epidemics and a history of efforts to scale-up HIV testing. To build on prior HIV testing campaigns and create new messages based on consultation with diverse stakeholders, a partnership with a community-based clinical trial to enhance HIV testing and treatment was established. The purpose of this paper is to describe the history of HIV testing campaigns in the two jurisdictions, the awareness raising conducted in collaboration with the HIV Prevention Trials Network (HPTN) study (HPTN 065) and provide evidence of its effect in these two communities.

Design/methodology/approach

The foundation of prior campaigns allowed for expansion of social mobilization efforts to specific priority populations (gay men and other men who have sex with men), the most severely affected groups in both communities, and to expand the efforts to include clinical settings. New compelling and acceptable messages were shaped through engagement with community members and based on input from focus groups with target populations in each city.

Findings

By engaging the target population in the development of new messaging, HPTN 065 study successfully built on campaigns that were already underway in both jurisdictions and was able to use those messages and platforms to further normalize HIV testing.

Practical implications

Modifying and adapting existing messages saved time and resources, which can be important factors to consider in settings with limited resources or high media purchasing costs.

Originality/value

Efforts of this kind may ultimately help to decrease HIV transmission in large urban settings.

Details

Journal of Social Marketing, vol. 10 no. 3
Type: Research Article
ISSN: 2042-6763

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Article

Holly Blake, Basharat Hussain, Jenny Hand, David Rowlands, Amdani Juma and Catrin Evans

There is a need to increase access to HIV testing in the UK in male migrant communities. The purpose of this paper is to assess the uptake and acceptability of a workplace…

Abstract

Purpose

There is a need to increase access to HIV testing in the UK in male migrant communities. The purpose of this paper is to assess the uptake and acceptability of a workplace HIV testing intervention aimed at increasing access to testing in non-clinical settings.

Design/methodology/approach

A total of 20 health check events were delivered at 11 UK organisations employing male migrant workers. Intervention included HIV testing, cholesterol, BMI, blood glucose, blood pressure; tailored health advice; take-away resources; optional post-event text reminders about HIV and general health. Mixed-methods evaluation included exit questionnaires (n=771), follow-up text messages (n=465) and qualitative interviews (n=35) to assess event acceptability. Qualitative data were analysed thematically.

Findings

Attendees were 776 employees from 50 countries (51 per cent male; 30 per cent migrant workers). A total of 52 per cent of attendees undertook an HIV test (75 per cent were first-time testers). In total, 96 per cent considered HIV testing to be an acceptable element of workplace health checks; 79 per cent reported new health-related knowledge; 60 per cent of attendees opted for follow-up text messaging; 26 per cent of text respondents reported independently taking HIV test post-event. High acceptability and uptake of HIV testing was associated with convenience, opportunity taking (through removal of deliberation and intentional test-seeking), and normalisation of HIV testing within a general health check.

Originality/value

This study is the first to demonstrate that opt-in HIV testing can be successfully delivered in the workplace within a multi-component health check. The workplace is an effective means of increasing access to HIV testing in groups at risk for HIV, including male migrant workers.

Details

International Journal of Workplace Health Management, vol. 11 no. 5
Type: Research Article
ISSN: 1753-8351

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Article

Paul Bowen, Rajen Govender, Peter Edwards and Keith Cattell

Prevalence of HIV/AIDS infection in the South African construction industry exceeds that of most other economic sectors. Voluntary counselling and testing is pivotal in…

Abstract

Purpose

Prevalence of HIV/AIDS infection in the South African construction industry exceeds that of most other economic sectors. Voluntary counselling and testing is pivotal in combatting the spread of the disease. Little is known about the attitudinal fear of testing among construction workers, and the determinants thereof. The purpose of this paper is to address these shortcomings.

