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Sample records for visual hiv test

  1. HIV Testing

    Science.gov (United States)

    ... Abroad Treatment Basic Statistics Get Tested Find an HIV testing site near you. Enter ZIP code or city Follow HIV/AIDS CDC HIV CDC HIV/AIDS See RSS | ... All Collapse All Should I get tested for HIV? CDC recommends that everyone between the ages of ...

  2. Rapid HIV testing using Determine™ HIV 1/2 antibody tests: is there a difference between the visual appearance of true- and false-positive tests?

    Science.gov (United States)

    Sacks, R; Omodele-Lucien, A; Whitbread, N; Muir, D; Smith, A

    2012-09-01

    HIV point-of-care tests (POCTs) give occasional false positive results, causing unnecessary patient anxiety. We aimed to elicit whether false- and true-positive POCTs differed visually. Seventeen false- and 17 true-positive serum samples were randomized into pairs, comprising one false- and one true-positive sample. Two independent readers identified each POCT as negative or positive and compared line strength between pairs. Six further readers graded line strength, 0-5, from POCT photographs. All true-positive samples were identified positive and 8/17 false-positive samples negative, on repeat testing of stored sera. Eight out of the 9 remaining false-positive tests were described as having weaker pigment uptake than their paired true-positive POCT. Mean grade of line strength was 4.2 in true- and 0.9 in false-positive samples, on photographic evaluation. These results suggest false-positive POCTs may differ visually from true-positive POCTs. If larger studies confirm these findings, we may be able to alleviate anxiety in low risk patients with faintly positive POCTs awaiting their confirmatory laboratory result, where the possibility of a false-positive result could be emphasized.

  3. HIV Genotypic Resistance Testing

    Science.gov (United States)

    ... that may be present in rare strains of HIV. The test may not detect a drug-resistant strain of ... Less Common Questions Related Content On This Site Tests: HIV Viral Load ; CD4 Count ; HIV Antibody and HIV ...

  4. HIV Genotypic Resistance Testing

    Science.gov (United States)

    ... High-sensitivity C-reactive Protein (hs-CRP) Histamine Histone Antibody HIV Antibody and HIV Antigen (p24) HIV ... antiretroviral drugs. With genotypic resistance testing, the genetic code of the HIV a person has been infected ...

  5. Performance of visual inspection with acetic acid and human papillomavirus testing for detection of high-grade cervical lesions in HIV positive and HIV negative Tanzanian women

    DEFF Research Database (Denmark)

    Dartell, Myassa Arkam; Rasch, Vibeke; Iftner, Thomas

    2014-01-01

    The aim of this cross sectional study was to assess type distribution of human papillomavirus (HPV) among HIV positive and HIV negative women who underwent cervical cancer screening, and to examine the ability of visual inspection with acetic acid (VIA), the standard detection method in Tanzania...

  6. National HIV Testing Day

    Centers for Disease Control (CDC) Podcasts

    2011-06-09

    Dr. Kevin A. Fenton, Director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, discusses National HIV Testing Day, an annual observance which raises awareness of the importance of knowing one's HIV status and encourages at-risk individuals to get an HIV test.  Created: 6/9/2011 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP).   Date Released: 6/9/2011.

  7. HIV Resistance Testing

    Science.gov (United States)

    ... 2016 Select a Language: Fact Sheet 126 HIV Resistance Testing WHAT IS RESISTANCE? HOW DOES RESISTANCE DEVELOP? ... one or more ARVs. This is called transmitted resistance. The more that HIV multiplies, the more mutations ...

  8. Visual acuity test

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/003396.htm Visual acuity test To use the sharing features on this page, please enable JavaScript. The visual acuity test is used to determine the smallest ...

  9. HIV testing in Europe

    DEFF Research Database (Denmark)

    Sullivan, Ann K; Sperle, Ida; Raben, Dorthe

    2017-01-01

    BACKGROUND: An evaluation of the 2010 ECDC guidance on HIV testing, conducted in October 2015-January 2016, assessed its impact, added value, relevance and usability and the need for updated guidance. METHODS: Data sources were two surveys: one for the primary target audience (health policymakers...... with other international guidance. Primary target audience respondents in 11 of 23 countries reported that they had used the guidance in development, monitoring and/or evaluation of their national HIV testing policy, guidelines, programme and/or strategy, and 29 of 51 of the broader target audience...... respondents reported having used the guidance in their work. Both the primary and broader target audience considered it important or very important to have an EU/EEA-level HIV testing guidance (23/28 and 46/51, respectively). CONCLUSION: The guidance has been widely used to develop policies, guidelines...

  10. Determinants of HIV testing.

    Science.gov (United States)

    Sawleshwarkar, Shailendra; Harrison, Christopher; Britt, Helena; Mindel, Adrian

    2011-08-01

    To determine the characteristics of general practitioners (GPs) who test and patients who are tested for HIV in Australia. A secondary analysis of data from the Bettering the Evaluation and Care of Health programme; a cross-sectional, national survey of GP activity. We identified GP, patient and encounter characteristics that were associated with HIV testing between April 2000 and March 2010. We looked at testing rates for patients with different characteristics, whether they had attended for screening and GP 'risk factor' identification. Multiple logistic regression was used to measure the independent effect of each GP, patient and encounter characteristic on testing for HIV. Data were available for 984,200 encounters from 9842 GPs. 1796 (18.2%) of GPs performed at least one HIV test. On logistic regression, independent predictors of HIV testing included the management of a 'risk factor' (OR 19.4, 95% CI 17.4 to 21.6), screening (OR 10.6, 95% CI 9.4 to 12.1), younger GP age, practice in a metropolitan area (OR 1.4, 95% CI 1.2 to 1.6), patient age, gender (male > female OR 3.0, 95% CI 2.7 to 3.3), being new to that practice (OR 2.1, 95% CI 1.8 to 2.3) and being Indigenous (OR 1.7, 95% CI 1.3 to 2.4). The most significant independent predictors of testing were identification of a risk factor and attendance for screening. Unless barriers to testing are addressed it is unlikely that altering guidelines alone will improve testing rates and reduce transmission.

  11. Predictive Validity And Usefulness Of Visual Scanning Task In Hiv ...

    African Journals Online (AJOL)

    To assess the predictive validity of computerized visual scanning test as a tool to screen for presence of brain damage in HIV/AIDS patients. Methods We used a neuropsychological tool, the computerized visual scanning task, a sensitive tool that discriminates between brain-damaged subjects and normal population, ...

  12. Get Tested for HIV

    Science.gov (United States)

    ... The Basics: What Is HIV? What is HIV? HIV stands for human immunodeficiency virus. This is the virus that causes AIDS. There is no cure yet for HIV/AIDS, but there are treatments that can help ...

  13. HIV Testing PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2017-11-28

    This 60 second public service announcement is based on the December 2017 CDC Vital Signs report. In the U.S., about 15 percent of people who have HIV don't know they have it. Learn about the importance of testing, early diagnosis, and treatment.  Created: 11/28/2017 by Centers for Disease Control and Prevention (CDC).   Date Released: 11/28/2017.

  14. Get Tested for HIV

    Science.gov (United States)

    ... AIDS from other websites National Women and Girls HIV/AIDS Awareness Day Blog topics HIV and AIDS Breaking Down ... t Miss a Beat National Women and Girls HIV/AIDS Awareness Day National Women's Health Week Supporting Nursing Moms ...

  15. Proposed national HIV testing policy.

    Science.gov (United States)

    Lal, S; Thakur, B B

    1993-11-01

    The National AIDS Control Organization of India is preparing a draft policy document on a national HIV testing policy. This paper presents some of the pertinent issues proposed for incorporation into that policy. Any testing procedure undertaken in the country must be in accordance with and part of the comprehensive control program on HIV. Testing upon an individual may be done to identify an individual infected with HIV for the diagnosis of clinically suspected AIDS, voluntary testing at the behest of the client, and for non-health purposes. For example, testing is also permitted to monitor the trend of HIV infection in a population or subgroup to guide eventual intervention; to test blood, organs, or tissue destined for donation; and for research on HIV infection. Such testing must be supported by social support and the means for intervention even if the testing is refused and ultimately not performed. All mandatory linked testing should be discouraged when it tends to identify an individual. Transfusion safety should be ensured throughout the country, with a single ESR test sufficing to avoid the risk of false negative results. The establishment of voluntary testing centers will be encouraged; the testing protocol using three ESR or three ESR with WB is considered scientific for identifying an infected individual; and surveillance is to be designed by the state epidemiologists/state program officers and carried out by the staff of the selected health institutions with samples tested in any HIV testing facility suitably situated and easily approachable by the staff of the surveillance site. Testing procedures for research must follow the highest international standards for scientific protocol. Test kits must be evaluated before they are manufactured indigenously. Finally, the existing HIV testing network will have to be restructured to carry out objective-wise testing, with internal and external quality assurance of the program rigorously implemented on a regular

  16. An Assessment of Visual Testing

    Energy Technology Data Exchange (ETDEWEB)

    Cumblidge, Stephen E.; Anderson, Michael T.; Doctor, Steven R.

    2004-11-01

    In response to increasing interest from nuclear utilities in replacing some volumetric examinations of nuclear reactor components with remote visual testing, the Pacific Northwest National Laboratory has examined the capabilities of remote visual testing for the Nuclear Regulatory Commission. This report describes visual testing and explores the visual acuities of the camera systems used to examine nuclear reactor components. The types and sizes of cracks typically found in nuclear reactor components are reviewed. The current standards in visual testing are examined critically, and several suggestions for improving these standards are proposed. Also proposed for future work is a round robin test to determine the effectiveness of visual tests and experimental studies to determine the values for magnification and resolution needed to reliably image very tight cracks.

  17. Ethnic Comparisons in HIV Testing Attitudes, HIV Testing, and Predictors of HIV Testing Among Black and White College Students.

    Science.gov (United States)

    Moore, Melanie P; Javier, Sarah J; Abrams, Jasmine A; McGann, Amanda Wattenmaker; Belgrave, Faye Z

    2017-08-01

    This study's primary aim was to examine ethnic differences in predictors of HIV testing among Black and White college students. We also examined ethnic differences in sexual risk behaviors and attitudes toward the importance of HIV testing. An analytic sample of 126 Black and 617 White undergraduatestudents aged 18-24 were analyzed for a subset of responses on the American College Health Association-National College Health Assessment II (ACHA-NCHA II) (2012) pertaining to HIV testing, attitudes about the importance of HIV testing, and sexual risk behaviors. Predictors of HIV testing behavior were analyzed using logistic regression. t tests and chi-square tests were performed to access differences in HIV test history, testing attitudes, and sexual risk behaviors. Black students had more positive attitudes toward testing and were more likely to have been tested for HIV compared to White students. A greater number of sexual partners and more positive HIV testing attitudes were significant predictors of HIV testing among White students, whereas relationship status predicted testing among Black students. Older age and history of ever having sex were significant predictors of HIV testing for both groups. There were no significant differences between groups in number of sexual partners or self-reports in history of sexual experience (oral, vaginal, or anal). Factors that influence HIV testing may differ across racial/ethnic groups. Findings support the need to consider racial/ethnic differences in predictors of HIV testing during the development and tailoring of HIV testing prevention initiatives targeting college students.

  18. Increasing HIV testing among male partners

    NARCIS (Netherlands)

    Orne-Gliemann, Joanna; Balestre, Eric; Tchendjou, Patrice; Miric, Marija; Darak, Shrinivas; Butsashvili, Maia; Perez-Then, Eddy; Eboko, Fred; Plazy, Melanie; Kulkarni, Sanjeevani; du Lou, Annabel Desgrees; Dabis, Francois

    2013-01-01

    Objective: Couple-oriented posttest HIV counselling (COC) provides pregnant women with tools and strategies to invite her partner to HIV counselling and testing. We conducted a randomized trial of the efficacy of COC on partner HIV testing in low/medium HIV prevalence settings (Cameroon, Dominican

  19. Successful treatment of bilateral visual loss caused by HIV ...

    African Journals Online (AJOL)

    Optic neuritis is not an uncommon diagnosis in HIV-infected patients, but it is rarely idiopathic. We report a case of a young HIV-infected woman who developed optic neuritis as her presenting manifestation of HIV infection. She had initially experienced sudden-onset right-sided painful visual loss; the left eye had become ...

