A call to action toward integrated testing and earlier care for viral hepatitis, HIV, STIs and TB

Raben, Dorthe; Hoekstra, M; Combs, Lauren; Sullivan, AK; Lazarus, Jeffrey V.; Lambert, John S.; Simões, Daniel; Rockstroh, JK; Streinu‐Cercel, Anca; Pop, Corina Silvia; Oprea, Cristiana; Gökengin, Deniz; Schatz, Eberhard; Ghita, Eugenia; Lazarus, Jeffrey V.; Tavochi, Lara; Ursan, Marian; Dascalu, Nicoleta; Leite, Ricardo Baptista; Pasanen, Sini; Reic, Tatjana; Grecu, Victor; Sönnerborg, Anders; Gazzard, Brian; West, Brian; Karpov, Igor; Lundgren, Jens D; Wit, John de; Rockstroh, Jürgen K.; Maistat, Liudmyla; Matičič, Mojca; Dedes, Nikos; Tsereteli, Nino; Pol, Stanislas; Platteau, Tom; Zuilhof, Wim; Yazdanpanah, Yazdan; Azad, Yusef; Pharris, Anastasia; Amato‐Gauci, Andrew J.; Noori, Teymur; Hedrich, Dagmar; Mozalevskis, Antons; Vovc, Elena; Dara, Masoud; Fenton, Kevin; Kakalou, Christine; Klavs, Irena; Wawer, Iwona; Casabona, Jordi; Hristojeva, Julia; Kivimets, Kristel; Cosmaro, Lella; Maffeo, Manuel; Kall, Meaghan; Mommi, Michele; Gasbarrini, Nadia; Wysocki, Piotr J.; Koutkias, Vassilis

doi:10.1111/hiv.12844

Cited by 3 publications

(2 citation statements)

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“…Ograniczenia w dostępie do opieki medycznej w czasie pandemii SARS-CoV-2 przełożyły się także na dostęp do diagnostyki w kierunku HIV (1,2). Od marca do czerwca 2020 wszystkie Punkty Konsultacyjno-Diagnostyczne, gdzie wykonywane są bezpłatne i anonimowe testy w kierunku HIV, były zamknięte.…”

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Self-testing for HIV among partners of newly diagnosed HIV persons – the pilot program of Test and Keep in Care (TAK) project

Ankiersztejn-Bartczak,

Kowalska

2022

Przegl Epidemiol

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OBJECTIVE. The objective of this study is to conduct a pilot program for self-testing for HIV during the SARS-CoV-2 pandemic. The target population was the partners of newly diagnosed HIV persons. The premise of the program was to offer such partners a test that they could perform in the conditions, at the time, and with the assistance of persons they themselves selected. MATERIAL AND METHODS. The self-test kits were sent to an outpatient clinic providing care for people living with HIV, where, after taking a preliminary history, the physician who treats the newly diagnosed HIV patients handed them over for use by the partner of the patient. Only the persons who reported having relations with their sexual partner were included in the study. Information on whether the partner accepted the test kit and the self-test result were obtained at the subsequent visit. RESULTS AND DISCUSSION. Between June 2020 and March 2021, the total number of handed out test kits was 48 kits intended for 24 persons, included 11 women, average age of participants: 35, sexual orientation: 20 persons reported heterosexual orientation, two persons reported homosexual orientation, two failed to provide information on their sexual orientation. All persons tested negative. The pilot program found that self-testing kits are a method for HIV screening in partners of newly diagnosed HIV persons that is simple to apply and easy to accept.

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Section: Wstępunclassified

“…Restricted access to healthcare during the SARS-CoV-2 pandemic also translated to limited access to HIV testing (1,2). From March to June 2020, all Counselling and Testing Centres that offer free and anonymous HIV tests were closed.…”

Section: Introductionmentioning

confidence: 99%

Self-testing for HIV among partners of newly diagnosed HIV persons – the pilot program of Test and Keep in Care (TAK) project

Ankiersztejn-Bartczak,

Kowalska

2022

Przegl Epidemiol

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Stigma‐associated attitudes and practices among Romanian clinical providers