Design/methodology/approach

A conceptual integrated model of fear of testing is proposed. Demographic characteristics and behavioural and cognitive factors are posited to explain attitudinal fear of testing. Regression analysis and structural equation modelling are used to test the model, using data gathered from 512 site-based participants in a questionnaire survey.

Findings

Prejudice and lifestyle risk are the terminal predictors of fear of testing. Prejudice is determined by education level and HIV/AIDS transmission knowledge. Knowledge is predicted by education level and ethnicity. Lifestyle risk is determined by age, gender, harmful substance use, and knowledge. Harmful substance use is determined by age, gender, ethnicity, and employment type. The inter-relationship between knowledge about HIV/AIDS, prejudice towards HIV+ persons, and fear of testing is complex and nuanced.

Practical implications

Intervention strategies by firms should positively address attitudinal fear of testing. Employers should ensure that effective communication is established with workers. Interventions relating to harmful substance use by employees need particular attention. Awareness campaigns should be sensitive to ethnic and cultural values, and to inter-generational differences.

Originality/value

Harmful substance use and knowledge about HIV/AIDS transmission are indirect predictors of fear of testing. Education and ethnicity are critical dimensions of knowledge. The complex inter-relationship between knowledge, prejudice, lifestyle risk, and fear of testing is highlighted, providing guidelines for intervention management.

Details

Engineering, Construction and Architectural Management, vol. 23 no. 1
Type: Research Article
ISSN: 0969-9988

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Book part

Brad Barber and Bronwen Lichtenstein

U.S. health policy promotes HIV testing and linkage to care (test-and-treat) with an emphasis on high risk groups such as convicted offenders. We sought to identify…

Abstract

Purpose

U.S. health policy promotes HIV testing and linkage to care (test-and-treat) with an emphasis on high risk groups such as convicted offenders. We sought to identify whether or not laws for mandatory HIV disclosure to sexual partners are a barrier to HIV testing among offenders under community supervision.

Methodology/approach

A total of 197 probationers and parolees were surveyed in a closed/item-open-ended item methodology on two reporting days in Alabama. Three main questions were asked: (1) What do offenders know about HIV? (2) What do they know about the law? (3) Do they support mandatory disclosure and HIV testing? Data for the quantitative items were analyzed with SPSS and matched with open-ended responses for explanatory purposes.

Findings

Testing and criminalization of non-disclosure were fully supported as key elements of HIV prevention. This support was framed by conceptions of HIV as a killer disease, of people with HIV as potential murderers, and by low self-awareness of HIV risk.

Social implications

While the study involved only a single group of convicted offenders in a southern state, the results suggest that disclosure laws legitimize HIV stigma and undermine test-and-treat strategies among communities at risk.

Originality/value

The research is the first of its kind to investigate possible links between HIV criminalization and barriers to HIV prevention and care among convicted offenders.

Details

Education, Social Factors, and Health Beliefs in Health and Health Care Services
Type: Book
ISBN: 978-1-78560-367-9

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Article

Anne S. De Groot, Madeline Dilorenzo, Mary Sylla and Joseph Bick

At least 20% of individuals living with HIV pass through prison and jail doors every year, in any nation, worldwide. Therefore, interventions that improve access to HIV

Abstract

At least 20% of individuals living with HIV pass through prison and jail doors every year, in any nation, worldwide. Therefore, interventions that improve access to HIV testing, HIV care, and education can have a broad impact on public health in every country. The benefits of these interventions in correctional settings have already been well documented. For example, improved access to HIV testing, treatment by an HIV specialist, preventive vaccinations and prophylactic medications, screening for concomitant infections such as HCV, and pre‐release planning services have been shown to decrease HIV‐related mortality and morbidity, to reduce the risk of HIV transmission and to decrease recidivism. Education of at‐risk individuals has also been shown to reduce HIV risk behaviors. Safe distribution of condoms and needle‐exchange programs have also been demonstrated to be safe and effective, although few such programs have been implemented in the United States. While all the available evidence has demonstrated that these public health‐oriented interventions can be and are successful in correctional settings, implementation on a national and international level lags far behind the evidence. The time has come to take an evidence‐based approach to improving HIV management in correctional settings. Implementations of the HIV management interventions described in this article make good medical sense and will have a positive impact on the health of inmates and the communities to which inmates return.