  20. Auditing HIV Testing Rates across Europe

    DEFF Research Database (Denmark)

    Raben, D; Mocroft, A; Rayment, M

    2015-01-01

    European guidelines recommend the routine offer of an HIV test in patients with a number of AIDS-defining and non-AIDS conditions believed to share an association with HIV; so called indicator conditions (IC). Adherence with this guidance across Europe is not known. We audited HIV testing behaviour...... candidiasis. Observed HIV-positive rates were applied by region and IC to estimate the number of HIV diagnoses potentially missed. Outcomes examined were: HIV test rate (% of total patients with IC), HIV test accepted (% of tests performed/% of tests offered) and new HIV diagnosis rate (%). There were 49...... audits from 23 centres, representing 7037 patients. The median test rate across audits was 72% (IQR 32-97), lowest in Northern Europe (median 44%, IQR 22-68%) and highest in Eastern Europe (median 99%, IQR 86-100). Uptake of testing was close to 100% in all regions. The median HIV+ rate was 0.9% (IQR 0...

  1. Visual testing: searching for guidelines

    NARCIS (Netherlands)

    van Gendt, Kitty; Verhagen, Pleunes Willem; Crawford, Margaret; Simonson, Michael; Lamboy, Carmen

    2001-01-01

    An experiment was conducted to investigate the influence of the variables "realism" and "context" on the performance of biology students on a visual test about the anatomy of a rat. The instruction was primarily visual with additional verbal information like Latin names and practical information

  2. Screening for cervical cancer among HIV-positive and HIV-negative women in Cameroon using simultaneous co-testing with careHPV DNA testing and visual inspection enhanced by digital cervicography: Findings of initial screening and one-year follow-up.

    Science.gov (United States)

    Cholli, Preetam; Bradford, Leslie; Manga, Simon; Nulah, Kathleen; Kiyang, Edith; Manjuh, Florence; DeGregorio, Geneva; Ogembo, Rebecca K; Orock, Enow; Liu, Yuxin; Wamai, Richard G; Sheldon, Lisa Kennedy; Gona, Philimon N; Sando, Zacharie; Welty, Thomas; Welty, Edith; Ogembo, Javier Gordon

    2018-01-01

    The World Health Organization (WHO)'s cervical cancer screening guidelines for limited-resource settings recommend sequential screening followed by same-day treatment under a "screen-and-treat" approach. We aimed to (1) assess feasibility and clinical outcomes of screening HIV-positive and HIV-negative Cameroonian women by pairing visual inspection with acetic acid and Lugol's iodine enhanced by digital cervicography (VIA/VILI-DC) with careHPV, a high-risk human papillomavirus (HR-HPV) nucleic acid test designed for low-resource settings; and (2) determine persistence of HR-HPV infection after one-year follow-up to inform optimal screening, treatment, and follow-up algorithms. We co-tested 913 previously unscreened women aged ≥30years and applied WHO-recommended treatment for all VIA/VILI-DC-positive women. Baseline prevalence of HR-HPV and HIV were 24% and 42%, respectively. On initial screen, 44 (5%) women were VIA/VILI-DC-positive, of whom 22 had HR-HPV infection, indicating 50% of women screened false-positive and would have been triaged for unnecessary same-day treatment. VIA/VILI-DC-positive women with HIV infection were three times more likely to be HR-HPV-positive than HIV-negative women (65% vs. 20%). All women positive for either VIA/VILI-DC or HR-HPV (n=245) were invited for repeat co-testing after one year, of which 136 (56%) returned for follow-up. Of 122 women who were HR-HPV-positive on initial screen, 60 (49%) re-tested negative, of whom 6 had received treatment after initial screen, indicating that 44% of initially HR-HPV-positive women spontaneously cleared infection after one year without treatment. Women with HIV were more likely to remain HR-HPV-positive on follow-up than HIV-negative women (61% vs. 22%, p<0.001). Treatment was offered to all VIA/VILI-DC positive women on initial screen, and to all women screening VIA/VILI-DC or HR-HPV positive on follow-up. We found careHPV co-testing with VIA/VILI-DC to be feasible and valuable in

  3. HIV testing in the workplace.

    Science.gov (United States)

    Tri, D L

    1988-11-01

    Because the incidence of AIDS continues to grow, affecting a greater number of the working population, the disease is also rapidly becoming a major issue for employers. AIDS has implications for employer decisions in the areas of hiring, termination, training, promotions, benefits, collective bargaining, health and safety in the workplace. This article examines the advantages and disadvantages of HIV screening in the workplace. Technical issues regarding the validity of current HIV tests being used are outlined. Precedent-setting court decisions are reviewed, and the resulting legal and ethical implications and dilemmas of employers and health care providers are examined.

  4. Increasing HIV Testing in Inpatient Psychiatry.

    Science.gov (United States)

    Shumway, Martha; Mangurian, Christina; Carraher, Noah; Momenzadeh, Amanda; Leary, Mark; Lee, Emily K; Dilley, James W

    2017-10-23

    People with serious mental illness (SMI) are at elevated risk of HIV infection, but do not receive HIV tests regularly. Inpatient psychiatric admissions provide opportunities for HIV testing. This study retrospectively examined the impact of three sequential interventions designed to increase HIV testing on an acute inpatient psychiatry service: (1) advocacy by an administrative champion, (2) an on-site HIV counselor, and (3) a clinician championing HIV testing. Demographic and HIV testing data were extracted from hospital data systems for 11,360 admissions of HIV-negative patients to an inpatient psychiatry service between 2006 and 2012. Relationships among interventions, length of stay, patient demographics, and receipt of an HIV test were examined using general estimating equation methods. In the year prior to the intervention, 7.2% of psychiatric inpatients received HIV tests. After 1 year of administrative advocacy, 11.2% received tests. Following the HIV counseling intervention, 25.1% of patients were tested. After the counseling intervention ended, continued administrative and clinical advocacy was associated with further increases in testing. In the final year studied, 30.3% of patients received HIV tests. Patients with shorter inpatient stays and those of Black or Asian race/ethnicity were less likely to be tested. Further, 1.6% of HIV tests were positive. Three interventions of varying intensity were associated with a 5-fold increase in HIV testing on an acute inpatient psychiatry service. Nonetheless, 70% of inpatients were not tested. Continued efforts are needed to increase HIV testing in inpatient psychiatric settings. Copyright © 2017 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

  5. Increasing HIV testing among male partners.

    Science.gov (United States)

    Orne-Gliemann, Joanna; Balestre, Eric; Tchendjou, Patrice; Miric, Marija; Darak, Shrinivas; Butsashvili, Maia; Perez-Then, Eddy; Eboko, Fred; Plazy, Melanie; Kulkarni, Sanjeevani; Desgrées du Loû, Annabel; Dabis, François

    2013-04-24

    Couple-oriented posttest HIV counselling (COC) provides pregnant women with tools and strategies to invite her partner to HIV counselling and testing. We conducted a randomized trial of the efficacy of COC on partner HIV testing in low/medium HIV prevalence settings (Cameroon, Dominican Republic, Georgia, India). Pregnant women were randomized to receive standard posttest HIV counselling or COC and followed until 6 months postpartum. Partner HIV testing events were notified by site laboratories, self-reported by women or both combined. Impact of COC on partner HIV testing was measured in intention-to-treat analysis. Socio-behavioural factors associated with partner HIV testing were evaluated using multivariable logistic regression. Among 1943 pregnant women enrolled, partner HIV testing rates (combined indicator) were 24.7% among women from COC group versus 14.3% in standard posttest HIV counselling group in Cameroon [odds ratio (OR) = 2.0 95% CI (1.2-3.1)], 23.1 versus 20.3% in Dominican Republic [OR = 1.2 (0.8-1.8)], 26.8 versus 1.2% in Georgia [OR = 29.6 (9.1-95.6)] and 35.4 versus 26.6% in India [OR = 1.5 (1.0-2.2)]. Women having received COC did not report more conjugal violence or union break-ups than in the standard posttest HIV counselling group. The main factors associated with partner HIV testing were a history of HIV testing among men in Cameroon, Dominican Republic and Georgia and the existence of couple communication around HIV testing in Georgia and India. A simple prenatal intervention taking into account the couple relationship increases the uptake of HIV testing among men in different socio-cultural settings. COC could contribute to the efforts towards eliminating mother-to-child transmission of HIV.

  6. [Recent progress in HIV screening tests and nucleic acid tests].

    Science.gov (United States)

    Imai, Mitsunobu; Kato, Shingo

    2010-03-01

    HIV testing plays a crucial role in detecting and monitoring HIV infection. Diagnosis of HIV infection is basically made by sequential two tests: a screening test with an enzyme immunoassay(EIA) and a confirmatory test with Western blot. The most recent EIAs, used in commercial laboratories, identify HIV infection earlier because they detect both HIV-1 antibody and antigen. Rapid tests represent another advance for HIV screening. They are widely used in voluntary counselling and testing at public health centers and private clinics. An assay for detection of HIV-1 RNA was approved as a confirmatory test of reactive screening tests to diagnose early infection. These new testing technologies offer more accurate, reliable, and convenient diagnosis of HIV infection.

  7. Developing Tests of Visual Dependency

    Science.gov (United States)

    Kindrat, Alexandra N.

    2011-01-01

    Astronauts develop neural adaptive responses to microgravity during space flight. Consequently these adaptive responses cause maladaptive disturbances in balance and gait function when astronauts return to Earth and are re-exposed to gravity. Current research in the Neuroscience Laboratories at NASA-JSC is focused on understanding how exposure to space flight produces post-flight disturbances in balance and gait control and developing training programs designed to facilitate the rapid recovery of functional mobility after space flight. In concert with these disturbances, astronauts also often report an increase in their visual dependency during space flight. To better understand this phenomenon, studies were conducted with specially designed training programs focusing on visual dependency with the aim to understand and enhance subjects ability to rapidly adapt to novel sensory situations. The Rod and Frame test (RFT) was used first to assess an individual s visual dependency, using a variety of testing techniques. Once assessed, subjects were asked to perform two novel tasks under transformation (both the Pegboard and Cube Construction tasks). Results indicate that head position cues and initial visual test conditions had no effect on an individual s visual dependency scores. Subjects were also able to adapt to the manual tasks after several trials. Individual visual dependency correlated with ability to adapt manual to a novel visual distortion only for the cube task. Subjects with higher visual dependency showed decreased ability to adapt to this task. Ultimately, it was revealed that the RFT may serve as an effective prediction tool to produce individualized adaptability training prescriptions that target the specific sensory profile of each crewmember.

  8. 33. Effects of HIV status and Linguistic Medium on the Test ...

    African Journals Online (AJOL)

    Esem

    Test Performance of Rural Low-Literacy Adults: Implications ... cognitive test performance like changes in visual perception ... selected. Those on ART were excluded from the HIV ..... the three Rural Health Centres for the support rendered to.

  9. Visual function assessment in simulated real-life situations in HIV-infected subjects.

    Directory of Open Access Journals (Sweden)

    Giulio Barteselli

    Full Text Available Visual function abnormalities are common in people living with HIV disease (PLWH without retinitis, even after improvement in immune status. Abnormalities such as reduced contrast sensitivity, altered color vision, peripheral visual field loss, and electrophysiological changes are related to a combination of retinal dysfunctions, involving inner and outer retinal structures. The standard protocol for testing vision performance in clinical practice is the Early Treatment Diabetic Retinopathy Study (ETDRS chart. However, this method poorly correlates with activities of daily living that require patients to assess visual stimuli in multiple light/contrast conditions, and with limited time. We utilized a novel interactive computer program (Central Vision Analyzer to analyze vision performance in PLWH under a variety of light/contrast conditions that simulate stressful and real-world environments. The program tests vision in a time-dependent way that we believe better correlates with daily living activities than the non-timed ETDRS chart. We also aimed to correlate visual scores with retinal neuro-fiber layer thickness on optical coherence tomography. Here we show that visual acuity is more affected in PLWH in comparison to HIV-seronegative controls in varying contrast and luminance, especially if the nadir CD4+ T-cell count was lower than 100 cells/mm3. Visual impairment reflects the loss of retinal nerve fiber layer thickness especially of the temporal-inferior sector. In PLWH the ETDRS chart test led to better visual acuity compared to the Central Vision Analyzer equivalent test, likely because patients had indefinite time to guess the letters. This study confirms and strengthens the finding that visual function is affected in PLWH even in absence of retinitis, since we found that the HIV serostatus is the best predictor of visual loss. The Central Vision Analyzer may be useful in the diagnosis of subclinical HIV-associated visual loss in multiple

  10. Number and timing of antenatal HIV testing

    DEFF Research Database (Denmark)

    Nguyen Thi Thuy, Hanh; Gammeltoft, Tine; Rasch, Vibeke

    2011-01-01

    ABSTRACT: BACKGROUND: HIV testing for pregnant women is an important component for the success of prevention of mother-to-child transmission of HIV (PMTCT). A lack of antenatal HIV testing results in loss of benefits for HIV-infected mothers and their children. However, the provision of unnecessary...... repeat tests at a very late stage of pregnancy will reduce the beneficial effects of PMTCT and impose unnecessary costs for the individual woman as well as the health system. This study aims to assess the number and timing of antenatal HIV testing in a low-income setting where PMTCT programmes have been...... scaled up to reach first level health facilities. METHODS: A cross-sectional community-based study was conducted among 1108 recently delivered mothers through face-to-face interviews following a structured questionnaire that focused on socio-economic characteristics, experiences of antenatal care and HIV...

