HIV Voluntary Counseling and Testing (VCT-HIV) effectiveness for sexual risk-reduction among key populations: A systematic review and meta-analysis

Costa, Ângelo Brandelli; Viscardi, Lucas Henriques; Feijó, Marina; Fontanari, Anna Martha Vaitses

doi:10.1016/j.eclinm.2022.101612

Cited by 10 publications

(8 citation statements)

References 40 publications

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“…This may stem from passive testing-detected individuals displaying inadequate HIV testing awareness and deficient HIV knowledge. In contrast, those identified through VCT exhibit more risk awareness and will voluntarily mitigate risky sexual behavior following the consultation [ 31 , 32 ]. Despite the gradually decreasing HRHB risk among MSM, the high potential for transmission persists, given the extensive population of bisexual individuals who function as a "bridge".…”

Section: Discussionmentioning

confidence: 99%

Behavioral verification and risk factors of HIV cross-population transmission in China: analysis of national surveillance data 1989–2022

Cai,

Tang,

Qin

et al. 2024

BMC Infect Dis

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Introduction The dynamic HIV/AIDS epidemic significantly impacts China, particularly affecting injection drug users (IDUs), former plasma donors (FPDs), men who have sex with men (MSM), and those engaging in high-risk heterosexual behavior (HRHB). This study specifically focuses on identifying the risk factors and influences that drive the spread of HIV among these population groups by performing a comprehensive analysis of contact histories of individuals diagnosed with HIV. Methods Data for this research were gathered from China’s HIV/AIDS Comprehensive Response Information Management System (CRIMS). Contact histories were described using bar and venn diagram. Trend in engaging in HBRB among MSM were identify potential change using the Cochran-Armitage test. Logistic regression was employed to analyze the factors influencing HBRB in MSM. Results From 1989 through to 2022, a total of 1,457,218 individuals aged 15 years or older in China, who reported being infected with HIV, indicated they had one or more types of contact histories including injecting drug use, male homosexual behavior, commercial plasma donation, and high-risk heterosexual behavior. Among these, 97.0% reported a single type of contact history, while 3.0% reported having multiple contact histories. Of those with multiple contact histories, 98.0% (42,258 individuals) had engaged in HRHB. Among all HIV-infected IDUs, MSM, and FPDs, their respective proportions of engagement in HRHB were 11.8%, 5.7% and 6.2%. Prior to 2012, most were reported to be IDUs; however, subsequent to this, most reported being MSM. Factors that heightened the risk of engaging in HRHB among HIV-infected MSM included being of age between 25–34 years [adjusted odds ratio (AOR) = 1.29] or 35–44 years (AOR = 1.22), marital status such as being married (AOR = 1.23) or being divorced/widowed (AOR = 1.17), belonging to an ethnic minority (AOR = 1.29), receiving diagnosis in hospitals (AOR = 1.81), residing in rural areas (AOR = 1.12), among others. However, the risk of HRHB decreased when age ≥ 55 years (55–64 years: AOR = 0.82; ≥ 65 years: AOR = 0.64). Conclusion The potential for HIV transmission among diverse populations is substantial. As such, it is imperative that strategies are implemented to mitigate the propagation of HIV to the general populace via heterosexual intercourse.

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Section: Discussionmentioning

confidence: 99%

Behavioral verification and risk factors of HIV cross-population transmission in China: analysis of national surveillance data 1989–2022

Cai,

Tang,

Qin

et al. 2024

BMC Infect Dis

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“…The present study observed a higher HPR in VCT clinics compared to medical institutions in a previous study ( 5 ). This discrepancy can primarily be attributed to the fact that VCT clinics primarily serve individuals engaged in high-risk sexual behaviors ( 3 ). In medical institutions, HIV testing mainly involves mandatory tests associated with surgeries and invasive procedures, and provider-initiated testing and counseling (PITC) services ( 5 ).…”

Section: Discussionmentioning

confidence: 99%

“…It is primarily through these VCT clinics that individuals from high-risk populations are able to access essential HIV testing services. Monitoring the HIV cases reported by these VCT clinics can provide valuable insights into the trends in HIV prevalence among high-risk populations ( 3 ).…”

mentioning

confidence: 99%

Temporal and Spatial Trends in HIV Positivity Rate for VCT Clinics — China, 2015–2022

