HIV Testing Strategies, Types of Tests, and Uptake by Men Who have Sex with Men and Transgender Women: A Systematic Review and Meta-analysis

Magno, Laio; Pereira, Marcos; Castro, Caroline Tianeze de; Rossi, Thaís Régis Aranha; Azevêdo, Laylla Mirella Galvão; Guimarães, Nathália Sernizon; Dourado, Inês

doi:10.1007/s10461-022-03803-5

Cited by 5 publications

(4 citation statements)

References 241 publications

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“…With the cost reduction, urine HIV antibody testing is gradually gaining attention and acceptance by public health policymakers, health institutions and the general public due to its advantages of being convenient, noninvasive, safe8–10 and reliable 11–14. However, these urine HIV antibody reagents required that urine samples be transported to the laboratory for centralised testing because of methodological limitations, which limits their convenience of application.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic performance evaluation of urine HIV-1 antibody rapid test kits in a real-life routine care setting in China

Lu,

Chen,

Liang

et al. 2024

BMJ Open

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ObjectivesTo evaluate the diagnostic performance of urine HIV antibody rapid test kits in screening diverse populations and to analyse subjects’ willingness regarding reagent types, purchase channels, acceptable prices, and self-testing.DesignsDiagnostic accuracy studiesParticipantsA total of 2606 valid and eligible samples were collected in the study, including 202 samples from female sex workers (FSWs), 304 persons with injection drug use (IDU), 1000 pregnant women (PW), 100 subjects undergoing voluntary HIV counselling and testing (VCT) and 1000 students in higher education schools or colleges (STUs). Subjects should simultaneously meet the following inclusion criteria: (1) being at least 18 years old and in full civil capacity, (2) signing an informed consent form and (3) providing truthful identifying information to ensure that the subjects and their samples are unique.ResultsThe sensitivity, specificity and area under the curve (AUC) of the urine HIV-1 antibody rapid test kits were 92.16%, 99.92% and 0.960 (95% CI: 0.952 to 0.968, p<0.001), respectively, among 2606 samples collected during on-site screenings. The kits showed good diagnostic performance in persons with IDU (AUC, 1.000; 95% CI, 1.000 to 1.000, p<0.001), PW (AUC, 0.999; 95% CI, 0.999 to 1.000, p<0.001) and FSWs (AUC, 1.000; 95% CI, 1.000 to 1.000, p<0.001). The AUC of the urine reagent kits in subjects undergoing VCT was 0.941 (95% CI: 0.876 to 0.978, p<0.001). The ‘acceptable price’ had the greatest influence on STUs (Pi=1.000) and PW (Pi=1.000), the ‘purchase channel’ had the greatest influence on subjects undergoing VCT (Pi=1.000) and persons with IDU (Pi=1.000) and the ‘reagent types’ had the greatest influence on FSWs (Pi=1.000).ConclusionsThe rapid urine test kits showed good diagnostic validity in practical applications, despite a few cases involving misdiagnosis and underdiagnosis.

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Section: Introductionmentioning

confidence: 99%

Diagnostic performance evaluation of urine HIV-1 antibody rapid test kits in a real-life routine care setting in China

Lu,

Chen,

Liang

et al. 2024

BMJ Open

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“…High coverage of HIV testing was the first step in achieving the 95-95-95 targets. However, the overall HIV testing coverage among MSM was 86.2% in Africa and 89% in North America [ 8 ]. There is a need for further improvement.…”

Section: Introductionmentioning

confidence: 99%

Counseling Supporting HIV Self-Testing and Linkage to Care Among Men Who Have Sex With Men: Systematic Review and Meta-Analysis