  11. HIV Testing in Urban Transgender Individuals: A Descriptive Study

    OpenAIRE

    Juarez-Cuellar, Adrian; Chang, Yu-Ping

    2017-01-01

    Abstract HIV testing is considered the initial component of HIV eradication strategies. This study aimed to describe HIV testing in urban, transgender individuals in western New York. The study uses HIV testing intake data from a sample of self-identified transgender males and females volunteering for an HIV test at a community-based healthcare organization. Transgender individuals with some characteristics were found to have more HIV tests including female gender, black, HIV status (positive...

  12. HIV/STI Testing, Abortion and Contraception

    African Journals Online (AJOL)

    AJRH Managing Editor

    address barriers like youth friendly services have yet to conclusively demonstrate impact on protective behaviours like condom or contraceptive use. ..... contraception and HIV/STI testing (p<0.000). Differences in barriers by SRH service across gender, community, school status and age group. HIV/STI testing. As shown in ...

  13. TB Testing for People Living with HIV

    Centers for Disease Control (CDC) Podcasts

    2012-07-23

    Dr. Kenneth Castro, Director of the Division of Tuberculosis Elimination, explains why it is important for people living with HIV to be tested for TB.  Created: 7/23/2012 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP).   Date Released: 7/23/2012.

  14. HIV testing during the neonatal period

    African Journals Online (AJOL)

    2015-04-24

    Apr 24, 2015 ... in non-breastfed infants, HIV DNA and RNA PCR sensitivity at 1 month of age for perinatally infected infants was 89%8. • in formula-fed infants who received 6 weeks of postpartum zidovudine (AZT), with or with- out other antiretrovirals, 32% of intrapartum-infected infants tested HIV DNA PCR negative.

  15. HIV Testing in the United States

    Science.gov (United States)

    ... health issues… CHIP Marketplaces Waivers menu KFF.org Facebook Twitter Email Twitter Facebook Email HIV/AIDS Search Graphics & Interactives Polls Home ... in the United States Published: Jun 23, 2017 Facebook Twitter LinkedIn Email Print Key Facts HIV testing ...

  16. HIV testing in the Danish population

    DEFF Research Database (Denmark)

    Lemcke, Asja; Kjøller, Mette; Ekholm, Ola

    2007-01-01

    between HIV testing and background variables, such as gender, age, marital status, educational level, and sexual orientation. RESULTS: Overall 28.5% of the Danish population aged over 16 years have "ever been tested for HIV". More females (29.4%) than males (27.6%) were tested; 12.6% might not be aware......AIMS: To describe the accumulated prevalence of HIV testing in the Danish population until and including the year 2000. METHODS: The study was based on nationally representative data from the Danish Health Interview Survey 2000. Multiple logistic regression analysis investigated the association...... of their blood being HIV tested when donating blood. More males (17.1%) than females (13.8%) had donated blood after 1985. Although males 30-39 years old were the most tested, males 50-59 years old had the highest odds of having donated blood after 1985. Concerning education, the less education one had, the less...

  17. Knowledge, Attitudes and Practices about HIV Testing and ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    The major objective of this study was to determine knowledge, attitudes and practices about HIV testing services and the ... Keywords: Malawi, Adolescents, HIV testing and counselling ..... suicide after being found HIV positive were also.

  18. Criteria for standardising counselling for HIV testing

    Directory of Open Access Journals (Sweden)

    Anna Maria Luzi

    2010-03-01

    Full Text Available In the present work, we outline basic health counselling skills, specifically, those for performing pre-test and post-test counselling for HIV infection. The ultimate goal is to propose that counselling be performed in facilities that carry out screening for anti-HIV antibodies, following standardised (and thus replicable criteria, with consistent focus on the quality of the relationship between the healthcare professional and the individual undergoing testing and on the individual's specific needs.

  19. Indeterminate and discrepant rapid HIV test results in couples' HIV testing and counselling centres in Africa

    Science.gov (United States)

    2011-01-01

    Background Many HIV voluntary testing and counselling centres in Africa use rapid antibody tests, in parallel or in sequence, to establish same-day HIV status. The interpretation of indeterminate or discrepant results between different rapid tests on one sample poses a challenge. We investigated the use of an algorithm using three serial rapid HIV tests in cohabiting couples to resolve unclear serostatuses. Methods Heterosexual couples visited the Rwanda Zambia HIV Research Group testing centres in Kigali, Rwanda, and Lusaka, Zambia, to assess HIV infection status. Individuals with unclear HIV rapid antibody test results (indeterminate) or discrepant results were asked to return for repeat testing to resolve HIV status. If either partner of a couple tested positive or indeterminate with the screening test, both partners were tested with a confirmatory test. Individuals with indeterminate or discrepant results were further tested with a tie-breaker and monthly retesting. HIV-RNA viral load was determined when HIV status was not resolved by follow-up rapid testing. Individuals were classified based on two of three initial tests as "Positive", "Negative" or "Other". Follow-up testing and/or HIV-RNA viral load testing determined them as "Infected", "Uninfected" or "Unresolved". Results Of 45,820 individuals tested as couples, 2.3% (4.1% of couples) had at least one discrepant or indeterminate rapid result. A total of 65% of those individuals had follow-up testing and of those individuals initially classified as "Negative" by three initial rapid tests, less than 1% were resolved as "Infected". In contrast, of those individuals with at least one discrepant or indeterminate result who were initially classified as "Positive", only 46% were resolved as "Infected", while the remainder was resolved as "Uninfected" (46%) or "Unresolved" (8%). A positive HIV serostatus of one of the partners was a strong predictor of infection in the other partner as 48% of individuals who

  20. A retrospective evaluation of proficiency testing, and rapid HIV test ...

    African Journals Online (AJOL)

    Background: Proficiency testing (PT) has been implemented as a form of External Quality Assurance (EQA) by the National HIV Reference Laboratory in Kenya since 2007 in order to monitor and improve on the quality of HIV testing and counselling HTC services. Objective: To compare concordance between National HIV ...

  1. HIV Testing Rates and Testing Locations, by Race and Ethnicity

    Science.gov (United States)

    Rountree, Michele A.; Chen Lynn; Brown Adama; Pomeroy, Elizabeth C.

    2009-01-01

    The purpose of this study is to report the HIV testing rates among white Americans, African Americans, and Hispanic Americans and to identify the frequency of use of HIV testing locations according to a variety of sociodemographic variables. Data for this study came from the 2005 Behavioral Risk Factor Surveillance System (BRFSS). Participants in…

  2. Implementation of Couples' Voluntary HIV Counseling and Testing ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Implementation of Couples' Voluntary HIV Counseling and Testing Services in Durban, South Africa, for HIV Prevention and Intervention. Heterosexual couples represent the largest HIV risk group in sub-Saharan Africa. Couples' Voluntary HIV Counseling and Testing (CVCT) is an effective HIV prevention strategy because ...

  3. Barriers and facilitators associated with HIV testing uptake in South African health facilities offering HIV Counselling and Testing

    Directory of Open Access Journals (Sweden)

    Neo Mohlabane

    2016-10-01

    Objective: An HCT survey was carried out to ascertain barriers and facilitators for HIV testing in South Africa. Methods: A cross-sectional survey of 67 HCT-offering health facilities in 8 South African provinces was undertaken. Individuals (n = 489 who had not tested for HIV on the day of the site visit were interviewed on awareness of HCT services, HIV testing history and barriers to HIV testing. Frequencies were run to describe the sample characteristics, barriers and facilitators to HIV testing. Bivariate and multivariate logistic regression was usedt o identify the association between never tested for HIV with socio-demographics, awareness of HCT services and type of HCT facilities. Results: In all 18.1% participants never had an HIV test. Major barriers to HCT uptake comprise being scared of finding out one's HIV test result or what people may say, shyness or embarrassment, avoidance of divulging personal information to health workers and fear of death. In multivariate analysis the age group 55 years and older, and not being recommended to have an HIV test were associated with never had an HIV test. Potential facilitators for HIV testing include community or household HIV testing, providing incentives for those who test for HIV, mandatory HIV testing and disclosure of HIV status by those who test HIV positive. Conclusion: The benefits of HCT which include the reduction of HIV transmission, the availability of HIV care and treatment needs to be emphasized to enhance HCT uptake.

  4. Potential for false positive HIV test results with the serial rapid HIV testing algorithm

    Directory of Open Access Journals (Sweden)

    Baveewo Steven

    2012-03-01

    Full Text Available Abstract Background Rapid HIV tests provide same-day results and are widely used in HIV testing programs in areas with limited personnel and laboratory infrastructure. The Uganda Ministry of Health currently recommends the serial rapid testing algorithm with Determine, STAT-PAK, and Uni-Gold for diagnosis of HIV infection. Using this algorithm, individuals who test positive on Determine, negative to STAT-PAK and positive to Uni-Gold are reported as HIV positive. We conducted further testing on this subgroup of samples using qualitative DNA PCR to assess the potential for false positive tests in this situation. Results Of the 3388 individuals who were tested, 984 were HIV positive on two consecutive tests, and 29 were considered positive by a tiebreaker (positive on Determine, negative on STAT-PAK, and positive on Uni-Gold. However, when the 29 samples were further tested using qualitative DNA PCR, 14 (48.2% were HIV negative. Conclusion Although this study was not primarily designed to assess the validity of rapid HIV tests and thus only a subset of the samples were retested, the findings show a potential for false positive HIV results in the subset of individuals who test positive when a tiebreaker test is used in serial testing. These findings highlight a need for confirmatory testing for this category of individuals.

  5. Potential for false positive HIV test results with the serial rapid HIV testing algorithm.

    Science.gov (United States)

    Baveewo, Steven; Kamya, Moses R; Mayanja-Kizza, Harriet; Fatch, Robin; Bangsberg, David R; Coates, Thomas; Hahn, Judith A; Wanyenze, Rhoda K

    2012-03-19

    Rapid HIV tests provide same-day results and are widely used in HIV testing programs in areas with limited personnel and laboratory infrastructure. The Uganda Ministry of Health currently recommends the serial rapid testing algorithm with Determine, STAT-PAK, and Uni-Gold for diagnosis of HIV infection. Using this algorithm, individuals who test positive on Determine, negative to STAT-PAK and positive to Uni-Gold are reported as HIV positive. We conducted further testing on this subgroup of samples using qualitative DNA PCR to assess the potential for false positive tests in this situation. Of the 3388 individuals who were tested, 984 were HIV positive on two consecutive tests, and 29 were considered positive by a tiebreaker (positive on Determine, negative on STAT-PAK, and positive on Uni-Gold). However, when the 29 samples were further tested using qualitative DNA PCR, 14 (48.2%) were HIV negative. Although this study was not primarily designed to assess the validity of rapid HIV tests and thus only a subset of the samples were retested, the findings show a potential for false positive HIV results in the subset of individuals who test positive when a tiebreaker test is used in serial testing. These findings highlight a need for confirmatory testing for this category of individuals.

  6. Discordant HIV Test Results: Implications on Perinatal and Haemotransfusion Screening for HIV Infection, Cape Coast, Ghana

    OpenAIRE

    Tetteh, Ato Kwamena; Agyarko, Edward

    2017-01-01

    Screening results of 488 pregnant women aged 15–44 years whose blood samples had been tested on-site, using First Response® HIV 1/2, and confirmed with INNO-LIA™ HIV I/II Score were used. Of this total, 178 were reactive (HIV I, 154; HIV II, 2; and HIV I and HIV II, 22). Of the 154 HIV I-reactive samples, 104 were confirmed to be HIV I-positive and 2 were confirmed to be HIV II-positive, while 48 were confirmed to be negative [false positive rate = 17.44% (13.56–21.32)]. The two HIV II sample...

  7. Ethical implications of HIV self-testing.

    Science.gov (United States)

    Youngs, Jonathan; Hooper, Carwyn

    2015-10-01

    In April 2015, the first legally approved HIV self-testing kit went on sale in the UK-except Northern Ireland where they remain illegal. These tests allow individuals to test their HIV status and read the result in the privacy of their own home, much like a home pregnancy test. This paper explores the ethical implications of HIV self-testing. We conclude that there are no strong ethical objections to self-testing being made widely available in the UK. Pretest counselling for an HIV test is not an ethical necessity, and self-testing has the potential to increase early diagnosis of HIV infection and thus improve prognosis and reduce ongoing transmission. Self-testing kits might also empower people and promote autonomy by allowing people to dictate the terms on which they test their HIV status. We accept that there are some potential areas of concern. These include the possibility of user error with the tests, and the concern that individuals may not present to health services following a reactive result. False negatives have the potential to cause harm if the 'window period' is not understood, and false positives might produce psychological distress. There is, however, little evidence to suggest that self-testing kits will cause widespread harm, and we argue that the only way to properly evaluate whether they do cause significant harm is to carefully evaluate their use, now that they are available on the market. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  8. Case Report: HIV test misdiagnosis

    African Journals Online (AJOL)

    never HIV positive. Discussion. With resources from the Global Fund, the Malawi government has been able to start more than 350000 patients on HAART since 2001. More than 250,000 patients remain in care. (ART unit quarterly reports). The Malawi ART programme relies on a public health approach for initiation of ART.

