Repeat HIV Testing at Voluntary Testing and Counseling Centers in Croatia: Successful HIV Prevention or Failure to Modify Risk Behaviors?

Puljić, Vlatka Matković; Ličina, Mirjana Lana Kosanović; Kavić, Marija; Blažić, Tatjana Nemeth

doi:10.1371/journal.pone.0093734

Cited by 17 publications

(13 citation statements)

References 17 publications

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“…This has a serious impact on planning and response to the HIV epidemic as resources might be wasted. Contrary to our findings, repeat/multiple testing has been mostly reported in people with prior HIV negative or unknown statuses [ 16 - 20 ]. Secondary and higher levels of education were associated with increasing odds of ever being tested, similar to findings in studies in SSA and Europe [ 16 , 17 , 20 ].…”

Section: Discussioncontrasting

confidence: 99%

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Challenges and barriers to HIV service uptake and delivery along the HIV care cascade in Cameroon

Meka¹,

Billong²,

Diallo³

et al. 2020

Pan Afr Med J

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Introduction The year 2017 marked a transition period with the end of the implementation of Cameroon´s 2014-2017 HIV/AIDS National Strategic Plan (NSP) and the development of the 2018-2022 NSP. We assessed barriers and challenges to service delivery and uptake along the HIV care cascade in Cameroon to inform decision making within the framework of the new NSP, to achieve the UNAIDS 90-90-90 target. Methods We conducted a cross sectional descriptive study nationwide, enrolling HIV infected patients and staff. Data were collected on sociodemographic characteristics, HIV testing, antiretroviral therapy and viral load testing delivery and uptake and factors that limit their access. Results A total of 137 staff and 642 people living with HIV (PLHIV) were interviewed. Of 642 PLHIV with known status, 339 (53%) repeated their HIV test at least once, with range: 1-10 and median: 2 (IQR: 1-3). Having attained secondary level of education (OR: 2.07, 95% CI: 1.04-4.14; P=0.04) or more (OR: 2.91, 95% CI: 1.16-7.28; P=0.02) were significantly associated with repeat testing. Psychological (refusal of service uptake and existence of HIV), community-level (stigmatization and fear of confidentiality breach) and commodity stock-outs “HIV test kits (21%), antiretrovirals (ARVs) (71.4%), viral load testing reagents (100%)” are the major barriers to service delivery and uptake along the cascade. Conclusion We identified individual, community-level, socio-economic and health care system related barriers which constitute persistent bottlenecks in HIV service delivery and uptake and a high rate of repeat testing by PLHIV with known status. Addressing all these accordingly can help the country achieve the UNAIDS 90-90-90 target.

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Section: Discussioncontrasting

confidence: 99%

“…Sex was not associated with repeat HIV testing in our study as reported by Matković Puljić et al . in Croatia [ 16 ] and Hensen et al in Zambia [ 17 ]. Forty per cent (40%) of people living with HIV are not aware of their HIV-positive status [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Challenges and barriers to HIV service uptake and delivery along the HIV care cascade in Cameroon

Meka¹,

Billong²,

Diallo³

et al. 2020

Pan Afr Med J

View full text Add to dashboard Cite

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“…The searches yielded 15 004 records after de‐duplication; after full‐text review, 368 studies were included in the overall systematic review (Figure ). Of the 368 studies, 130 are described in this paper, exploring interventions and feasibility of HIV testing in health care settings in Europe, including 84 peer‐reviewed articles and 46 conference proceedings (Table ) .…”

Section: Resultsmentioning

confidence: 99%

“…Other testing strategies included routine testing ( n = 32) , provision of HIV testing as a component of an integrated testing programme ( n = 29) , IC testing ( n = 14) and partner notification ( n = 4) . Routine testing was most commonly implemented in hospital departments including emergency departments ( n = 15) , inpatient units ( n = 10) and outpatient departments ( n = 4) .…”