Chen,

Fang,

Chan

et al. 2024

JMIR Public Health Surveill

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Background Counseling supporting HIV self-testing (HIVST) is helpful in facilitating linkage to care and promoting behavior changes among men who have sex with men (MSM). Different levels of counseling support for MSM HIVST users may lead to variance in the linkage to care. Objective This study aims to synthesize evidence on counseling supporting MSM HIVST users and to conduct a meta-analysis to quantify the proportion of MSM HIVST users who were linked to care. Methods A systematic search was conducted using predefined eligibility criteria and relevant keywords to retrieve studies from the MEDLINE, Global Health, Web of Science, Embase, APA PsycINFO, and Scopus databases. This search encompassed papers and preprints published between July 3, 2012, and June 30, 2022. Studies were eligible if they reported counseling supporting HIVST or quantitative outcomes for linkage to care among MSM and were published in English. The screening process and data extraction followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The quality of the included studies was assessed by the National Institutes of Health quality assessment tool. Data were extracted using random effects models to combine the proportion of HIVST users who were linked to care. Subgroup analyses and metaregression were conducted to assess whether linkage to care varied according to study characteristics. All analyses were performed with R (version 4.2.1; R Foundation for Statistical Computing) using the metafor package. Results A total of 55 studies published between 2014 and 2021, including 43 observational studies and 12 randomized controlled trials, were identified. Among these studies, 50 (91%) provided active counseling support and 5 (9%) provided passive counseling support. In studies providing active counseling support, most MSM HIVST users were linked to various forms of care, including reporting test results (97.2%, 95% CI 74.3%-99.8%), laboratory confirmation (92.6%, 95% CI 86.1%-96.2%), antiretroviral therapy initiation (90.8%, 95% CI 86.7%-93.7%), and referral to physicians (96.3%, 95% CI 85%-99.2%). In studies providing passive counseling support, fewer MSM HIVST users were linked to laboratory confirmation (78.7%, 95% CI 17.8%-98.4%), antiretroviral therapy initiation (79.1%, 95% CI 48.8%-93.7%), and referral to physicians (79.1%, 95% CI 0%-100%). Multivariate metaregression indicated that a higher number of essential counseling components, a smaller sample size (<300), and the use of mobile health technology to deliver counseling support were associated with better linkage to care. The quality of the studies varied from fair to good with a low to high risk of bias. Conclusions Proactively providing counseling support for all users, involving a higher number of essential components in the counseling support, and using mobile health technology could increase the linkage to care among MSM HIVST users. Trial Registration PROSPERO CRD42022346247; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=346247

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“…3 Like other key populations, transgender women often do not have access to adequate STI testing services or are prevented from seeking STI-related care due to concerns about autonomy, inconvenience, stigma, discrimination, and lack of privacy. 3,4 Gender-insensitive health care has also been associated with a lower likelihood of STI testing among transgender women. 5 Sexually transmitted infection testing requires a sample of blood, urine, or specimens collected at relevant anatomical sites (ie, anorectal or oropharyngeal) to provide accurate pathogen detection for targeted treatment.…”

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confidence: 99%

“…Sexually transmitted infection testing services are crucial components of a comprehensive response to HIV and STIs 3 . Like other key populations, transgender women often do not have access to adequate STI testing services or are prevented from seeking STI-related care due to concerns about autonomy, inconvenience, stigma, discrimination, and lack of privacy 3,4 . Gender-insensitive health care has also been associated with a lower likelihood of STI testing among transgender women 5 …”

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confidence: 99%

Acceptability and Usability of Self-Sampling for the Detection of Sexually Transmitted Infections Among Transgender Women: The TransOdara Multicentric Study in Brazil

McCartney,

Bassichetto,

Leal

et al. 2024

Sexual Trans Dis

Self Cite

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Background The effective testing of sexually transmitted infections (STIs) requires sampling from potential infection sites. This study aimed to assess the choice, satisfaction, and performance of self-collected samples (SCS) from potential infection sites for STI testing among transgender women in Brazil. Methods TransOdara was a multicentric, cross-sectional STI prevalence study conducted in 5 Brazilian cities. Using respondent-driven sampling, 1317 transgender women 18 years or older were recruited. Participants completed interviewer-led questionnaires and provided swab samples from multiple sites (anorectal, oropharyngeal, genital) for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and human papillomavirus (HPV) testing. Participants were given a choice of SCS or provider-collected samples (PCS) at each site. Results Most participants selected SCS for anorectal (74.9%; 95% confidence interval [CI], 72.4–77.3) and genital (72.7%; 95% CI, 70.2–75.1) sites, whereas fewer chose for oropharyngeal samples (49.8%; 95% CI, 47.0–52.6). For future testing, most participants expressed a preference for SCS for genital (72.2%; 95% CI, 69.5–74.7) and anorectal (70.2%; 95% CI, 67.6–72.7) sites. There was no significant difference in the positive test results for CT and NG between SCS and PCS at anorectal and oropharyngeal sites, or for HPV at anorectal and genital (penile or neovaginal) sites. Conclusions This study demonstrated a high level of acceptability and usability of self-sampling for STI testing among transgender women. A preference for SCS was evident at the anorectal and genital sites, and the results of SCS were comparable to those of PCS. The findings suggest that multisite STI testing utilizing self-collection methods as a provided option can be effectively integrated into sexual health services for transgender women.

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HIV Testing Strategies, Types of Tests, and Uptake by Men Who have Sex with Men and Transgender Women: A Systematic Review and Meta-analysis

Cited by 5 publications

References 241 publications

Diagnostic performance evaluation of urine HIV-1 antibody rapid test kits in a real-life routine care setting in China

Diagnostic performance evaluation of urine HIV-1 antibody rapid test kits in a real-life routine care setting in China

Counseling Supporting HIV Self-Testing and Linkage to Care Among Men Who Have Sex With Men: Systematic Review and Meta-Analysis

Acceptability and Usability of Self-Sampling for the Detection of Sexually Transmitted Infections Among Transgender Women: The TransOdara Multicentric Study in Brazil

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