  9. HIV testing in women: missed opportunities.

    Science.gov (United States)

    Duffus, Wayne A; Davis, Harley T; Byrd, Michael D; Heidari, Khosrow; Stephens, Terri G; Gibson, James J

    2012-02-01

    To investigate opportunities for early human immunodeficiency virus (HIV) testing of women. A retrospective cohort study design linked case reports from HIV surveillance to several statewide health-care databases. Medical encounters occurring before the first positive HIV test (missed opportunities) were categorized by diagnosis/procedure codes to distinguish visits that were likely to have prompted an HIV test. Women were categorized as late testers (AIDS diagnosis 12 months of HIV diagnosis), of reproductive age (13-44 years old), and not of reproductive age (>44 years old). Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were used to estimate risk and its statistical significance. Of 3303 HIV-infected women diagnosed during the study period, 2408 (73%) had missed opportunity visits. Late testers (39%) were more likely to be black than white (aOR 1.48, 95% CI 1.12-1.95), be older (>44 years old; aOR 7.85, 95% CI 4.49-13.7), and have >10 missed opportunity visits (aOR 2.17, 95% CI 1.62-2.91). Fifty-four percent of women >44 years old were also late testers. Women >44 years old had lower median initial CD4 counts (p44 years old and Papanicolau smear was ranked fourth for late testers. Feasibility and acceptability of routine HIV testing in nontraditional health-care settings, such as mammography and Papanicolau screenings, should be explored to identify late testers and older (not of reproductive age) HIV-infected women.

  10. Indeterminate HIV western blot test result.

    Science.gov (United States)

    Barnett, Deborah L; Duffus, Wayne A

    2008-12-01

    An IWB is a test result that creates uncertainty. Explaining this result to patients can cause provider discomfort but the more the provider practices, the comfort level increases. HIV diagnosis is no longer considered a death sentence. It has become a manageable disease when patients enter care early. That is why it is important to encourage screening for all. The earlier a patient is linked to care the better the health outcome and this prevents ongoing HIV transmission.

  11. Accuracy and user-acceptability of HIV self-testing using an oral fluid-based HIV rapid test.

    Directory of Open Access Journals (Sweden)

    Oon Tek Ng

    Full Text Available BACKGROUND: The United States FDA approved an over-the-counter HIV self-test, to facilitate increased HIV testing and earlier linkage to care. We assessed the accuracy of self-testing by untrained participants compared to healthcare worker (HCW testing, participants' ability to interpret sample results and user-acceptability of self-tests in Singapore. METHODOLOGY/PRINCIPAL FINDINGS: A cross-sectional study, involving 200 known HIV-positive patients and 794 unknown HIV status at-risk participants was conducted. Participants (all without prior self-test experience performed self-testing guided solely by visual instructions, followed by HCW testing, both using the OraQuick ADVANCE Rapid HIV 1/2 Antibody Test, with both results interpreted by the HCW. To assess ability to interpret results, participants were provided 3 sample results (positive, negative, and invalid to interpret. Of 192 participants who tested positive on HCW testing, self-testing was positive in 186 (96.9%, negative in 5 (2.6%, and invalid in 1 (0.5%. Of 794 participants who tested negative on HCW testing, self-testing was negative in 791 (99.6%, positive in 1 (0.1%, and invalid in 2 (0.3%. Excluding invalid tests, self-testing had sensitivity of 97.4% (95% CI 95.1% to 99.7% and specificity of 99.9% (95% CI: 99.6% to 100%. When interpreting results, 96%, 93.1% and 95.2% correctly read the positive, negative and invalid respectively. There were no significant demographic predictors for false negative self-testing or wrongly interpreting positive or invalid sample results as negative. Eighty-seven percent would purchase the kit over-the-counter; 89% preferred to take HIV tests in private. 72.5% and 74.9% felt the need for pre- and post-test counseling respectively. Only 28% would pay at least USD15 for the test. CONCLUSIONS/SIGNIFICANCE: Self-testing was associated with high specificity, and a small but significant number of false negatives. Incorrectly identifying model results as

  12. Accuracy and user-acceptability of HIV self-testing using an oral fluid-based HIV rapid test.

    Science.gov (United States)

    Ng, Oon Tek; Chow, Angela L; Lee, Vernon J; Chen, Mark I C; Win, Mar Kyaw; Tan, Hiok Hee; Chua, Arlene; Leo, Yee Sin

    2012-01-01

    The United States FDA approved an over-the-counter HIV self-test, to facilitate increased HIV testing and earlier linkage to care. We assessed the accuracy of self-testing by untrained participants compared to healthcare worker (HCW) testing, participants' ability to interpret sample results and user-acceptability of self-tests in Singapore. A cross-sectional study, involving 200 known HIV-positive patients and 794 unknown HIV status at-risk participants was conducted. Participants (all without prior self-test experience) performed self-testing guided solely by visual instructions, followed by HCW testing, both using the OraQuick ADVANCE Rapid HIV 1/2 Antibody Test, with both results interpreted by the HCW. To assess ability to interpret results, participants were provided 3 sample results (positive, negative, and invalid) to interpret. Of 192 participants who tested positive on HCW testing, self-testing was positive in 186 (96.9%), negative in 5 (2.6%), and invalid in 1 (0.5%). Of 794 participants who tested negative on HCW testing, self-testing was negative in 791 (99.6%), positive in 1 (0.1%), and invalid in 2 (0.3%). Excluding invalid tests, self-testing had sensitivity of 97.4% (95% CI 95.1% to 99.7%) and specificity of 99.9% (95% CI: 99.6% to 100%). When interpreting results, 96%, 93.1% and 95.2% correctly read the positive, negative and invalid respectively. There were no significant demographic predictors for false negative self-testing or wrongly interpreting positive or invalid sample results as negative. Eighty-seven percent would purchase the kit over-the-counter; 89% preferred to take HIV tests in private. 72.5% and 74.9% felt the need for pre- and post-test counseling respectively. Only 28% would pay at least USD15 for the test. Self-testing was associated with high specificity, and a small but significant number of false negatives. Incorrectly identifying model results as invalid was a major reason for incorrect result interpretation. Survey

  13. Does provider-initiated HIV testing and counselling lead to higher HIV testing rate and HIV case finding in Rwandan clinics?

    NARCIS (Netherlands)

    Kayigamba, Felix R.; van Santen, Daniëla; Bakker, Mirjam I.; Lammers, Judith; Mugisha, Veronicah; Bagiruwigize, Emmanuel; de Naeyer, Ludwig; Asiimwe, Anita; Schim van der Loeff, Maarten F.

    2016-01-01

    Provider-initiated HIV testing and counselling (PITC) is promoted as a means to increase HIV case finding. We assessed the effectiveness of PITC to increase HIV testing rate and HIV case finding among outpatients in Rwandan health facilities (HF). PITC was introduced in six HFs in 2009-2010. HIV

  14. Sensitivity of HIV rapid tests compared with fourth-generation enzyme immunoassays or HIV RNA tests.

    Science.gov (United States)

    Tan, Wei Sheng; Chow, Eric P F; Fairley, Christopher K; Chen, Marcus Y; Bradshaw, Catriona S; Read, Tim R H

    2016-07-31

    Determine the sensitivity of HIV rapid tests compared with fourth-generation enzyme immunoassays (EIA) or nucleic acid amplification tests (NAAT) in clinical settings. Systematic review and meta-analysis. Medline, PubMed, Embase, Cochrane Controlled Trials Register, Cochrane reviews and Cumulative Index to Nursing and Allied Health Literature were searched until 14 July 2015 for studies of adults comparing point-of-care HIV rapid tests to fourth-generation HIV EIA antibody/p24 antigen or HIV NAAT. From 953 titles, 18 studies were included, involving 110 122 HIV rapid test results. Compared with EIA, the estimated sensitivity (random effects) of HIV rapid tests was 94.5% [95% confidence interval (CI): 87.4-97.7]. Compared with NAAT, the sensitivity of HIV rapid tests was 93.7% (95% CI: 88.7-96.5). The sensitivity of HIV rapid tests in high-income countries was 85.7% (95% CI: 81.9-88.9) and in low-income countries was 97.7% (95% CI: 95.2-98.9) compared with either EIA or NAAT (P HIV rapid tests were less sensitive in high-income countries compared with low-income countries, missing about one in seven infections, possibly because of the larger proportion of acute infections in targeted populations. This suggests that in high-income countries, HIV rapid tests should be used in combination with fourth-generation EIA or NAAT tests, except in special circumstances. Prospective Registration of Systematic Reviews registration number CRD42015020154.Supplementary video link: http://links.lww.com/QAD/A924.

  15. HIV Testing Within At-Risk Populations in the United States and the Reasons for Seeking or Avoiding HIV Testing

    National Research Council Canada - National Science Library

    Kellerman, Scott E; Lehman, Stan J; Lansky, Amy; Stevens, Mark R; Hecht, Frederick M; Bindman, Andrew B; Wortley, Pascale M

    2002-01-01

    OBJECTIVES:We determined proportions of high-risk persons tested for HIV, the reasons for testing and not testing, and attitudes and perceptions regarding HIV testing, information that is critical for planning prevention programs...

  16. Bedside paediatric HIV testing in Malawi: Impact on testing rates ...

    African Journals Online (AJOL)

    Background Provider initiated testing and counselling (PITC) is recommended for all inpatients in Malawi if they have not been tested in the previous 3 months. However testing rates remain low among children. We audited the effect of implementing a bedside diagnostic HIV testing service to determine if it would improve ...

  17. Diagnostic accuracy of confrontation visual field tests.

    Science.gov (United States)

    Kerr, N M; Chew, S S L; Eady, E K; Gamble, G D; Danesh-Meyer, H V

    2010-04-13

    To determine the diagnostic accuracy of confrontation visual field testing and to compare the accuracy of confrontation tests both individually and in combination. Patients were prospectively recruited from ophthalmology clinics over a 6-month period. All patients underwent SITA-standard 24-2 Humphrey visual field analysis. Two examiners, masked to the automated perimetry results and the results of the other examiner, assessed patients using 7 common confrontation visual field tests. The order of testing was randomized to reduce any learning effect. For each individual test and combination of tests, the sensitivity, specificity, positive predictive value, and negative predictive value were calculated. A total of 301 eyes from 163 patients were included in the study. The average mean deviation was -5.91 +/- 7.72 (SD) dB. Most confrontation tests were insensitive to the identification of field loss. The sensitivity and specificity varied depending on the type, density, and cause of the visual field defect. Kinetic testing with a red target provided the highest sensitivity (74.4%) and specificity (93.0%) of any individual test and when combined with static finger wiggle testing achieved a sensitivity of 78.3% while retaining a specificity of 90.1%. Confrontation visual field tests are insensitive at detecting visual field loss when performed individually and are therefore a poor screening test. Combining confrontation tests is a simple and practical method of improving the sensitivity of confrontation testing.

  18. A Near Visual Acuity Test for Dentists.

    Science.gov (United States)

    Perrin, P; Eichenberger, M; Neuhaus, K W; Lussi, A

    2017-07-14

    Unimpaired near vision is crucial in dentistry, but appropriate visual tests at dental working distance are not publicly available. The aim of this study was to validate a novel visual triage test for dentists that is easy to use and freely available. The near visual acuity at 300 mm of 106 dental professionals (aged 21-65 years) was assessed with 1) a validated near visual test for scientific purposes miniaturized on a microfilm; 2) an experimental test using a US $5 bill, in which the first five words of each line in the Lincoln Memorial frieze had to be read under a dental operating light. The Spearman rank correlation coefficient of 0.784 revealed a strong correlation between the two tests (pdentists tested. If none of the words could be read, the chance of having a near visual acuity below the median of the peer group was 89%. The influence of the dentists' age and experience on their visual performance reported in former studies was corroborated with this new test. The US $5 bill offers a simple and easily available near visual test to rank individuals' near vision relative to that of other dentists and to recognize the progression of presbyopia with increasing age.

