Enhancing HIV/AIDS, Viral Hepatitis, Sexually Transmitted Disease, and Tuberculosis Prevention in the United States Through Program Collaboration and Service Integration

Steiner, Riley J.; Aquino, Gustavo A.; Fenton, Kevin

doi:10.1097/olq.0000000000000002

Cited by 11 publications

(9 citation statements)

References 26 publications

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“…Moreover, STIs, perhaps with the exception of HSV-2, tend to be less stigmatizing than HIV, which may encourage HHR to seek out STI testing in these types of circumstances ( 65 ), highlighting the important role of STI testing in achieving the goal of HIV elimination ( 66 ). Yet at present, the STI and HIV prevention systems in the US are considered “siloed” or largely separate, which may lead to missed opportunities for comprehensive sexual health services ( 67 ). In fact, public health system leaders in the US have called for better integration of STI and HIV services to improve the early diagnosis of a range of sexually transmitted health problems ( 63 ).…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with Recent HIV Testing among Heterosexuals at High Risk for HIV Infection in New York City

Gwadz

Cleland

Kutnick

et al. 2016

Front. Public Health

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BackgroundThe Centers for Disease Control and Prevention recommends persons at high risk for HIV infection in the United States receive annual HIV testing to foster early HIV diagnosis and timely linkage to health care. Heterosexuals make up a significant proportion of incident HIV infections (>25%) but test for HIV less frequently than those in other risk categories. Yet factors that promote or impede annual HIV testing among heterosexuals are poorly understood. The present study examines individual/attitudinal-, social-, and structural-level factors associated with past-year HIV testing among heterosexuals at high risk for HIV.MethodsParticipants were African-American/Black and Hispanic heterosexual adults (N = 2307) residing in an urban area with both high poverty and HIV prevalence rates. Participants were recruited by respondent-driven sampling in 2012–2015 and completed a computerized structured assessment battery covering background factors, multi-level putative facilitators of HIV testing, and HIV testing history. Separate logistic regression analysis for males and females identified factors associated with past-year HIV testing.ResultsParticipants were mostly male (58%), African-American/Black (75%), and 39 years old on average (SD = 12.06 years). Lifetime homelessness (54%) and incarceration (62%) were common. Half reported past-year HIV testing (50%) and 37% engaged in regular, annual HIV testing. Facilitators of HIV testing common to both genders included sexually transmitted infection (STI) testing or STI diagnosis, peer norms supporting HIV testing, and HIV testing access. Among women, access to general medical care and extreme poverty further predicted HIV testing, while recent drug use reduced the odds of past-year HIV testing. Among men, past-year HIV testing was also associated with lifetime incarceration and substance use treatment.ConclusionThe present study identified gaps in rates of HIV testing among heterosexuals at high risk for HIV, and both common and gender-specific facilitators of HIV testing. Findings suggest a number of avenues for increasing HIV testing rates, including increasing the number and types of settings offering high-quality HIV testing; promoting STI as well as HIV testing; better integrating STI and HIV testing systems; implementing peer-driven social/behavioral intervention approaches to harness the positive influence of social networks and reduce unfavorable shared peer norms; and specialized approaches for women who use drugs.

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Section: Discussionmentioning

confidence: 99%

Factors Associated with Recent HIV Testing among Heterosexuals at High Risk for HIV Infection in New York City

Gwadz

Cleland

Kutnick

et al. 2016

Front. Public Health

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“…Thus concerns about STIs and STI testing can play important roles in achieving the goal of HIV elimination. Yet the STI and HIV prevention systems are largely “siloed,” which may lead to missed opportunities for comprehensive sexual health services that consider both STIs and HIV infection [ 60 , 61 ]. The CDC has called for better integration of STI and HIV services to improve the early diagnosis of a range of sexually transmitted health problems [ 62 ].…”

Section: Discussionmentioning

confidence: 99%

Exploring Factors Associated with Recent HIV Testing among Heterosexuals at High Risk for HIV Infection Recruited with Venue-based Sampling

et al. 2016

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Annual HIV testing is recommended for high-risk populations in the United States, to identify HIV infections early and provide timely linkage to treatment. However, heterosexuals at high risk for HIV, due to their residence in urban areas of high poverty and elevated HIV prevalence, test for HIV less frequently than other risk groups, and late diagnosis of HIV is common. Yet the factors impeding HIV testing in this group, which is predominantly African American/Black and Latino/Hispanic, are poorly understood. The present study addresses this gap. Using a systematic community-based sampling method, venue-based sampling (VBS), we estimate rates of lifetime and recent (past year) HIV testing among high-risk heterosexuals (HRH), and explore a set of putative multi-level barriers to and facilitators of recent testing, by gender. Participants were 338 HRH African American/Black and Latino/Hispanic adults recruited using VBS, who completed a computerized structured assessment battery guided by the Theory of Triadic Influence, comprised of reliable/valid measures on socio-demographic characteristics, HIV testing history, and multi-level barriers to HIV testing. Logistic regression analysis was used to identify factors associated with HIV testing within the past year. Most HRH had tested at least once (94%), and more than half had tested within the past year (58%), but only 37% tested annually. In both men and women, the odds of recent testing were similar and associated with structural factors (better access to testing) and sexually transmitted infection (STI) testing and diagnosis. Thus VBS identified serious gaps in rates of annual HIV testing among HRH. Improvements in access to high-quality HIV testing and leveraging of STI testing are needed to increase the proportion of HRH testing annually for HIV. Such improvements could increase early detection of HIV, improve the long-term health of individuals, and reduce HIV transmission by increasing rates of viral suppression.

