Designing HIV Testing and Self-Testing Services for Young People in Nigeria: A Discrete Choice Experiment

Ong, Jason J.; Nwaozuru, Ucheoma; Obiezu-Umeh, Chisom; Airhihenbuwa, Collins O.; Xian, Hong; Terris‐Prestholt, Fern; Gbaja-Biamila, Titilola; Musa, Adesola Z.; Oladele, David; Idigbe, Ifeoma; David, Agatha; Okwuzu, Jane; Bamidele, Tajudeen; Iwelunmor, Juliet; Tucker, Joseph D.; Ezechi, Oliver

doi:10.1007/s40271-021-00522-2

Cited by 9 publications

(17 citation statements)

References 27 publications

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“…Another possibility is that unlike other studies which specifically assessed the impact of rapid testing compared with venepuncture, our systematic review examined the difference in HIV test uptake between settings where rapid testing was available compared with settings that did not have rapid testing uptake. Therefore, there could be other confounders related to sub-populations attending these settings [ 37 , 38 ]. There is evidence of greater appeal of rapid testing compared with venepuncture.…”

Section: Discussionmentioning

confidence: 99%

HIV Testing Uptake According to Opt-In, Opt-Out or Risk-Based Testing Approaches: a Systematic Review and Meta-Analysis

Soh

Chow

et al. 2022

Curr HIV/AIDS Rep

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Purpose of Review Improving HIV testing uptake is essential to ending the HIV pandemic. HIV testing approaches can be opt-in, opt-out or risk-based. This systematic review examines and compares the uptake of HIV testing in opt-in, opt-out and risk-based testing approaches. Recent Findings There remain missed opportunities for HIV testing in a variety of settings using different approaches: opt-in (a person actively accepts to be tested for HIV), opt-out (a person is informed that HIV testing is routine/standard of care, and they actively decline if they do not wish to be tested for HIV) or risk-based (using risk-based screening tools to focus testing on certain individuals or sub-populations at greater risk of HIV). It is not clear how the approach could impact HIV test uptake when adjusted for other factors (e.g. rapid testing, country-income level, test setting and population tested). Summary We searched four databases for studies reporting on HIV test uptake. In total, 18,238 records were screened, and 150 studies were included in the review. Most studies described an opt-in approach (87 estimates), followed by opt-out (76) and risk-based (19). Opt-out testing was associated with 64.3% test uptake (I2 = 99.9%), opt-in testing with 59.8% (I2 = 99.9%) and risk-based testing with 54.4% (I2 = 99.9%). When adjusted for settings that offered rapid testing, country income level, setting and population tested, opt-out testing had a significantly higher uptake (+ 12% (95% confidence intervals: 3–21), p = 0.007) than opt-in testing. We also found that emergency department patients and hospital outpatients had significantly lower HIV test uptake than other populations.

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Section: Discussionmentioning

confidence: 99%

HIV Testing Uptake According to Opt-In, Opt-Out or Risk-Based Testing Approaches: a Systematic Review and Meta-Analysis

Soh

Chow

et al. 2022

Curr HIV/AIDS Rep

Self Cite

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“…Therefore, there could be other confounders related to subpopulations attending these settings. (37, 38) There is evidence of greater appeal of rapid testing compared with venepuncture. For example, a 2013 systematic review on rapid point-of-care HIV testing found that youth preferred rapid point-of-care tests compared to traditional testing methods.…”

Section: Discussionmentioning

confidence: 99%

HIV testing uptake according to opt-in, opt-out or risk-based testing approaches: a systematic review and meta-analysis