Details

International Journal of Prisoner Health, vol. 2 no. 3
Type: Research Article
ISSN: 1744-9200

Keywords

Content available
Article

Jaelan Sumo Sulat, Yayi Suryo Prabandari, Rossi Sanusi, Elsi Dwi Hapsari and Budiono Santoso

Community-based HIV testing and counselling (HTC) has been recommended for improving access to prevention, care, and treatment services in at-risk populations. Earlier…

Abstract

Purpose

Community-based HIV testing and counselling (HTC) has been recommended for improving access to prevention, care, and treatment services in at-risk populations. Earlier systematic reviews and meta-analyses have been undertaken, but due to some methodological limitations, their findings do not yet provide a practical significance. The purpose of this paper is to re-examine the recent evidence of the efficacy of community-based HTC approaches on the uptake of HTC in at-risk populations.

Design/methodology/approach

The database of PubMed online, Science Direct, the Lancet Global Health, the Cochrane Central Register of Controlled Trials, and Google Scholar were systematically searched using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to obtain empirical papers published between March 2013 and December 2015.

Findings

Of 600 collected papers, there were 6 cluster randomized trials papers which met the inclusion criteria. Compared to the health facilities-based HTC, community-based HTC approaches have been shown to improve the uptake of HIV testing from 5.8 to 37 per cent, and improve HIV testing in men and their partners together from 6.8 to 34 per cent. The community approaches also detected lower HIV-positive cases (0.29 per cent as compared to 4 per cent), improved access to treatment services from 0.3 to 25 per cent, demonstrated higher cluster differentiation 4 count in newly diagnosed patients (median of 400-438 cells/µl), and increased the rate of first-time HIV testing from 9 to 11.8 per cent. With respect to social and behavioural outcomes, community-based HTC increased social norms for HIV testing by 6 per cent (95 per cent CI 3-9), decreased multiple sex partners by 55 per cent (95 per cent CI 42-73), lowered casual sex by 45 per cent (95 per cent CI 33-62), increased knowledge about HIV (83.2 vs 28.9 per cent), improved positive attitudes towards HIV patients (73.0 vs 34.3 per cent), and increased the use of condoms (28.0 vs 12.3 per cent).

Originality/value

Community-based HTC combined with behavioural interventions have been found to be more effective in increasing the uptake of HIV testing as well as other outcomes as compared to the conventional health facilities-based testing and counselling approaches.

Details

Journal of Health Research, vol. 32 no. 2
Type: Research Article
ISSN: 0857-4421

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Article

Erni Juwita Nelwan, Ahmad Isa, Bachti Alisjahbana, Nurlita Triani, Iqbal Djamaris, Ilham Djaja, Herdiman T Pohan, Prisca Zwanikken, Reinout van Crevel, Andre van der Ven and Andre Meheus

Routine HIV screening of prisoners is generally recommended, but rarely implemented in low-resource settings. Targeted screening can be used as an alternative. Both…

Abstract

Purpose

Routine HIV screening of prisoners is generally recommended, but rarely implemented in low-resource settings. Targeted screening can be used as an alternative. Both strategies may provide an opportunity to start HIV treatment but no formal comparisons have been done of these two strategies. The paper aims to discuss these issues.

Design/methodology/approach

The authors compared yield and costs of routine and targeted screening in a narcotic prison in Indonesia. Routine HIV screening was done for all incoming prisoners from August 2007-February 2009, after it was switched for budgetary reasons to targeted (“opt-out”) HIV screening of inmates classified as people who inject drugs (PWIDs), and “opt-in” HIV testing for all non-PWIDs.