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“…At risk individuals are recommended to get tested at least once a year [11]. Routine HIV testing can be used to identify persons infected with HIV who have yet to receive the diagnosis and to link them with primary and secondary prevention services [15]. Previous studies have shown the persistent and unequal distribution of HIV across the US population by age, race, sex, and Socioeconomic Status (SES) [16–18].…”

Section: Introductionmentioning

confidence: 99%

Factors Associated with Self-Reported HIV Testing Among Persons 18 Years and Over in the United States - Findings from the 2012 Behavioral Risk Factor Surveillance System (BRFSS)

Archie-Booker

Claridy

et al. 2016

INID

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Background The Centers for Disease Control and Prevention (CDC) estimates that 14 percent of persons infected with HIV in the United States (US) are unaware of their infection and many of the estimated 50,000 new HIV infections each year are transmitted by people who do not know that they are HIV-positive. HIV testing is an important component of HIV prevention. This study examined predictors of self-reported HIV testing among persons 18 years and over in the US. Methods Data from the 2012 BRFSS were utilized. We used univariate analysis to calculate relative frequencies for gender, race or ethnicity, age, education, income, marital status, region of residence, and having engaged in HIV/AIDS risky behaviors to characterize the overall sample. We conducted bivariate analysis for an initial assessment of factors independently associated with HIV testing. Multivariable logistic regression models were used to obtain the Adjusted Odds Ratios (AORs) and 95% Confidence Intervals (95% CIs) for factors associated with getting tested for HIV. Analyses were conducted using SAS version 9.2. Results Of the 439,327 respondents, 30% had been tested for HIV. Of those who had been tested for HIV, 59% were female; 41% were two or more races and 47% were between 18–44 years of age. The majority (39%) of the respondents were college graduates. Over one-third (31%) of the participants who had been tested had annual household incomes which were less than $25,000. Half (50%) were married and 24% of the respondents were from the Western region of the US. Five percent of the respondents reported that they had engaged in HIV/AIDS risky behaviors. Factors associated with lower odds of getting tested included being Asian (AOR=0.56; 95% CI=0.41, 0.78); Native Hawaiian or Other Pacific Islander (AOR=0.42; 95% CI=0.18, 0.90); and having an income between $25,000 to $49,000 (AOR=0.82; 95% CI=0.78–0.87); $50,000 to $74,999 (AOR=0.86; 95% CI=0.79–0.93); or $75,000 or more (AOR=0.87; 95% CI=0.81–0.94). Also, respondents from the Midwest (AOR=0.78; 95% CI=0.73, 0.83) and the West (AOR=0.88; 95% CI=0.83, 0.93) were less likely to get tested for HIV. Our adjusted analyses also showed that being non-Hispanic Black or African American, Hispanic or Latino, identifying as having two or more races, and being American Indian or Alaska Native increased the likelihood of getting tested for HIV. Having engaged in HIV/AIDS risky behaviors had significantly higher odds of being tested for HIV (AOR=2.45; 95% CI=2.19, 2.74). Conclusion Our findings suggest that the HIV/AIDS prevention education and training programs in the US that have focused on traditionally classified high-risk populations have been effective. Findings from this study uncover an interesting paradox, which suggests that populations with higher incomes have been overlooked in efforts to combat HIV/AIDS. Our results suggest that these populations are at greatest risk of not knowing their HIV status and are therefore most likely to unknowingly contribute to the number of new HIV infections...

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Enhancing HIV/AIDS, Viral Hepatitis, Sexually Transmitted Disease, and Tuberculosis Prevention in the United States Through Program Collaboration and Service Integration

Cited by 11 publications

References 26 publications

Factors Associated with Recent HIV Testing among Heterosexuals at High Risk for HIV Infection in New York City

Factors Associated with Recent HIV Testing among Heterosexuals at High Risk for HIV Infection in New York City

Exploring Factors Associated with Recent HIV Testing among Heterosexuals at High Risk for HIV Infection Recruited with Venue-based Sampling

Factors Associated with Self-Reported HIV Testing Among Persons 18 Years and Over in the United States - Findings from the 2012 Behavioral Risk Factor Surveillance System (BRFSS)

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