Barbosu,

Avirvarei,

Manciuc

et al. 2024

HIV Medicine

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ObjectivesPeople living with HIV/AIDS today expect a typical lifespan, although many continue to encounter psychological and societal challenges, including stigma and discrimination. In healthcare settings, this may manifest as refusal of care or treatment, non‐consensual testing, confidentiality breaches, and unfavourable attitudes, among other issues. We sought to better understand stigma‐related beliefs and practices within the Romanian clinician community.MethodsWe designed an analytical cross‐sectional study to measure potentially stigmatizing clinical practices and to identify training gaps that could help alleviate stigma. We conducted a 17‐question survey that was distributed online to healthcare providers in Moldova, the North‐Eastern Romanian region, via the WhatsApp platform, between 1 August and 30 September 2023.ResultsA total of 139 healthcare providers participated in the survey: 71.9% physicians, 23.7% nurses, and 4.3% other providers (e.g., psychologists, pharmacists) working in the fields of infectious disease (36.0%), primary care (13.7%), internal medicine (22.3%), and other specialties such as obstetrics‐gynaecology or paediatrics (18.0%). Most participants indicated that they were not worried about providing care to someone living with HIV/AIDS, most were hesitant to perform HIV testing because they feared the patient's response, and most indicated that co‐workers were hesitant to work alongside a colleague with HIV. In total, 31.7% of participants reported no stigmatizing attitudes or practices, 18.7% reported one stigmatizing attitude or practice, 32.4% reported two, and 17.3% reported three or more. After controlling for confounders, not having an HIV discrimination policy in place and not having been trained on HIV‐related confidentiality were significantly predictive of holding one or more stigmatizing attitudes or practices.ConclusionsThe policy context—particularly anti‐discrimination workplace policies and provider training on HIV‐related confidentiality—is an important determinant of HIV‐related stigmatizing practices and attitudes in Romania.

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Integrated Diagnosis in Africa’s Low- and Middle-Income Countries: What Is It, What Works, and for Whom? A Realist Synthesis

Gwaza,

Plüddemann,

McCall

et al. 2024

Int J Integr Care

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Introduction: Integrated diagnosis can improve health outcomes and patient experiences through early diagnosis and identification of cases that could otherwise be overlooked. Although existing research highlight the feasibility of integrated diagnosis across various conditions, a significant evidence gap remains regarding its direct impact on patient experiences and health outcomes. This review explores the conceptualizations of integrated diagnosis by different stakeholders along the healthcare pathway and examines the necessary contexts and mechanisms crucial for its effectiveness. Methods: This study adopts a realist methodology to explore integrated diagnosis. Using a systematic approach, the research aims to collect, assess, and synthesize existing evidence on integrated diagnosis, guided by a program theory developed through literature review and expert consultations. Primary studies and reviews related to integrated diagnosis, multi-disease testing, or integrated healthcare with a diagnostic focus were sourced from major databases and global health organization websites. The collected evidence was used to construct and refine the evolving theoretical framework. Results: This study identified three models of integrated diagnosis interventions: individual/human resource integration, facility or mobile-based integration, and technology integration. Successful implementation of these models relies on understanding the values and perceptions of both healthcare workers and patients/clients. This research emphasizes a holistic approach that considers all elements within the health system and underscores their interdependence. Using the WHO health systems framework to contextualise factors, the study positions diagnosis as an integral component of the broader health ecosystem. A key finding of the research is the importance of addressing the barriers and facilitators of integrated diagnosis interventions. This includes policy frameworks, diagnostic tools, funding mechanisms, treatment pathways, and human resource issues. Improving patient experiences requires cultivating positive relationships with healthcare workers ensuring elements such as respect, confidentiality, accessibility, and timeliness of services are prioritised. Discussion and Conclusion: The diverse conceptualisations of integrated diagnosis highlight the importance of clear definitions for each intervention. This clarity is essential for transferring lessons learned, comparing programs, and effectively measuring results. The success of integrated diagnosis is not a one-size-fits-all scenario; decisions regarding the approach, conditions to be integrated, and timing of integration must be guided by local contexts to ensure sustainable outcomes. The review findings suggest that integrated diagnosis may be suitable at the primary care level in LMICs under specific circumstances. Successful implementation hinges on addressing the perspectives of healthcare workers and patients/clients alike, requiring adequate time, resources, and a well-defined intervention model.

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A call to action toward integrated testing and earlier care for viral hepatitis, HIV, STIs and TB

Cited by 3 publications

References 1 publication

Self-testing for HIV among partners of newly diagnosed HIV persons – the pilot program of Test and Keep in Care (TAK) project

Self-testing for HIV among partners of newly diagnosed HIV persons – the pilot program of Test and Keep in Care (TAK) project

Stigma‐associated attitudes and practices among Romanian clinical providers

Integrated Diagnosis in Africa’s Low- and Middle-Income Countries: What Is It, What Works, and for Whom? A Realist Synthesis

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A call to action toward integrated testing and earlier care for viral hepatitis, HIV, STIs and TB

Cited by 3 publications

References 1 publication

Self-testing for HIV among partners of newly diagnosed HIV persons – the pilot program of Test and Keep in Care (TAK) project

Self-testing for HIV among partners of newly diagnosed HIV persons – the pilot program of Test and Keep in Care (TAK) project

Stigma‐associated attitudes and practices among Romanian clinical providers

Integrated Diagnosis in Africa&rsquo;s Low- and Middle-Income Countries: What Is It, What Works, and for Whom? A Realist Synthesis

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Product

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Integrated Diagnosis in Africa’s Low- and Middle-Income Countries: What Is It, What Works, and for Whom? A Realist Synthesis