  19. HIV testing week 2015: lowering barriers for HIV testing among high-risk groups in Amsterdam.

    Science.gov (United States)

    Bartelsman, M; Joore, I K; van Bergen, J E; Hogewoning, A A; Zuure, F R; van Veen, M G

    2017-08-01

    Evaluation of the HIV Testing Week (HTW) 2015 in Amsterdam: the number of (positive) tested persons, characteristics and testing history of the tested population, the differences in attendance per location and the healthcare workers' experiences and opinions concerning the HTW. The HTW took place from 28 November till 4 December 2015. Anonymous HIV rapid testing (INSTI™ HIV1/HIV2 Ab test or Determine™ HIV-1/2 Ag/Ab test) was offered free of charge at four hospitals, 12 general practitioner (GP) clinics, a sexually transmitted infections (STI) clinic, a laboratory, sites of a community-based organisation, and at outreach locations. Home-based testing (OraQuick® In-Home HIV Test) was offered online. The focus was to motivate two groups to test: men who have sex with men (MSM) and non-Western migrants. Questionnaires regarding participant's characteristics and HIV testing history were collected. Also healthcare workers were asked to complete a questionnaire evaluating the HTW. In total, 1231 participants were tested. With three positive HIV tests, the detection rate was 0.3% (95%CI 0.26-0.37). Of all participants, 24.7% (304/1231) were MSM. Respectively, 22.3% (275/1231) and 15.7% (193/1231) were first- and second-generation migrants from a non-Western country. Altogether, 56.7% (698/1231) of participants belonged to one of the targeted risk groups. For 32.7% (402/1231) of participants, it was the first time they received testing, and 35.1% (432/1231) were tested more than 1 year ago. Among MSM 13.2% were tested for the first time, among first- and second-generation non-Western migrants this percentage was significantly higher at 27.2% and 33.5% respectively (p tested participants per location varied widely, especially between GP clinics (range 3-63). Healthcare workers were positive about the HTW: about half (46.2%) stated they would more readily offer an HIV test following their experience with the HTW. This was the first time the Amsterdam HTW was organised

  20. Discordant HIV Test Results: Implications on Perinatal and Haemotransfusion Screening for HIV Infection, Cape Coast, Ghana.

    Science.gov (United States)

    Tetteh, Ato Kwamena; Agyarko, Edward

    2017-01-01

    Screening results of 488 pregnant women aged 15-44 years whose blood samples had been tested on-site, using First Response® HIV 1/2, and confirmed with INNO-LIA™ HIV I/II Score were used. Of this total, 178 were reactive (HIV I, 154; HIV II, 2; and HIV I and HIV II, 22). Of the 154 HIV I-reactive samples, 104 were confirmed to be HIV I-positive and 2 were confirmed to be HIV II-positive, while 48 were confirmed to be negative [false positive rate = 17.44% (13.56-21.32)]. The two HIV II samples submitted were confirmed to be negative with the confirmatory test. For the 22 HIV I and HIV II samples, 7 were confirmed to be HIV I-positive and 1 was confirmed to be HIV I- and HIV II-positive, while 14 were confirmed to be negative. Of the 310 nonreactive samples, 6 were confirmed to be HIV I-positive and 1 was confirmed to be HIV II-positive [false negative rate = 5.79% (1.63-8.38)], while 303 were negative. False negative outcomes will remain unconfirmed, with no management options for the client. False negative rate of 5.79% requires attention, as its resultant implications on control of HIV/AIDS could be dire.

  1. Discordant HIV Test Results: Implications on Perinatal and Haemotransfusion Screening for HIV Infection, Cape Coast, Ghana

    Directory of Open Access Journals (Sweden)

    Ato Kwamena Tetteh

    2017-01-01

    Full Text Available Screening results of 488 pregnant women aged 15–44 years whose blood samples had been tested on-site, using First Response® HIV 1/2, and confirmed with INNO-LIA™ HIV I/II Score were used. Of this total, 178 were reactive (HIV I, 154; HIV II, 2; and HIV I and HIV II, 22. Of the 154 HIV I-reactive samples, 104 were confirmed to be HIV I-positive and 2 were confirmed to be HIV II-positive, while 48 were confirmed to be negative [false positive rate = 17.44% (13.56–21.32]. The two HIV II samples submitted were confirmed to be negative with the confirmatory test. For the 22 HIV I and HIV II samples, 7 were confirmed to be HIV I-positive and 1 was confirmed to be HIV I- and HIV II-positive, while 14 were confirmed to be negative. Of the 310 nonreactive samples, 6 were confirmed to be HIV I-positive and 1 was confirmed to be HIV II-positive [false negative rate = 5.79% (1.63–8.38], while 303 were negative. False negative outcomes will remain unconfirmed, with no management options for the client. False negative rate of 5.79% requires attention, as its resultant implications on control of HIV/AIDS could be dire.

  2. Comparative performance of the Geenius™ HIV-1/HIV-2 supplemental test in Florida's public health testing population.

    Science.gov (United States)

    Fordan, Sally; Bennett, Berry; Lee, Meghan; Crowe, Susanne

    2017-06-01

    The Centers for Disease Control and Prevention (CDC) published updated guidelines in 2014 for the laboratory diagnosis of HIV in the United States, which recommend use of a supplemental immunoassay (IA) that differentiates HIV-1 from HIV-2 after a repeatedly reactive HIV-1/2 antigen/antibody "Combo" screening test. In October 2014, Bio-Rad Laboratories introduced the FDA-cleared Geenius HIV-1/HIV-2 Supplemental assay and in July 2016, it replaced the Multispot HIV-1/HIV-2 differentiation rapid test as the second test in the HIV diagnostic algorithm. To compare performance of the new FDA-cleared Bio-Rad Geenius HIV-1/HIV-2 Supplemental assay and the Bio-Rad Multispot HIV-1/HIV-2 differentiation assay for use as the primary supplemental test in the 2014 CDC/APHL HIV Diagnostic Algorithm. Two sets of specimens were used to assess the performance of Geenius; 340 select retrospective specimens, obtained through routine clinical submissions from individuals seeking HIV serostatus determinations and 10 known HIV-2 antibody reactive specimens provided by Bio-Rad Laboratories. Panels were created and characterized solely by in-house laboratory results. The panels consisted of: algorithm-defined "established HIV-1 infections" (n=250), "acute HIV-1 infections" (n=20), "early HIV-1 infections" (n=10) and "false positive Combo specimens" (n=60). CONCLUSIONS: The Geenius assay provides significant advantages over Multispot as an appropriate replacement for the primary supplemental test in the HIV Diagnostic Algorithm. In this retrospective study, Geenius was highly concordant with Multispot, reclassified some acute and early algorithm-defined HIV-1 positive specimens and demonstrated a potential decrease in the number HIV-1 RNA nucleic acid amplification tests needed to complete the diagnostic algorithm. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Acute HIV Discovered During Routine HIV Screening With HIV Antigen-Antibody Combination Tests in 9 US Emergency Departments.

    Science.gov (United States)

    White, Douglas A E; Giordano, Thomas P; Pasalar, Siavash; Jacobson, Kathleen R; Glick, Nancy R; Sha, Beverly E; Mammen, Priya E; Hunt, Bijou R; Todorovic, Tamara; Moreno-Walton, Lisa; Adomolga, Vincent; Feaster, Daniel J; Branson, Bernard M

    2018-01-05

    Newer combination HIV antigen-antibody tests allow detection of HIV sooner after infection than previous antibody-only immunoassays because, in addition to HIV-1 and -2 antibodies, they detect the HIV-1 p24 antigen, which appears before antibodies develop. We determine the yield of screening with HIV antigen-antibody tests and clinical presentations for new diagnoses of acute and established HIV infection across US emergency departments (EDs). This was a retrospective study of 9 EDs in 6 cities with HIV screening programs that integrated laboratory-based antigen-antibody tests between November 1, 2012, and December 31, 2015. Unique patients with newly diagnosed HIV infection were identified and classified as having either acute HIV infection or established HIV infection. Acute HIV infection was defined as a repeatedly reactive antigen-antibody test result, a negative HIV-1/HIV-2 antibody differentiation assay, or Western blot result, but detectable HIV ribonucleic acid (RNA); established HIV infection was defined as a repeatedly reactive antigen-antibody test result and a positive HIV-1/HIV-2 antibody differentiation assay or Western blot result. The primary outcomes were the number of new HIV diagnoses and proportion of patients with laboratory-defined acute HIV infection. Secondary outcomes compared reason for visit and the clinical presentation of acute HIV infection. In total, 214,524 patients were screened for HIV and 839 (0.4%) received a new diagnosis, of which 122 (14.5%) were acute HIV infection and 717 (85.5%) were established HIV infection. Compared with patients with established HIV infection, those with acute HIV infection were younger, had higher RNA and CD4 counts, and were more likely to have viral syndrome (41.8% versus 6.5%) or fever (14.3% versus 3.4%) as their reason for visit. Most patients with acute HIV infection displayed symptoms attributable to acute infection (median symptom count 5 [interquartile range 3 to 6]), with fever often

  4. Acceptance of counseling, voluntary HIV testing and use of ...

    African Journals Online (AJOL)

    The overall acceptance of pre-test counseling in labour among women with unknown sero-status was 71.7% while acceptance of counseling and voluntary HIV testing was 56.6%. Among those who accepted pre-test counseling in labour, 78.9% accepted HIV testing and 8.6% of these were found to be HIV infected.

  5. ACCEPTABILITY OF ROUTINE OFFER OF HIV TESTING (OPT-OUT ...

    African Journals Online (AJOL)

    2011-03-01

    Mar 1, 2011 ... SUMMARY. Background: With the introduction of the opt out HIV testing policy in Ghana, the HIV test is offered rou- tinely to all pregnant women unless they decline test- ing. Objective: To assess acceptability of the routine offer of HIV testing antenatal clinic (ANC) clients in the Wa municipality, Ghana.

  6. HIV testing and informed consent - ethical considerations

    African Journals Online (AJOL)

    against his will, even where the patient suffers as a consequence; and the need for informed consent for an HIV test performed for the patient's own sake is simply one instance of that general duty to respect the patient's autonomy. The general duty to gain ir-lformed consent for a medical procedure is subject to exceptions, ...

  7. HIV Risk Behavior and Access to Services: What Predicts HIV Testing among Heterosexually Active Homeless Men?

    Science.gov (United States)

    Wenzel, Suzanne L.; Rhoades, Harmony; Tucker, Joan S.; Golinelli, Daniela; Kennedy, David P.; Zhou, Annie; Ewing, Brett

    2012-01-01

    HIV is a serious epidemic among homeless persons, where rates of infection are estimated to be three times higher than in the general population. HIV testing is an effective tool for reducing HIV transmission and for combating poor HIV/AIDS health outcomes that disproportionately affect homeless persons, however, little is known about the HIV…

  8. Awareness of Repeat Antenatal HIV Testing in Mothers Six Weeks ...

    African Journals Online (AJOL)

    PMTCT) recommend that all pregnant women and breastfeeding mothers must have HIV tests every 3 months. However, less than 10% of pregnant women in Lusaka District get retested. Repeat HIV testing identifies women who seroconvert ...

  9. Standardised opt-out testing for HIV.

    Science.gov (United States)

    Millett, Danna

    2011-12-01

    This article offers a literature review of the benefits of, and problems associated with, a standardised opt-out screening programme for HIV, and the attitudes of healthcare professionals and patients to its potential introduction in emergency departments. There is a lack of research on the subject in the UK and so the article relies on work undertaken in the US and on opt-out testing in antenatal services in the UK. It reviews the potential benefits of such a programme, in particular the opportunities it offers to improve public health and reduced the stigma associated with HIV, and discusses the issue of consent.

  10. Clinical performance of the Multispot HIV-1/HIV-2 rapid test to correctly differentiate HIV-2 from HIV-1 infection in screening algorithms using third and fourth generation assays and to identify cross reactivity with the HIV-1 Western Blot.

    Science.gov (United States)

    Ramos, Eric M; Harb, Socorro; Dragavon, Joan; Coombs, Robert W

    2013-12-01

    An accurate and rapid serologic method to differentiate HIV-2 from HIV-1 infection is required since the confirmatory HIV-1 Western Blot (WB) may demonstrate cross-reactivity with HIV-2 antibodies. To evaluate the performance of the Bio-Rad Multispot HIV-1/HIV-2 rapid assay as a supplemental test to correctly identify HIV-2 infection and identify HIV-1 WB cross-reactivity with HIV-2 in clinical samples tested at an academic medical center. Between August 2008 and July 2012, clinical samples were screened for HIV using either 3rd- or 4th-generation HIV-1/2 antibody or combination antibody and HIV-1 p24 antigen assays, respectively. All repeatedly reactive samples were reflexed for Multispot rapid testing. Multispot HIV-2 and HIV-1 and HIV-2-reactive samples were further tested using an HIV-2 immunoblot assay and HIV-1 or HIV-2 RNA assays when possible. The HIV-1 WB was performed routinely for additional confirmation and to assess for HIV-2 antibody cross-reactivity. Of 46,061 samples screened, 890 (89.6%) of 993 repeatedly reactive samples were also Multispot-reactive: 882 for HIV-1; three for only HIV-2; and five for both HIV-1 and HIV-2. All three HIV-2-only Multispot-positives along with a single dually reactive HIV-1/2 Multispot-positive were also HIV-2 immunoblot-positive; the latter was HIV-1 RNA negative and HIV-2 RNA positive. The Multispot rapid test performed well as a supplemental test for HIV-1/2 diagnostic testing. Four new HIV-2 infections (0.45%) were identified from among 890 Multispot-reactive tests. The use of HIV-1 WB alone to confirm HIV-1/2 screening assays may underestimate the true prevalence of HIV-2 infection in the United States. Copyright © 2013 Elsevier B.V. All rights reserved.