Section: Resultsmentioning

confidence: 99%

HIV testing strategies employed in health care settings in the European Union/European Economic Area (EU/EEA): evidence from a systematic review

et al. 2019

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Objectives Despite the availability of HIV testing guidelines to facilitate prompt diagnosis, late HIV diagnosis remains high across Europe. The study synthesizes recent evidence on HIV testing strategies adopted in health care settings in the European Union/European Economic Area (EU/EEA). Methods Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines were followed and systematic searches were run in five databases (2010–2017) to identify studies describing HIV testing interventions in health care settings in the EU/EEA. The grey literature was searched for unpublished studies (2014–2017). Two reviewers independently performed study selection, data extraction and critical appraisal. Results One hundred and thirty intervention and/or feasibility studies on HIV testing in health care settings were identified. Interventions included testing provision (n = 94), campaigns (n = 14) and education and training for staff and patients (n = 20). HIV test coverage achieved through testing provision varied: 2.9–94% in primary care compared to 3.9–66% in emergency departments. HIV test positivity was lower in emergency departments (0–1.3%) and antenatal services (0–0.05%) than in other hospital departments (e.g. inpatients: 0–5.3%). Indicator condition testing programmes increased HIV test coverage from 3.9–72% before to 12–85% after their implementation, with most studies reporting a 10–20% increase. There were 51 feasibility and/or acceptability studies that demonstrated that HIV testing interventions were generally acceptable to patients and providers in health care settings (e.g. general practitioner testing acceptable: 77–93%). Conclusions This review has identified several strategies that could be adopted to achieve high HIV testing coverage across a variety of health care settings and populations in the EU/EEA. Very few studies compared the intervention under investigation to a baseline, but, where this was assessed, data suggested increases in testing.

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“…However, it is interesting to note that the proportion of a previous HIV test is similar between groups, suggesting that both groups may have similar perceived high risk of acquiring HIV. 29 30 …”

Section: Strengths and Limitationsmentioning

confidence: 99%

The Lisbon Cohort of men who have sex with men

et al. 2015

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PurposeNewly diagnosed HIV infections among men who have sex with men (MSM) are rising in many European countries. Surveillance tools must be tailored to the current state of the epidemic, and include decentralised prospective monitoring of HIV incidence and behavioural changes in key populations. In this scenario, an open prospective cohort study was assembled—The Lisbon Cohort of MSM—aiming to dynamically monitor the frequency of disease and its predictors.ParticipantsThe Lisbon Cohort of MSM is an ongoing observational prospective study conducted at a community-based voluntary HIV counselling and testing centre in Lisbon, Portugal (CheckpointLX). Men testing negative for HIV, aged 18 or over and reporting having had sex with men are invited to follow-up visits every 6 months. At each evaluation, a face-to-face interview using a structured questionnaire is conducted, and HIV and syphilis rapid tests are performed by trained peer counsellors. From April 2011 to February 2014, 3106 MSM were eligible to the cohort of whom 923 (29.7%) did not participate. The remaining 2183 (70.3%) MSM were enrolled and 804 had at least one follow-up evaluation, for a total of 893 person-years of observation.Future plansThe study findings will be disseminated in peer-reviewed journals and presented at national and international conferences. The follow-up of this cohort of HIV-negative MSM will be a valuable tool for monitoring HIV incidence in a setting where limited prospective information existed. Moreover, it will allow for a deeper analytical approach to the study of population time trends and individual changes in risk factors that currently shape the HIV epidemic among MSM.

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Repeat HIV Testing at Voluntary Testing and Counseling Centers in Croatia: Successful HIV Prevention or Failure to Modify Risk Behaviors?

Cited by 17 publications

References 17 publications

Challenges and barriers to HIV service uptake and delivery along the HIV care cascade in Cameroon

Challenges and barriers to HIV service uptake and delivery along the HIV care cascade in Cameroon

HIV testing strategies employed in health care settings in the European Union/European Economic Area (EU/EEA): evidence from a systematic review

The Lisbon Cohort of men who have sex with men

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