Search results

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.

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.

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.

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.

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

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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).

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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

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.

Sexual transmitted infections (STIs) are associated with high stigma leading to poor sexual health-seeking behaviour and mental health problems. Although human immunodeficiency virus (HIV) prevention has generally been successful in many communities across the world, statistics for young people have remained relatively low, especially among most affected communities such as the black sub-Sahara African (BSSA) communities. This paper aims to explore the barriers to STIs and HIV testing among young BSSA communities living in the UK.

The research study used an explorative qualitative approach. The study included 6 focus groups comprising 10 people each (N = 60), and 12 one-to-one follow-up interviews were held with the research participants. Two one-to-one follow-up interviews were held from each focus group (N = 12).

The study found that perceived risk taking, perceived HIV test embarrassment, sexual health professionals’ attitudes, perceived HIV as death sentence, limited educational awareness and general HIV stigma prevented research participants from testing and impacted on their mental health well-being.

There is a need to increase sexual health and mental health education awareness among young BSSA communities. More importantly culturally sensitive interventions to reduce the impact of HIV stigma need to be rolled out in different diverse communities. This study is the first of its kind to look at the barriers affecting young BSSA communities in accessing sexual health testing services in the UK.