‘Bringing testing closer to you’: barriers and facilitators in implementing HIV self-testing among Filipino men-having-sex-with-men and transgender women in National Capital Region (NCR), Philippines – a qualitative study

Dinglasan, Jeanno Lorenz G.; Rosadiño, John Danvic T; Pagtakhan, Ronivin G; Cruz, Denis P.; Briñes, Matthew T; Regencia, Zypher Jude G.; Baja, Emmanuel S.

doi:10.1136/bmjopen-2021-056697

Cited by 7 publications

(3 citation statements)

References 40 publications

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“…MSM and TGW participated in a qualitative study conducted in the Philippines and most of them reported that HIST was convenient and time saving. In addition, some informants described HIST as “discreet” and “very confidential” [ 81 ]. TGW in particular may associate clinical testing with stigma and lack of privacy [ 74 , 76 , 82 ], and having HIVST may increase their sense of control over the testing process [ 74 , 83 ].…”

Section: Resultsmentioning

confidence: 99%

Self-Testing as a Hope to Reduce HIV in Transgender Women—Literature Review

Budzyńska

Patryn

Kozioł

et al. 2022

IJERPH

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So far, the rate of HIV-positive people who do not know their sero-status is about 14% and the percentage is higher among transgender women (TGW). They represent one of the most vulnerable groups to infection. HIV self-testing (HIVST) may be a way to reduce transmission of the virus. The aim of this analysis and in-depth review was to collect available data on factors that may influence the use and dissemination of HIVST among TGW. This review was conducted in accordance with PRISMA guidelines for systematic reviews and meta-analyses. All data from 48 papers were used. From the available literature, HIVST is a convenient and preferred method of testing due to its high confidentiality and possibility of being performed at home. However, there are barriers that limit its use, including marginalization of transgender people, stigma by medical personnel, lack of acceptance of sexual partners, and even cultural standards. Therefore, there is a need for activities that promote and inform on the possibility of using HIVST as well as enable easier access to it.

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Section: Resultsmentioning

confidence: 99%

Self-Testing as a Hope to Reduce HIV in Transgender Women—Literature Review

Budzyńska

Patryn

Kozioł

et al. 2022

IJERPH

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“…However, challenges remain in the rollout of HIV self-testing. Most of the HIV self-testing kits in the Philippines are blood-based tests, despite the acceptability of oral-based tests [ 60 ]. Moreover, there are unauthorized online sellers of HIV test kits [ 61 ].…”

Section: Hiv Counseling and Testingmentioning

confidence: 99%

The State of the HIV Epidemic in the Philippines: Progress and Challenges in 2023

Gangcuangco

Eustaquio²

2023

TropicalMed

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In the past decade, the Philippines has gained notoriety as the country with the fastest-growing human immunodeficiency virus (HIV) epidemic in the Western Pacific region. While the overall trends of HIV incidence and acquired immunodeficiency syndrome (AIDS)-related deaths are declining globally, an increase in new cases was reported to the HIV/AIDS and ART Registry of the Philippines. From 2012 to 2023, there was a 411% increase in daily incidence. Late presentation in care remains a concern, with 29% of new confirmed HIV cases in January 2023 having clinical manifestations of advanced HIV disease at the time of diagnosis. Men having sex with men (MSM) are disproportionately affected. Various steps have been taken to address the HIV epidemic in the country. The Philippine HIV and AIDS Policy Act of 2018 (Republic Act 11166) expanded access to HIV testing and treatment. HIV testing now allows for the screening of minors 15–17 years old without parental consent. Community-based organizations have been instrumental in expanding HIV screening to include self-testing and community-based screening. The Philippines moved from centralized HIV diagnosis confirmation by Western blot to a decentralized rapid HIV diagnostic algorithm (rHIVda). Dolutegravir-based antiretroviral therapy is now the first line. Pre-exposure prophylaxis in the form of emtricitabine–tenofovir disoproxil fumarate has been rolled out. The number of treatment hubs and primary HIV care facilities continues to increase. Despite these efforts, barriers to ending the HIV epidemic remain, including continued stigma, limited harm reduction services for people who inject drugs, sociocultural factors, and political deterrents. HIV RNA quantification and drug resistance testing are not routinely performed due to associated costs. The high burden of tuberculosis and hepatitis B virus co-infection complicate HIV management. CRF_01AE is now the predominant subtype, which has been associated with poorer clinical outcomes and faster CD4 T-cell decline. The HIV epidemic in the Philippines requires a multisectoral approach and calls for sustained political commitment, community involvement, and continued collaboration among various stakeholders. In this article, we outline the current progress and challenges in curbing the HIV epidemic in the Philippines.

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“…Adoption of HIV self-testing, even where available, varies throughout the region. A study in Singapore found that the fear of a positive diagnosis and a perceived lack of confidentiality contributed to barriers to HIV self-testing; a study from the Philippines showed that despite the increased convenience of tests, there were concerns of lack of privacy associated with purchasing and delivery of self-test kits [ 48 , 49 ]. Overall, barriers to HIV self-test implementation and adoption are multidimensional and setting-specific and deserve more study.…”

Section: Reasons For Late Presentation To Carementioning

confidence: 99%

HIV Late Presenters in Asia: Management and Public Health Challenges

Wong

Wei

Kim

2023

AIDS Research and Treatment

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Many individuals are diagnosed with human immunodeficiency virus (HIV) infection at an advanced stage of illness and are considered late presenters. We define late presentation as a CD4 cell count below 350 cells/mm3 at the time of HIV diagnosis, or presenting with an AIDS-defining illness regardless of CD4 count. Across Asia, an estimated 34–72% of people diagnosed with HIV are late presenters. HIV late presenters generally have a higher disease burden and higher comorbidity such as opportunistic infections than those who are diagnosed earlier. They also have a higher mortality rate and generally exhibit poorer immune recovery following combined antiretroviral therapy (cART). As such, late HIV presentation leads to increased resource burden and costs to healthcare systems. HIV late presentation also poses an increased risk of community transmission since the transmission rate from people unaware of their HIV status is approximately 3.5 times higher than that of early presenters. There are several factors which contribute to HIV late presentation. Fear of stigmatisation and discrimination are significant barriers to both testing and accessing treatment. A lack of perceived risk and a lack of knowledge by individuals also contribute to late presentation. Lack of referral for testing by healthcare providers is another identified barrier in China and may extend to other regions across Asia. Effective strategies are still needed to reduce the incidence of late presentation across Asia. Key areas of focus should be increasing community awareness of the risk of HIV, reducing stigma and discrimination in testing, and educating healthcare professionals on the need for early testing and on the most effective ways to engage with people living with HIV. Recent initiatives such as intensified patient adherence support programs and HIV self-testing also have the potential to improve access to testing and reduce late diagnosis.

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‘Bringing testing closer to you’: barriers and facilitators in implementing HIV self-testing among Filipino men-having-sex-with-men and transgender women in National Capital Region (NCR), Philippines – a qualitative study

Cited by 7 publications

References 40 publications

Self-Testing as a Hope to Reduce HIV in Transgender Women—Literature Review

Self-Testing as a Hope to Reduce HIV in Transgender Women—Literature Review

The State of the HIV Epidemic in the Philippines: Progress and Challenges in 2023

HIV Late Presenters in Asia: Management and Public Health Challenges

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