Usage of purchased self-tests for HIV infections among migrants living in the UK, France and the Netherlands: a cross-sectional study

Bil, Janneke P.; Prins, Maria; Fakoya, Ibidun; Volny‐Anne, Alain; Burns, Fiona; Zuure, Freke

doi:10.1136/sextrans-2018-053583

Cited by 6 publications

(3 citation statements)

References 10 publications

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“…Free and easy to access self-tests could also lower the barrier for stigma among several risk groups [ 30 ]. In addition, HIV awareness on early testing in disproportionately affected subgroups should be increased among general practitioners and other healthcare workers.…”

Section: Discussionmentioning

confidence: 99%

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Characteristics and short- and long-term direct medical costs among adults with timely and delayed presentation for HIV care in the Netherlands

Popping

Versteegh²,

Nichols³

et al. 2023

PLoS ONE

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Introduction In Europe, half of people living with HIV (PLWH) present late to care, with associated higher morbidity and mortality. This study aims to assess short- and long-term costs of HIV-care based on time of presentation and identify other factors contributing to higher costs in the first and fifth year after antiretroviral therapy (ART) initiation. Material and methods We included ATHENA cohort data which prospectively includes 98% of PLWH in the Netherlands. PLWH who initiated ART in 2013 were included and followed over five years. PLWH were divided in three categories based on CD4 cell-count at time of ART initiation: timely presentation (CD4>350cells/μL), late presentation (CD4 200-350cells/μL or >350cells/μL with AIDS-defining illness) and very late presentation (CD4<200cells/μL). The total HIV-care cost was calculated distinguishing ART medication and non-ART medication costs (hospitalization, outpatient clinic visits, co-medications, and HIV-laboratory tests). Results From 1,296 PLWH, 273 (21%) presented late and 179 (14%) very late. Nearly half of those who entered HIV-care in a very late stage were of non-Dutch origin, with 21% originating from sub-Saharan Africa. The mean cost per patient in the first year was €12,902 (SD€11,098), of which about two-thirds due to ART (€8,250 (SD€3,142)). ART costs in the first and fifth year were comparable regardless of time of presentation. During the first year on treatment, non-ART medication costs were substantially higher among those with late presentation (€4,749 (SD€8,009)) and very late presentation (€15,886 (SD€ 21,834)), compared with timely presentation (€2,407(SD€4,511)). Higher non-ART costs were attributable to hospitalization and co-medication. The total non-ART costs incurred across five years on treatment were 56% and 246% higher for late and very late presentation respectively as compared to timely presentation. Conclusion Very late presentation is associated with substantial costs, with non-ART costs nearly seven times higher than for those presenting timely. Hospitalization and co-medication costs are likely to continue to drive higher costs for individuals with late presentation into the future. Programs that identify individuals earlier will therefore likely provide significant short- and long-term health cost savings.

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Section: Discussionmentioning

confidence: 99%

“…Therefore migrants are placed at risk of poor HIV related clinical outcomes [29]. In order to reach this unaware population more aggressive testing could be performed by for example HIV indicator condition testing or implement the distribution of HIV self-tests [30][31][32].…”

Section: Plos Onementioning

confidence: 99%

Characteristics and short- and long-term direct medical costs among adults with timely and delayed presentation for HIV care in the Netherlands

Popping

Versteegh²,

Nichols³

et al. 2023

PLoS ONE

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“…HIV self-testing (HIVST) enables people to test for HIV conveniently and privately and is a promising tool to improve HIV testing uptake among migrant GBMSM ( 27 , 28 ). Studies from several countries have confirmed that access to HIVST kits increases HIV testing uptake and frequency among GBMSM ( 29 – 32 ).…”

Section: Introductionmentioning

confidence: 99%

Preferences for HIV Testing Services and HIV Self-Testing Distribution Among Migrant Gay, Bisexual, and Other Men Who Have Sex With Men in Australia

et al. 2022

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BackgroundIn Australia, undiagnosed HIV rates are much higher among migrant gay, bisexual, or other men who have sex with men (GBMSM) than Australian-born GBMSM. HIV self-testing is a promising tool to overcome barriers to HIV testing and improve HIV testing uptake among migrant GBMSM. We compared the preferences for HIV testing services, including HIV self-testing, among migrant and Australian-born GBMSM.MethodsPreferences were assessed via two discrete choice experiments (DCEs). Participants were recruited between December 2017 and January 2018 using online and offline advertising and randomly assigned to complete one of two online DCE surveys. Migrant GBMSM were classified as being born in a country with a reciprocal healthcare agreement (RHCA) with Australia (providing free or subsided health care) or not. Latent class analysis and mixed logit models were used to explore heterogeneity in preferences.FindingsWe recruited 1,606 GBMSM, including 583 migrant men of whom 419 (72%) were born in non-RHCA countries. Most participants preferred a free or cheap oral test with higher accuracy and a shorter window period to facilitate early detection of infections. Cost was more important for men born in non-RHCA countries than for men from RHCA countries or Australia. All groups preferred accessing kits through online distributers or off the shelf purchasing from pharmacies. Men born in RHCA countries least preferred accessing HIV self-testing kits from a medical clinic, while more than half of men from non-RHCA countries most preferred sourcing kits from a clinic. Sex-on-premises venues were the least preferred location to access test kits among all groups. In addition, two latent class analyses explored heterogeneity in preferences among men from non-RHCA countries and we found four latent classes for HIV testing services and two latent classes for HIVST distribution.InterpretationOur findings emphasise the need for high-performing and low-cost HIV self-testing kits that are accessible from a variety of distribution points as a component of Australia's HIV response, especially for those who do not have access to free or subsidised health care in Australia.

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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

Magno

Pereira²,

Castro³

et al. 2022

AIDS Behav

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Usage of purchased self-tests for HIV infections among migrants living in the UK, France and the Netherlands: a cross-sectional study

Cited by 6 publications

References 10 publications

Characteristics and short- and long-term direct medical costs among adults with timely and delayed presentation for HIV care in the Netherlands

Characteristics and short- and long-term direct medical costs among adults with timely and delayed presentation for HIV care in the Netherlands

Preferences for HIV Testing Services and HIV Self-Testing Distribution Among Migrant Gay, Bisexual, and Other Men Who Have Sex With Men in Australia

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

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