  11. Factors that influence the acceptance of HIV testing by pregnant ...

    African Journals Online (AJOL)

    Highest educational level and occupation of the pregnant women significantly influenced their having and HIV test (P<0.001). All the women with tertiary education have had an HIV test while 66.7% and 7.1% of those with primary and secondary education respectively had not taken an HIV test for the first time. Also house ...

  12. Knowledge and Preference of HIV Testing Types Among Antenatal ...

    African Journals Online (AJOL)

    Context Knowledge of different HIV testing modules is necessary to make an informed consent. The basic conditions of confidentiality, voluntary and counseling (pre-and-post) should apply in all HIV testing. Objective To assess the knowledge and preference of HIV counseling and testing types among antenatal women at ...

  13. HIV counselling and testing utilisation and attitudes of male inmates ...

    African Journals Online (AJOL)

    Results indicate that a poor health system (OR=0.34, 95%CI:0.23 - 0.50) was inversely associated with HIV testing acceptance in prison, while age, educational level, population group, marital status, length of incarceration and access to HIV testing in prison were not associated with HIV testing acceptance in prison. Half of ...

  14. The Visual Analysis Test: An Initial Report.

    Science.gov (United States)

    Rosner, Jerome

    A copying test (VAT) is described in which the test items can function as teaching objectives with the expectation that acquiring competency in the represented behaviors will be generalized to other visual-motor tasks. Six hundred and sixty-seven kindergarten first- and second-grade children were tested. Results show: (1) a reliable scoring method…

  15. Evaluation of nine HIV rapid test kits to develop a national HIV testing algorithm in Nigeria

    Directory of Open Access Journals (Sweden)

    Orji Bassey

    2015-05-01

    Full Text Available Background: Non-cold chain-dependent HIV rapid testing has been adopted in many resource-constrained nations as a strategy for reaching out to populations. HIV rapid test kits (RTKs have the advantage of ease of use, low operational cost and short turnaround times. Before 2005, different RTKs had been used in Nigeria without formal evaluation. Between 2005 and 2007, a study was conducted to formally evaluate a number of RTKs and construct HIV testing algorithms. Objectives: The objectives of this study were to assess and select HIV RTKs and develop national testing algorithms. Method: Nine RTKs were evaluated using 528 well-characterised plasma samples. These comprised 198 HIV-positive specimens (37.5% and 330 HIV-negative specimens (62.5%, collected nationally. Sensitivity and specificity were calculated with 95% confidence intervals for all nine RTKs singly and for serial and parallel combinations of six RTKs; and relative costs were estimated. Results: Six of the nine RTKs met the selection criteria, including minimum sensitivity and specificity (both ≥ 99.0% requirements. There were no significant differences in sensitivities or specificities of RTKs in the serial and parallel algorithms, but the cost of RTKs in parallel algorithms was twice that in serial algorithms. Consequently, three serial algorithms, comprising four test kits (BundiTM, DetermineTM, Stat-Pak® and Uni-GoldTM with 100.0% sensitivity and 99.1% – 100.0% specificity, were recommended and adopted as national interim testing algorithms in 2007. Conclusion: This evaluation provides the first evidence for reliable combinations of RTKs for HIV testing in Nigeria. However, these RTKs need further evaluation in the field (Phase II to re-validate their performance.

  16. The influence of stigma on voluntary HIV testing among pregnant ...

    African Journals Online (AJOL)

    Internal and external stigmas are often lumped together while addressing issues of stigma and HIV-testing, not considering that one of them may actually affect the disposition HIV-testing than the other. This study, therefore, investigated the effect of HIV/AIDS-related internal and external stigma on the disposition of pregnant ...

  17. Low HIV testing rates among tuberculosis patients in Kampala, Uganda

    NARCIS (Netherlands)

    Sendagire, Ibrahim; Schreuder, Imke; Mubiru, Mesach; van der Loeff, Maarten Schim; Cobelens, Frank; Konde-Lule, Joseph

    2010-01-01

    HIV testing among tuberculosis patients is critical in improving morbidity and mortality as those found to be HIV positive will be offered a continuum of care including ART if indicated. We conducted a cross-sectional study in three Kampala City primary care clinics: to assess the level of HIV test

  18. A Comprehensive Sex Education Approach for HIV Testing and Counselling

    Science.gov (United States)

    Colpin, Hilde

    2006-01-01

    Despite huge prevention efforts the number of HIV infections worldwide continues to increase dramatically. Among other strategies, the HIV test offers an important chance for targeted prevention, provided quality counselling is offered. Several studies have revealed that HIV testing is often performed in less than optimal conditions and is often…

  19. Determinants In HIV Counselling And Testing In Couples In North ...

    African Journals Online (AJOL)

    Background: Voluntary HIV counselling and testing (VCT) has been shown to be an acceptable and effective tool in the fight against HIV/AIDS. Couple HIV Counselling and Testing (CHCT) however, is a relatively new concept whose acceptance and efficacy is yet to be determined. Objective: To describe factors that ...

  20. Validity of oral mucosal transudate specimens for HIV testing using ...

    African Journals Online (AJOL)

    The overall sensitivity of OMT specimens for HIV testing in children using ELISA was low. Stratifying the analysis by sector showed that OMT samples are good specimens for HIV testing. It is important to note that factors such as the low HIV prevalence in our study population, quality of the OMT, diet and oral hygiene could ...

  1. HIV Testing Patterns among Urban YMSM of Color

    Science.gov (United States)

    Leonard, Noelle R.; Rajan, Sonali; Gwadz, Marya V.; Aregbesola, Temi

    2014-01-01

    The heightened level of risk for HIV infection among Black and Latino young men who have sex with men (YMSM) is driven by multilevel influences. Using cross-sectional data, we examined HIV testing patterns among urban YMSM of color in a high-HIV seroprevalence area (ages 16 to 21 years). Self-reported frequency of testing was high, with 42% of…

  2. Womens experiences of HIV testing and counselling in the labour ...

    African Journals Online (AJOL)

    Introduction. HIV counseling and testing during labour can be emotional, but is important because it allows mothers and babies to receive PMTCT prophylaxis if previous identification of HIV infection has not occurred. The study explores how HIV testing and counseling during early labour affects women. Methodology.

  3. Testing Visual Functions in Patients with Visual Prostheses

    Science.gov (United States)

    Wilke, Robert; Bach, Michael; Wilhelm, Barbara; Durst, Wilhelm; Trauzettel-Klosinski, Susanne; Zrenner, Eberhart

    A number of different technical devices for restoring vision in blind patients have been proposed to date. They employ different strategies for the acquisition of optical information, image processing, and electrical stimulation. Devices with external cameras or with integrated components for light detection have been developed and are designed to stimulate such different sites as the retina, optic nerve, and cortex. First clinical trials for these devices are being planned or already underway. As vision with these artificial vision devices (AVDs) may differ considerably from natural vision and as it may not be possible to predict visual functions provided by such devices on the basis of technical specifications alone, novel test strategies are needed to comprehensively describe visual performance. We propose a battery of tests for standardized well-controlled investigations in these patients that allow for objective assessment of efficacy of these devices.

  4. Lack of HIV testing and dissatisfaction with HIV testing and counselling among men having sex with men in Hungary.

    Science.gov (United States)

    Nyitray, Alan G; Bagyinszky, Ferenc; Ross, Michael W; Schmidt, Axel J

    2017-11-22

    Using data from a large internet-based survey of European men having sex with men (MSM), we assessed factors associated with HIV testing and reasons for dissatisfaction with HIV testing and counselling among Hungarian MSM. A total of 2052 Hungarian MSM provided evaluable data for the European MSM Internet Survey (EMIS) in 2010. χ2 tests and Poisson regression with a robust variance estimator were used to assess factors associated with HIV testing and dissatisfaction with HIV testing and counselling. A total of 42.1% of MSM reported never being testing for HIV. Over one-half of men (54.1%) who reported condomless anal intercourse (CAI) in the prior 12 months with a person of unknown or sero-discordant HIV status reported no lifetime HIV testing. The factor most strongly associated with dissatisfaction with HIV testing and counselling was test site with increased dissatisfaction with inpatient hospital settings vs. community-based organizations. Both lack of HIV testing and dissatisfaction with testing were independently associated with MSM who reported that no one, or only a few people, knew they were attracted to men. Lack of HIV testing was strongly associated with CAI. MSM reported that community-based organizations better supported confidentiality and were more respectful during HIV testing.

  5. Software testing using Visual Studio 2012

    CERN Document Server

    Subashni, S

    2013-01-01

    We will be setting up a sample test scenario, then we'll walk through the features available to deploy tests.This book is for developers and testers who want to get to grips with Visual Studio 2012 and Test Manager for all testing activities and managing tests and results in Team Foundation Server. It requires a minimal understanding of testing practices and the software development life cycle; also, some coding skills would help in customizing and updating the code generated from the web UI testing.

  6. HIV testing and linkage to services for youth

    Directory of Open Access Journals (Sweden)

    Ann E Kurth

    2015-02-01

    Full Text Available Introduction: HIV testing is the portal to serostatus knowledge that can empower linkage to care for HIV treatment and HIV prevention. However, young people's access to HIV testing is uneven worldwide. The objective of this paper is to review the context and concerns faced by youth around HIV testing in low- as well as high-income country settings. Discussion: HIV testing is a critical entry point for primary and secondary prevention as well as care and treatment for young people including key populations of vulnerable youth. We provide a framework for thinking about the role of testing in the continuum of prevention and care for young people. Brief case study examples from Kenya and the US illustrate some of the common barriers and issues involved for young people. Conclusions: Young people worldwide need more routine access to HIV testing services that effectively address the developmental, socio-political and other issues faced by young women and men.

  7. Determination of HIV status in African adults with discordant HIV rapid tests

    Science.gov (United States)

    Fogel, Jessica M.; Piwowar-Manning, Estelle; Donohue, Kelsey; Cummings, Vanessa; Marzinke, Mark A.; Clarke, William; Breaud, Autumn; Fiamma, Agnès; Donnell, Deborah; Kulich, Michal; Mbwambo, Jessie K. K.; Richter, Linda; Gray, Glenda; Sweat, Michael; Coates, Thomas J.; Eshleman, Susan H.

    2015-01-01

    Background In resource-limited settings, HIV infection is often diagnosed using two rapid tests. If the results are discordant, a third tie-breaker test is often used to determine HIV status. This study characterized samples with discordant rapid tests and compared different testing strategies for determining HIV status in these cases. Methods Samples were previously collected from 173 African adults in a population-based survey who had discordant rapid test results. Samples were classified as HIV positive or HIV negative using a rigorous testing algorithm that included two fourth-generation tests, a discriminatory test, and two HIV RNA tests. Tie-breaker tests were evaluated, including: rapid tests (one performed in-country), a third-generation enzyme immunoassay (EIA), and two fourth-generation tests. Selected samples were further characterized using additional assays. Results Twenty-nine (16.8%) samples were classified as HIV positive; 24 (82.8%) of those samples had undetectable HIV RNA. Antiretroviral drugs were detected in one sample. Sensitivity was 8.3%–43% for the rapid tests; 24.1% for the third-generation EIA; 95.8% and 96.6% for the fourth-generation tests. Specificity was lower for the fourth-generation tests than the other tests. Accuracy ranged from 79.5–91.3%. Conclusions In this population-based survey, most HIV-infected adults with discordant rapid tests were virally suppressed without antiretroviral drugs. Use of individual assays as tie-breaker tests was not a reliable method for determining HIV status in these individuals. More extensive testing algorithms that use a fourth-generation screening test with a discriminatory test and HIV RNA test are preferable for determining HIV status in these cases. PMID:25835607

  8. Evaluation of HIV testing recommendations in specialty guidelines for the management of HIV indicator conditions

    DEFF Research Database (Denmark)

    Lord, E; Stockdale, A J; Malek, R

    2017-01-01

    OBJECTIVES: European guidelines recommend HIV testing for individuals presenting with indicator conditions (ICs) including AIDS-defining conditions (ADCs). The extent to which non-HIV specialty guidelines recommend HIV testing in ICs and ADCs is unknown. Our aim was to pilot a methodology in the UK...... to review specialty guidelines and ascertain if HIV was discussed and testing recommended. METHODS: UK and European HIV testing guidelines were reviewed to produce a list of 25 ADCs and 49 ICs. UK guidelines for these conditions were identified from searches of the websites of specialist societies...... (48%) and 36 of 49 (73%) ICs. In total, 78 guidelines were reviewed (range 0-13 per condition). HIV testing was recommended in six of 17 ADC guidelines (35%) and 24 of 61 IC guidelines (39%). At least one guideline recommended HIV testing for six of 25 ADCs (24%) and 16 of 49 ICs (33...