Findings

During routine screening 662 inmates were included. All 115 PWIDs and 93.2 percent of non-PWIDs agreed to be tested, 37.4 percent and 0.4 percent respectively were HIV-positive. During targeted screening (March 2009-October 2010), of 888 inmates who entered prison, 107 reported injecting drug use and were offered HIV testing, of whom 31 (29 percent) chose not to be tested and 25.0 percent of those tested were HIV-positive. Of 781 non-PWIDs, 187 (24 percent) came for testing (opt-in), and 2.1 percent were infected. During targeted screening fewer people admitted drug use (12.0 vs 17.4 percent). Routine screening yielded twice as many HIV-infected subjects (45 vs 23). The estimated cost per detected HIV infection was 338 USD for routine and 263 USD for targeted screening.

Originality/value

In a resource limited setting like Indonesia, routine HIV screening in prison is feasible and more effective than targeted screening, which may be stigmatizing. HIV infections that remain unrecognized can fuel ongoing transmission in prison and lead to unnecessary disease progression and deaths.

Details

International Journal of Prisoner Health, vol. 12 no. 1
Type: Research Article
ISSN: 1744-9200

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Article

Paul Cambridge

Informed consent, confidentiality, disclosure, policy and the wider consequences of HIV testing are issues explored in this paper concerning a man with learning…

Abstract

Informed consent, confidentiality, disclosure, policy and the wider consequences of HIV testing are issues explored in this paper concerning a man with learning disabilities who tested positive for HIV. The events and outcomes are summarised, with lessons identified for policy and practice in HIV risk management and adult protection in services for people with learning disabilities.

Details

The Journal of Adult Protection, vol. 3 no. 4
Type: Research Article
ISSN: 1466-8203

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Article

Stephanie E. Perrett and Thomas D. Waite

Prison populations are considered at elevated risk of blood borne virus (BBV) transmission. Between December 2015 and February 2016, four new cases of HIV infection were…

Abstract

Purpose

Prison populations are considered at elevated risk of blood borne virus (BBV) transmission. Between December 2015 and February 2016, four new cases of HIV infection were diagnosed across two male vulnerable prisoner (VP) custodial units in Wales, UK. Cases were identified through routine BBV testing. The paper aims to discuss these issues.

Design/methodology/approach

As a result of identifying four new HIV cases, targeted BBV testing across the VP units using dried blood spot testing for HIV, Hepatitis C (HCV) and Hepatitis B was undertaken.

Findings

A total of 617 men were offered testing, 256 (41 per cent) were tested. No further cases of HIV were identified. Eight men were identified as HCV antibody positive. There was no evidence to suggest the four original cases of HIV were linked.

Practical implications

Embedding universal BBV screening within prison health provision will ensure timely identification of cases. Further research is needed to better understand BBV transmission risks within subsets of the prison population such as the VP and sex offending groups.

Originality/value

Little is known about the prevalence of BBVs in vulnerable prison populations. The findings add to the knowledge available for practitioners in the field.

Details

International Journal of Prisoner Health, vol. 15 no. 3
Type: Research Article
ISSN: 1744-9200

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Article

Jose Catalan, Massimo Riccio and Christopher Thompson

This article sets out guidelines for psychiatric practice prepared at the request of The Royal College of Psychiatrists. It gives an overview of psychosocial and…

Abstract

This article sets out guidelines for psychiatric practice prepared at the request of The Royal College of Psychiatrists. It gives an overview of psychosocial and neuropsychiatric problems in HIV disease, service implications and guidance on HIV screening and testing. Advice is given on the issue of confidentiality in relation to HIV status, the avoidance of infection and general recommendations for implementing the guidelines and the development of any necessary special policies or practices in Mental Health Units.

Details

International Journal of Health Care Quality Assurance, vol. 3 no. 1
Type: Research Article
ISSN: 0952-6862

Keywords

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