Soh

Chow

et al. 2022

Preprint

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Purpose of review Improving HIV testing uptake is essential to ending the HIV pandemic. HIV testing approaches can be opt-in, opt-out or risk-based. This systematic review examines and compares the uptake of HIV testing in opt-in, opt-out and risk-based testing approaches. Recent findings There remains missed opportunities for HIV testing in a variety of settings using different approaches: opt-in (a person actively accepts to be tested for HIV), opt-out (a person is informed that HIV testing is routine/standard of care, and they actively decline if they do not wish to be tested for HIV) or risk-based (using risk-based screening tools to focus testing on certain individuals or sub-populations at greater risk of HIV). It is not clear how the approach could impact HIV test uptake when adjusted for other factors (e.g. rapid testing, country-income level, test setting and population tested). Summary We searched four databases for studies reporting on HIV test uptake. In total, 18,238 records were screened, and 150 studies were included in the review. Most studies described an opt-in approach (87 estimates), followed by opt-out (76) and risk-based (19). Opt-out testing was associated with 64.3% test uptake (I2=99.9%), opt-in testing with 59.8% (I2=99.9%), and risk-based testing with 54.4% (I2=99.9%). When adjusted for settings that offered rapid testing, country income level, setting and population tested, opt-out testing had a significantly higher uptake (+12% (95% confidence intervals: 3-21), p=0.007) than opt-in testing. We also found that emergency department patients and hospital outpatients had significantly lower HIV test uptake than other populations.

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“…Although we identified self-care examples contributing to each of the life-saving objectives of the MISP, many other SRH self-care interventions could be supported alongside tested interventions [ 16 ]. Several studies excluded from the review were identified in crisis-affected countries but not years or parts of the country with a humanitarian funding appeal or response plan [ 59 – 63 ]. These studies can also provide valuable country-specific insights, particularly in crisis-affected countries such as Ethiopia, Nigeria, and Uganda which have recently launched national guidelines on self-care for SRH [ 64 ].…”

Section: Discussionmentioning

confidence: 99%

Self-care interventions for sexual and reproductive health in humanitarian and fragile settings: a scoping review

Dawson

Tappis²,

Tran

2022

BMC Health Serv Res

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Background Self-care is the ability of individuals, families, and communities to promote health, prevent disease, maintain health, and manage illness and disability with or without a health care provider. In resource-constrained settings with disrupted sexual and reproductive health (SRH) service coverage and access, SRH self-care could play a critical role. Despite SRH conditions being among the leading causes of mortality and morbidity among women of reproductive age in humanitarian and fragile settings, there are currently no reviews of self-care interventions in these contexts to guide policy and practice. Methods We undertook a scoping review to identify the design, implementation, and outcomes of self-care interventions for SRH in humanitarian and fragile settings. We defined settings of interest as locations with appeals for international humanitarian assistance or identified as fragile and conflict-affected situations by the World Bank. SRH self-care interventions were described according to those aligned with the Minimum Initial Services Package for Reproductive Health in Crises. We searched six databases for records using keywords guided by the PRISMA statement. The findings of each included paper were analysed using an a priori framework to identify information concerning effectiveness, acceptability and feasibility of the self-care intervention, places where self-care interventions were accessed and factors relating to the environment that enabled the delivery and uptake of the interventions. Results We identified 25 publications on SRH self-care implemented in humanitarian and fragile settings including ten publications on maternal and newborn health, nine on HIV/STI interventions, two on contraception, two on safe abortion care, one on gender-based violence, and one on health service provider perspectives on multiple interventions. Overall, the findings show that well-supported self-care interventions have the potential to increase access to quality SRH for crisis-affected communities. However, descriptions of interventions, study settings, and factors impacting implementation offer limited insight into how practical considerations for SRH self-care interventions differ in stable, fragile, and crisis-affected settings. Conclusion It is time to invest in self-care implementation research in humanitarian settings to inform policies and practices that are adapted to the needs of crisis-affected communities and tailored to the specific health system challenges encountered in such contexts.

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Designing HIV Testing and Self-Testing Services for Young People in Nigeria: A Discrete Choice Experiment

Cited by 9 publications

References 27 publications

HIV Testing Uptake According to Opt-In, Opt-Out or Risk-Based Testing Approaches: a Systematic Review and Meta-Analysis

HIV Testing Uptake According to Opt-In, Opt-Out or Risk-Based Testing Approaches: a Systematic Review and Meta-Analysis

HIV testing uptake according to opt-in, opt-out or risk-based testing approaches: a systematic review and meta-analysis

Self-care interventions for sexual and reproductive health in humanitarian and fragile settings: a scoping review

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