  9. Missed opportunities for HIV control: Gaps in HIV testing for partners of people living with HIV in Lima, Peru.

    Directory of Open Access Journals (Sweden)

    Ana L Vasquez

    Full Text Available Based on the hypothesis that HIV programs struggle to deliver health services that harmonize necessities of treatment and prevention, we described the outcomes of routinely provided HIV testing to partners of people living with HIV (PLWH through a secondary analysis of routine data collected at a public hospital in Lima, Peru.Among PLWH enrolled in the study center's HIV program between 2005 and 2014, we identified index cases (IC: PLWH who reported a unique partner not previously enrolled. We grouped partners according to their HIV status as reported by IC and collected data on HIV testing, clinical characteristics and admissions. The main outcome was the frequency of HIV testing among partners with reported unknown/seronegative HIV status.Out of 1586 PLWH who reported a unique partner at enrollment, 171 had a previously enrolled partner, leaving 1415 (89% IC. HIV status of the partner was reported as unknown in 571 (40%, seronegative in 325 (23% and seropositive in 519 (37%. Out of 896 partners in the unknown/seronegative group, 72 (8% had HIV testing, 42/72 (58% tested within three months of IC enrollment. Among the 49/72 (68% who tested positive for HIV, 33 (67% were enrolled in the HIV program. The proportion in WHO clinical stage IV was lower in enrolled partners compared to IC (37% vs 9%, p = 0.04. Non-tested partners (824 were likely reachable by the hospital, as 297/824 (36% of their IC were admitted in the study center at least once, 51/243 (21% female IC had received pregnancy care at the study center, and 401/692 (64% of IC on antiretroviral therapy had achieved viral suppression, implying frequent visits to the hospital for pill pick-up.In this setting, HIV testing of partners of PLWH was suboptimal, illustrating missed opportunities for HIV control. Integration of HIV strategies in primarily clinical-oriented services is a challenging need.

  10. False positive HIV test in low prevalence region: Pakistan.

    Science.gov (United States)

    Ikram, Nadeem; Ahmad, Sajid

    2012-01-01

    The prevalence of HIV in Pakistan is less than 0.1%, but is feared to be spreading among the general population rapidly. Screening tests for HIV is based on antibody detection. There seems to be little knowledge regarding the interpretation of HIV results among the population. Most often the patients are being issued a positive HIV report based on single screening test when in fact it should be confirmed before issuing a positive HIV result. There is a lot of stigma associated with the disease in Pakistan, on the other hand the test is done mostly without counselling services hence causing physical and mental trauma to the patients.

  11. Determinants and prevalence of late HIV testing in Tijuana, Mexico.

    Science.gov (United States)

    Carrizosa, Claudia M; Blumberg, Elaine J; Hovell, Melbourne F; Martinez-Donate, Ana P; Garcia-Gonzalez, Gregorio; Lozada, Remedios; Kelley, Norma J; Hofstetter, C Richard; Sipan, Carol L

    2010-05-01

    Timely diagnosis of HIV is essential to improve survival rates and reduce transmission of the virus. Insufficient progress has been made in effecting earlier HIV diagnoses. The Mexican border city of Tijuana has one of the highest AIDS incidence and mortality rates in all of Mexico. This study examined the prevalence and potential correlates of late HIV testing in Tijuana, Mexico. Late testers were defined as participants who had at least one of: (1) an AIDS-defining illness within 1 year of first positive HIV test; (2) a date of AIDS diagnosis within 1 year of first positive HIV test; or (3) an initial CD4 cell count below 200 cells per microliter within 1 year of first positive HIV test. Medical charts of 670 HIV-positive patients from two HIV/AIDS public clinics in Tijuana were reviewed and abstracted; 362 of these patients were interviewed using a cross-sectional survey. Using multivariate logistic regression, we explored potential correlates of late HIV testing based on the Behavioral Ecological Model. From 342 participants for whom late testing could be determined, the prevalence of late testing was 43.2%. Multivariate logistic regression results (n = 275) revealed five significant correlates of late testing: "I preferred not to know I had HIV" (adjusted odds ratio [AOR] = 2.78, 1.46-5.31); clinic (AOR = 1.90, 1.06-3.41); exposure to peers engaging in high-risk sexual behavior (AOR = 1.14, 1.02-1.27); stigma regarding HIV-infected individuals (AOR = 0.65, 0.47-0.92); and stigma regarding HIV testing (AOR = 0.66, 0.45-0.97). These findings may inform the design of interventions to increase timely HIV testing and help reduce HIV transmission in the community at large.

  12. Factors affecting willingness to HIV Counseling and Testing among ...

    African Journals Online (AJOL)

    Background: There is ample scientific evidence that a person with an untreated sexually transmitted infection (STI), particularly those inducing ulcers or discharge, is at an increased risk of passing on or acquiring HIV during sexual intercourse. HIV counseling and testing (HIV CT) for STI cases is thus an important tool in the ...

  13. The influence of stigma on voluntary HIV testing among pregnant ...

    African Journals Online (AJOL)

    This study, therefore, investigated the effect of HIV/AIDS-related internal and external stigma on the disposition of pregnant women in the Limpopo Province of South Africa to go for voluntary HIV-testing. Four hundred and fifty ... Furthermore, HIV/AIDS-related internal stigma came out to be a significant factor. The more ...

  14. HIV-Selectest enzyme immunoassay and rapid test: ability to detect seroconversion following HIV-1 infection.

    Science.gov (United States)

    Khurana, Surender; Norris, Philip J; Busch, Michael P; Haynes, Barton F; Park, Susan; Sasono, Pretty; Mlisana, Koleka; Salim, Abdool Karim; Hecht, Frederick M; Mulenga, Joseph; Chomba, Elwyn; Hunter, Eric; Allen, Susan; Nemo, George; Rodriguez-Chavez, Isaac R; Margolick, Joseph B; Golding, Hana

    2010-01-01

    HIV-Selectest is a serodiagnostic enzyme immunoassay (EIA), containing p6 and gp41 peptides, designed to differentiate between vaccine-induced antibodies and true infections. A rapid test version of the HIV-Selectest was developed. Both assays detected HIV antibodies in men and women within 2 to 4 weeks of infection, with sensitivity similar to third-generation EIAs.

  15. Enhancing HIV status disclosure and partners' testing through ...

    African Journals Online (AJOL)

    Background: In Tanzania HIV Testing and Counselling (HTC) is being implemented through voluntary counselling and testing (VCT), provider initiated counselling and testing (PITC) and work place counselling and testing (HTC). Within these programmes, HIV status disclosure is emphasized. However, among persons who ...

  16. Evaluation of HIV testing recommendations in specialty guidelines for the management of HIV indicator conditions.

    Science.gov (United States)

    Lord, E; Stockdale, A J; Malek, R; Rae, C; Sperle, I; Raben, D; Freedman, A; Churchill, D; Lundgren, J; Sullivan, A K

    2017-04-01

    European guidelines recommend HIV testing for individuals presenting with indicator conditions (ICs) including AIDS-defining conditions (ADCs). The extent to which non-HIV specialty guidelines recommend HIV testing in ICs and ADCs is unknown. Our aim was to pilot a methodology in the UK to review specialty guidelines and ascertain if HIV was discussed and testing recommended. UK and European HIV testing guidelines were reviewed to produce a list of 25 ADCs and 49 ICs. UK guidelines for these conditions were identified from searches of the websites of specialist societies, the National Institute of Clinical Excellence (NICE) website, the NICE Clinical Knowledge Summaries (CKS) website, the Scottish Intercollegiate Guidance Network (SIGN) website and the British Medical Journal Best Practice database and from Google searches. We identified guidelines for 12 of 25 ADCs (48%) and 36 of 49 (73%) ICs. In total, 78 guidelines were reviewed (range 0-13 per condition). HIV testing was recommended in six of 17 ADC guidelines (35%) and 24 of 61 IC guidelines (39%). At least one guideline recommended HIV testing for six of 25 ADCs (24%) and 16 of 49 ICs (33%). There was no association between recommendation to test and publication year (P = 0.62). The majority of guidelines for ICs do not recommend testing. Clinicians managing ICs may be unaware of recommendations produced by HIV societies or the prevalence of undiagnosed HIV infection among these patients. We are piloting methods to engage with guideline development groups to ensure that patients diagnosed with ICs/ADCs are tested for HIV. We then plan to apply our methodology in other European settings as part of the Optimising Testing and Linkage to Care for HIV across Europe (OptTEST) project. © 2016 The Authors. HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association.

  17. Visually Storying Living with HIV: Bridging Stressors and Supports in Accessing Care

    Science.gov (United States)

    Schrader, S. M.; Deering, E. N.; Zahl, D. A.; Wallace, M.

    2011-01-01

    This paper examines how visual narratives may bridge relational understandings between people living with HIV/AIDS (PLWH/A) and future oral health care providers. Borrowing from literature in participatory visual methods such as photo elicitation and photovoice, we explored how PLWH/A visually choose to represent their daily lives. This study uses…

  18. Uptake of HIV testing during antenatal care in Honduras.

    Science.gov (United States)

    Kuhlmann, Anne Sebert; Bergquist, Eleanor P; Fu, Qiang; Shacham, Enbal; Foggia, Janine; Sierra, Manuel

    2017-01-01

    In order to interrupt vertical transmission of HIV, the WHO recommends universal HIV testing during antenatal care (ANC), a policy that has been adopted by the Ministry of Health in Honduras. We examined HIV counseling and testing practices during ANC in the Honduras Demographic and Health Survey to understand compliance with this established standard of care. Among currently married women with a child aged five years or younger who attended ANC, only 66% recalled being offered HIV testing during ANC, yet 95% of those got tested. Older, less literate women who lived in a rural area, a small household, or had an older husband were significantly less likely to recall being offered HIV testing. These findings highlight necessary revisions to ANC protocols to ensure that all women in Honduras get HIV testing to interrupt mother-to-child transmission.

  19. Visual perception skills testing: preliminary results

    CSIR Research Space (South Africa)

    Smith, Adrew C

    2009-02-01

    Full Text Available stream_source_info Smith_d4_2009.pdf.txt stream_content_type text/plain stream_size 7318 Content-Encoding UTF-8 stream_name Smith_d4_2009.pdf.txt Content-Type text/plain; charset=UTF-8 Visual Perception Skills Testing...: Preliminary Results Andrew Cyrus Smith CSIR Meraka Institute PO Box 395 Pretoria, 0001, South Africa +27 12 841 4626 acsmith @ csir.co.za ABSTRACT Good visual perception skills are important in the effective manipulation of Tangible User...

  20. Evaluation of an alternative supplemental testing strategy for HIV diagnosis by retrospective analysis of clinical HIV testing data.