Liu,

Su,

et al. 2024

China CDC Weekly

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Introduction Human immunodeficiency virus (HIV) voluntary counseling and testing (VCT) clinics play a critical role in identifying and diagnosing HIV cases. This study aimed to describe the trend of HIV positivity rate (HPR) among Chinese VCT clinics between 2015 and 2022. Methods This study utilized data from the China Information System for Disease Control and Prevention to analyze the trend in the HPR for VCT clinics from 2015 to 2022. The HPR was calculated by dividing the number of newly-reported HIV cases by the number of HIV tests, multiplied by 100%. To identify temporal and spatial trends in the HPR, we employed joinpoint regression analysis and the Getis-Ord hotspot analysis. Results From 2015 to 2022, VCT clinics in China performed a total of 22,075,386 HIV tests, leading to the identification of 260,353 HIV cases, resulting in a HPR of 1.18%. The HPR consistently declined over the study period, with an average annual percent change (AAPC) of −7.5% (95% confidence interval: −12.6%, −2.2%, P <0.05). The number of HPR hotspots also decreased from 41 in 2015 to 23 in 2022. These HPR hotspots were primarily located in Yunnan, Sichuan, Guangdong, and Guangxi provincial-level administrative divisions (PLADs). Among the 31 PLADs, 16 showed a significant decrease in HPR during the study period (AAPC<0, P AAPC <0.05). Conclusions VCT clinics in China have played a significant role in identifying HIV cases. The declining HPR observed in these clinics may indicates the progress has been made in some degree in mitigating HIV among high-risk populations. Therefore, it is crucial to further improving the utilization of VCT clinics for HIV testing.

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“…This could result in missing important conditions for implementation in the realist setting and the long-term impact of home-based CSH. As most included studies focused on MSM, information is lacking for other key populations, a common occurrence [75, 86, 87]. Therefore, future research should consider sampling key populations such as migrants, transgender people and sex workers.…”

Section: Discussionmentioning

confidence: 99%

Understanding Reach, Effectiveness, Adoption, Implementation, and Maintenance of home-based comprehensive sexual health care: a Realist Review

Goense,

Doan,

Kpokiri

et al. 2023

Preprint

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BackgroundTesting forhuman immunodeficiency virus(HIV) and sexually transmitted infections (STI) is increasingly offered outside a clinic-based setting. Among key populations barriers to accessing testing and sexual health care may could be lowered due to home-based testing and care services. This review identifies which elements of home-based comprehensive sexual health care (home-based CSH) impacted which key populations, under which circumstances.MethodsA realist review of studies focused on home-based CSH with at least self-sampling or self-testing HIV and additional sexual health care (e.g., treatment, counselling). PubMed, Embase, Cochrane Register of Controlled Trials, and PsycINFO databases were searched. Peer-reviewed quantitative and qualitative literature published between February 2012 and February 2023 was examined. The RE-AIM framework was used to systematically assess the (R) reach of key populations, (E) effectiveness of the intervention, and (AIM) effects on the adoption, implementation, and maintenance within routine sexual health care.ResultsOf 730 uniquely identified records, 92 were selected for extraction. Of these studies, 59% (54/92) reported actual interventions and 41% (38/92) described the acceptability and feasibility. Studies were mainly based in Europe or North America and were mostly targeted to MSM (59%; 55/92) (R). Overall, self-sampling or self-testing was highly acceptable across key populations. The effectiveness (E) of most studies was (expected) increased HIV testing. Adoption (A) of the home-based CSH was acceptable for care providers if linkage to care was available, even though a minority of studies reported adoption by care providers and implementation fidelity (I) of the intervention. In terms of maintenance (M), home-based CSH should be institutionalised and complementary to clinic-based sexual health care.ConclusionsFive key findings were identified which may enhance implementation of home-based CSH. When providing the individual with a choice of testing, clear instructions, and tailored dissemination successful uptake of HIV testing may increase. For implementers perceived care and treatment benefits for clients may increase their willingness to implement home-based CSH. Therefore, home-based CSH may determine more accessible sexual health care and increased uptake of HIV testing among key populations.

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HIV Voluntary Counseling and Testing (VCT-HIV) effectiveness for sexual risk-reduction among key populations: A systematic review and meta-analysis

Cited by 10 publications

References 40 publications

Behavioral verification and risk factors of HIV cross-population transmission in China: analysis of national surveillance data 1989–2022

Behavioral verification and risk factors of HIV cross-population transmission in China: analysis of national surveillance data 1989–2022

Temporal and Spatial Trends in HIV Positivity Rate for VCT Clinics — China, 2015–2022

Understanding Reach, Effectiveness, Adoption, Implementation, and Maintenance of home-based comprehensive sexual health care: a Realist Review

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