The Impact of Providing Free HIV Self-testing on Sexual Risk Behaviors Among Men who have Sex with Men in Hunan, China: A Randomized Controlled Trial

Zhang, Ci; Goldsamt, Lloyd A.; Zheng, Sining; Qian, Han-Zhu; Wang, Honghong; Li, Qing; Li, Xianhong; Koniak‐Griffin, Deborah

doi:10.1007/s10461-022-03804-4

Cited by 4 publications

(2 citation statements)

References 34 publications

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“…[5][6][7] RCTs of HIV screening strategies have also been reported in studies outside of the United States, including Africa, [8][9][10][11] Australia, United Kingdom, 13 and China. [14][15][16] Cost-effectiveness analyses of HIV screening strategies have used conventional modeling methods, such as decision trees, Markov models, dynamic models, and individual-and population-based models, [17][18][19][20][21][22] while mostly using cohort data as model inputs with a few studies using RCT data to calibrate the model. 22,23 However, net-benefit regression 24 can also be used to conduct cost-effectiveness analyses of HIV screening strategies using person-level data obtained from an RCT.…”

Section: Introductionmentioning

confidence: 99%

Estimating the Cost-Effectiveness of HIV Self-Testing in the United States Using Net Benefit Regression

Islam,

Shrestha,

Hoch

et al. 2024

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background: Cost-effectiveness analysis of HIV self-testing using patient-level data from a randomized clinical trial can inform HIV prevention funding decisions. Cost-effectiveness analysis using net benefit regression addresses the sampling uncertainty in the trial data and the variability of policymakers’ willingness to pay (WTP). Methods: We used published data from a 12-month longitudinal randomized clinical trial that enrolled 2665 men who sex with men (MSM) randomly assigned to the self-testing arm (participants receiving self-test kits) and control arm (participants receiving standard-of-care), and the self-testing arm identified 48 additional new HIV cases. We used net benefit regression to investigate the cost-effectiveness of an HIV self-testing intervention, which compared the incremental cost per new HIV diagnosis with policymakers’ WTP thresholds. We addressed the uncertainties in estimating the incremental cost and the policymakers’ WTP per new diagnosis through the incremental net benefit (INB) regression and cost-effectiveness acceptability curve (CEAC) analyses. Results: From the healthcare provider’s perspective, the INB analysis showed a positive net-benefit of HIV self-testing compared to standard-of-care when policymakers’ WTP per new HIV diagnosis was $9,365 (95% CI: $5,700 - $25,500) or higher. The CEAC showed that the probability of HIV self-testing being cost-effective compared to standard-of-care was 58% and >99% at a WTP of $10 000 and $50 000 per new HIV diagnosis, respectively. Conclusion: The INB and CEAC analyses suggest that HIV self-testing has the potential to be cost-effective for relatively low values of policymakers’ WTP.

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Section: Introductionmentioning

confidence: 99%

Estimating the Cost-Effectiveness of HIV Self-Testing in the United States Using Net Benefit Regression

Islam,

Shrestha,

Hoch

et al. 2024

JAIDS Journal of Acquired Immune Deficiency Syndromes

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“…Risk compensation refers to an increase in risk-related behaviors when an intervention diminishes an individual's or population's perception of risk [8,9]. Current research on sexual risk compensation includes HIV pre-exposure prophylaxis (PrEP) and HIV self-testing (HIVST) [10,11]. Similar to PrEP and HIVST, receiving HIV serostatus disclosure from partners before sex increases MSM's sense of safety.…”

Section: Introductionmentioning

confidence: 99%

Sexual Risk Behaviors and HIV Incidence Among Men Who Have Sex with Men in Southern China: Investigating the Role of HIV Serostatus Disclosure

Mo,

Tian,

Wang

et al. 2023

Preprint

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Background The impact of HIV serostatus disclosure on sexual risk behaviors and HIV risk among men who have sex with men (MSM) is unclear. We aim to examine associations between receiving HIV serostatus disclosure from partners before sex and sexual risk behaviors and reveal the impact of such disclosure on HIV incidence. Methods We recruited HIV-negative MSM who had reported engaging in homosexual encounters within the previous 6 months. Participants completed questionnaires every 3 months and were tracked for 12 months. Generalized Estimation Equations (GEE) were used to evaluate factors associated with receiving HIV serostatus disclosure from partners and to examine the impact of receiving this disclosure on sexual risk behaviors. Results Among 363 participants, 350 completed at least one follow-up. On average, 50.60% (95% CI: 47.30%-53.70%) of participants received HIV serostatus disclosure from sexual partnersduring the follow-up visits.The HIV incidence was 1.47 per 100 person-years (95% CI: 0.479-3.398). Participants who had tested for HIV in the last 3 months (aOR=3.145, 95% CI: 2.109-4.691; P＜0.001) were more likely to receive HIV serostatus disclosure from partners. Conversely, Participants who have male casual partners (aOR=0.209, 95% CI: 0.127-0.346, P＜0.001) were less likely to receive such disclosure.Adjusting for potential confounders in GEE models, receiving HIV serostatus disclosure from partners is not a contributing factor to multiple partners (aOR=0.468, 95% CI: 0.347-0.632, P＜0.001). There was no significant association between receiving HIV serostatus disclosure and engaging in unprotected anal intercourse (OR=1.128, 95% CI: 0.876-1.453, P=0.351). MSM who did not consistently receive HIV serostatus disclosure from their partners appeared to have a higher seroconversion rate than those who consistently received such disclosure, though the difference was not statistically significant (IRR=0.531; 95%CI=0.060-4.699, P=1.000). Conclusion Our study found that the proportion of MSM who received HIV serostatus disclosure from their partners before sex was relatively low. HIV testing facilitates HIV serostatus disclosure. Receiving HIV serostatus disclosure from partners before sex does not increase risky sex. These findings promote regular HIV testing and encourage HIV serostatus disclosure with sexual partners.

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Effectiveness of Linkage to Care and Prevention Interventions Following HIV Self-Testing: A Global Systematic Review and Meta-analysis

Adeagbo,

Badru,

Nkfusai

et al. 2023

AIDS Behav

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The Impact of Providing Free HIV Self-testing on Sexual Risk Behaviors Among Men who have Sex with Men in Hunan, China: A Randomized Controlled Trial

Cited by 4 publications

References 34 publications

Estimating the Cost-Effectiveness of HIV Self-Testing in the United States Using Net Benefit Regression

Estimating the Cost-Effectiveness of HIV Self-Testing in the United States Using Net Benefit Regression

Sexual Risk Behaviors and HIV Incidence Among Men Who Have Sex with Men in Southern China: Investigating the Role of HIV Serostatus Disclosure

Effectiveness of Linkage to Care and Prevention Interventions Following HIV Self-Testing: A Global Systematic Review and Meta-analysis

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