    Science.gov (United States)

    Styer, Linda M; Sullivan, Timothy J; Parker, Monica M

    2011-12-01

    Because newer screening assays are more sensitive than traditional confirmatory assays, a new HIV testing algorithm was proposed by the Centers for Disease Control and Prevention (CDC) and Association of Public Health Laboratories (APHL) in 2010 to replace the current enzyme immunoassay (EIA)-Western blot (WB) algorithm that was established in 1989. The new algorithm includes a sensitive screening EIA and a HIV-1/HIV-2 differentiation immunoassay (Multispot) for confirmation. Concordant reactive specimens are reported as HIV-1 and/or HIV-2 positive; those with discordant results receive nucleic acid testing (NAT). Our laboratory uses all components of both the current and proposed algorithms and conducted a retrospective analysis of test results to compare algorithm performance. All available test results from 38,257 specimens were analyzed, of which 36,598 were EIA non-reactive. Of 1659 EIA-reactive specimens, 1578 were defined by our laboratory as HIV-1 positive, 5 as HIV-2 positive, 69 as negative and 7 as unknown. These results were used to evaluate both algorithms. Under the proposed algorithm, all 1578 HIV-1-positive specimens would be reported as 'HIV-1 positive', whereas the current algorithm only confirmed 98% (1546/1578). The proposed algorithm produced fewer inconclusive results (9 vs 48); consequently, fewer follow-up specimens would be needed. The current algorithm produced one false-positive result whereas the proposed algorithm produced four. Two of these four false-positive results could be eliminated by requiring NAT for specimens with discordant HIV-1 results on the Multispot. Although both algorithms identified all HIV-2-positive specimens, the current algorithm required an additional 112 tests. The CDC/APHL HIV testing algorithm, proposed in 2010, outperformed the current algorithm because it was more sensitive for detecting HIV-1 infection, provided a greater number of definitive HIV results, and detected HIV-2 more efficiently. Copyright

  1. The International HIV Dementia Scale: a new rapid screening test for HIV dementia.

    Science.gov (United States)

    Sacktor, Ned C; Wong, Matthew; Nakasujja, Noeline; Skolasky, Richard L; Selnes, Ola A; Musisi, Seggane; Robertson, Kevin; McArthur, Justin C; Ronald, Allan; Katabira, Elly

    2005-09-02

    HIV dementia is an important neurological complication of advanced HIV infection. The use of a cross-cultural screening test to detect HIV dementia within the international community is critical for diagnosing this condition. The objective of this study was to evaluate the sensitivity and specificity of a new screening test for HIV dementia, the International HIV Dementia Scale (IHDS) in cohorts from the US and Uganda. Two cross-sectional cohort studies designed to evaluate for the presence of HIV dementia. Sixty-six HIV-positive individuals in the US and 81 HIV-positive individuals in Uganda received the IHDS and full standardized neurological and neuropsychological assessments. The sensitivity and specificity of varying cut-off scores of the IHDS were evaluated in the two cohorts. In the US cohort, the mean IHDS score for HIV-positive individuals without dementia and with dementia were 10.6 and 9.3 respectively (P dementia with the IHDS were 80% and 57% respectively in the US cohort, and 80% and 55% respectively in the Uganda cohort. The IHDS may be a useful screening test to identify individuals at risk for HIV dementia in both the industrialized world and the developing world. Full neuropsychological testing should then be performed to confirm a diagnosis of HIV dementia.

  2. Private healthcare sector doctors and HIV testing practices in the ...

    African Journals Online (AJOL)

    Background: Human immunodeficiency virus (HIV) testing has many logistic and ethical challenges. The UNAIDS/WHO policy statement states that the testing of individuals must be confidential, be accompanied by counselling, and be conducted with informed consent. HIV testing is integral to the management of the ...

  3. evaluation of commercial hiv test kits used in nigeria

    African Journals Online (AJOL)

    User

    As technology evolved, screening, confirmatory and. HIV monitoring assays have greatly improved in terms of quality and speed. Coupled with this development is the unprecedented increase in the number of test kits that are available for determining. HIV status. Test kits that are simple, instrument-free simple/rapid tests ...

  4. Womens experiences of HIV testing and counselling in the labour ...

    African Journals Online (AJOL)

    tested to update their status. Four women were found HIV-positive while 6 were HIVnegative. The primary theme was that women appreciated and accepted HIV testing and counseling. Testing was accepted as a necessary step to protect the ...

  5. Social problems of indeterminate and false positive HIV test results ...

    African Journals Online (AJOL)

    Increased availability of Human Immunodeficiency Virus (HIV) screening test and more public enlightenment have resulted in more people coming forward to access counseling and testing at the HIV counseling and testing centers in Nigeria. Some of the clients however obtained indeterminate and false positive results ...

  6. Are students being coerced into HIV testing? Ethical considerations ...

    African Journals Online (AJOL)

    A social marketing strategy, including substantial prizes, was used to promote HIV testing at 17 institutions of higher learning in South Africa. Over 20 000 students with a mean age of 19 years were counselled and tested for HIV. The majority were being tested for the first time. Afterwards they signed a public pledge: 'We, ...

  7. Review of HIV Testing Efforts in Historically Black Churches

    Directory of Open Access Journals (Sweden)

    Latrice Crystal Pichon

    2015-05-01

    Full Text Available This paper aims to critically assess the state of HIV testing in African American churches. A comprehensive review of peer-reviewed publications on HIV testing in church-based settings was conducted by two independent coders. Twenty-six papers published between 1991 and 2015, representing 24 unique projects, were identified addressing at least one dimension of HIV testing. Thirteen faith-based projects have implemented HIV testing events or had clergy promote the importance of testing and knowing one’s HIV status, but empirical data and rigorous study designs were limited. Only eight papers reported onsite HIV testing in churches. Less than 5% of the studies reported the percentage of congregants who returned for their test results. Finally, no study has examined at baseline or post-intervention behavioral intentions to be screened for HIV. Future research is needed to evaluate the effectiveness of HIV testing in churches and to explore the possibilities of the role of the church and leadership structure in the promotion of HIV treatment and care.

  8. Rapid HIV-1 testing during labor: a multicenter study.

    Science.gov (United States)

    Bulterys, Marc; Jamieson, Denise J; O'Sullivan, Mary Jo; Cohen, Mardge H; Maupin, Robert; Nesheim, Steven; Webber, Mayris P; Van Dyke, Russell; Wiener, Jeffrey; Branson, Bernard M

    2004-07-14

    Timely testing of women in labor with undocumented human immunodeficiency virus (HIV) status could enable immediate provision of antiretroviral prophylaxis. To determine the feasibility and acceptance of rapid HIV testing among women in labor and to assess rapid HIV assay performance. The Mother-Infant Rapid Intervention At Delivery (MIRIAD) study implemented 24-hour counseling and voluntary rapid HIV testing for women in labor at 16 US hospitals from November 16, 2001, through November 15, 2003. A rapid HIV-1 antibody test for whole blood was used. Acceptance of HIV testing; sensitivity, specificity, and predictive value of the rapid test; time from blood collection to patient notification of results. There were 91,707 visits to the labor and delivery units in the study, 7381 of which were by eligible women without documentation of HIV testing. Of these, 5744 (78%) women were approached for rapid HIV testing and 4849 (84%) consented. HIV-1 test results were positive for 34 women (prevalence = 7/1000). Sensitivity and specificity of the rapid test were 100% and 99.9%, respectively; positive predictive value was 90% compared with 76% for enzyme immunoassay (EIA). Factors independently associated with higher test acceptance included younger age, being black or Hispanic, gestational age less than 32 weeks, and having had no prenatal care. Lower acceptance was associated with being admitted between 4 pm and midnight, particularly on Friday nights, but this may be explained in part by fewer available personnel. Median time from blood collection to patient notification of result was 66 minutes (interquartile range, 45-120 minutes), compared with 28 hours for EIA (PHIV testing is feasible and delivers accurate and timely test results for women in labor. It provides HIV-positive women prompt access to intrapartum and neonatal antiretroviral prophylaxis, proven to reduce perinatal HIV transmission, and may be particularly applicable to higher-risk populations.

  9. A review of the impact of cost and quality of HIV kits on HIV testing in ...

    African Journals Online (AJOL)

    Ademu

    Double ELISA was used to test blood samples before a particular specimen was diagnosed as reactive or non-reactive. A time came when immunoconfirmatory test was introduced into HIV antibodies testing for confirmations of the presence of HIV. Objectives: This present retospective study is to review the impact of cost ...

  10. Ethnicity and HIV risk behaviour, testing and knowledge in Guatemala.

    Science.gov (United States)

    Taylor, Tory M; Hembling, John; Bertrand, Jane T

    2015-01-01

    To describe levels of risky sexual behaviour, HIV testing and HIV knowledge among men and women in Guatemala by ethnic group and to identify adjusted associations between ethnicity and these outcomes. Data on 16,205 women aged 15-49 and 6822 men aged 15-59 from the 2008-2009 Encuesta Nacional de Salud Materno Infantil were used to describe ethnic group differences in sexual behaviour, HIV knowledge and testing. We then controlled for age, education, wealth and other socio-demographic factors in a multivariate logistic regression model to examine the effects of ethnicity on outcomes related to age at sexual debut, number of lifetime sex partners, comprehensive HIV knowledge, HIV testing and lifetime sex worker patronage (men only). The data show low levels of risky sexual behaviour and low levels of HIV knowledge among indigenous women and men, compared to other respondents. Controlling for demographic factors, indigenous women were more likely than other women never to have been tested for HIV and to lack comprehensive HIV knowledge. They were less likely to report early sexual debut and three or more lifetime sexual partners. Indigenous men were more likely than other men to lack comprehensive HIV knowledge and demonstrated lower odds of early sexual debut, 10 or more lifetime sexual partners and sex worker patronage. The Mayan indigenous population in Guatemala, while broadly socially vulnerable, does not appear to be at elevated risk for HIV based on this analysis of selected risk factors. Nonetheless, low rates of HIV knowledge and testing may be cause for concern. Programmes working in indigenous communities should focus on HIV education and reducing barriers to testing. Further research into the factors that underlie ethnic self-identity and perceived ethnicity could help clarify the relative significance of these measures for HIV risk and other health outcomes.

  11. New HIV Testing Algorithm: Promising Tool in the Fight Against HIV

    Centers for Disease Control (CDC) Podcasts

    2016-09-21

    In this podcast, CDC’s Dr. Phil Peters discusses the new HIV testing algorithm and how this latest technology can improve the diagnosis of acute HIV infection. Early detection of HIV is critical to saving lives, getting patients into treatment, and preventing transmission.  Created: 9/21/2016 by National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention (NCHHSTP), • Division of HIV/AIDS Prevention (DHAP).   Date Released: 9/21/2016.

  12. Tailoring HIV testing in a setting of late HIV diagnosis: is the tide turning?

    Science.gov (United States)

    Freer, Joseph; Lascar, Monica; Phiri, Elias

    2015-10-01

    Routine HIV testing in areas of high HIV prevalence has been shown to be both cost effective and to avert downstream morbidity and mortality from 'late' HIV diagnosis (defined as CD4 cell count<350 cells/ml). In the London borough of Waltham Forest in 2010, late HIV diagnoses were resulting in high morbidity with associated lengthy and costly hospital admissions. A retrospective analysis of all new HIV diagnoses was undertaken within a two-phased quality improvement project 2010-13. Newly diagnosed patients in 2010 were characterized, including immunological state, presence of HIV-related illness and department where they presented. After an intervention to set up an opt-out, walk-in rapid HIV testing service in outpatients, an analysis was conducted of numbers of tests, prevalence and immunological state of newly diagnosed patients in 2013. A total of 91 patients were diagnosed with HIV, January-December 2010, 70% of which were a late diagnosis, including 48% defined as 'very immunosuppressed' (CD4 count<100 cells/ml). Of these, 51 out of 91 patients (56%) had attended hospital services in the 5 years before diagnosis, including 204 outpatient department attendances. After the intervention, rates of late diagnosis in 2013 had reduced to 46%, and rates of those diagnosed 'very immunosuppressed' had reduced from 48% to 8%. HIV testing in outpatients is feasible and acceptable to patients and can be offered alongside routine outpatient care. The rate of positive HIV tests in this group of patients in the authors' setting has been much higher than the HIV positivity rate of larger scale HIV testing interventions in other hospital settings. This approach also provides a model for more integrated care of HIV-positive patients.

  13. Assessing factors associated with HIV testing among adolescents in Malawi.

    Science.gov (United States)

    Mkandawire, Paul

    2017-07-01

    Despite being at high risk of HIV/AIDS, most young people do not know their HIV status. Using survey data (n = 2428) and applying multilevel models, this paper assesses factors associated with HIV testing among adolescents in Northern Malawi. The results show that among both boys (OR = 0.39) and girls (OR = 0.47), orphan status is associated with low likelihood of HIV testing. Correct knowledge about HIV/AIDS (OR = 2.55) and having secondary education (OR = 3.24) are associated with HIV testing among boys and girls, respectively. At the household level, living in a household whose head has secondary or higher education is positively associated with testing for boys (OR = 2.63), while residing together with biological siblings predicts higher odds of testing (OR = 2.67) for girls. Notably, orphaned girls' disadvantage regarding HIV testing loses significance when residential arrangement is controlled. At the community level, having HIV testing facility (OR = 2.70) or post-test club (OR = 1.40) is positively associated with HIV testing for boys, while girls from areas where religious leaders hold judgmental views about HIV/AIDS are less likely (OR = 0.45) to test. These findings suggest that efforts to scale up HIV testing among youth could benefit greatly from an understanding of how individual and community factors operate to influence adolescents to know their sero-status.

  14. "There's No Place Like Home": Perceptions of Home-Based HIV Testing in Lesotho

    Science.gov (United States)

    Mantell, J. E.; DiCarlo, A. L.; Remien, R. H.; Zerbe, A.; Morris, D.; Pitt, B.; Nkonyana, J. P.; Abrams, E. J.; El-Sadr, W.

    2014-01-01

    HIV testing has the potential to reduce HIV transmission by identifying and counseling individuals with HIV, reducing risk behaviors, linking persons with HIV to care and earlier treatment, and reducing perinatal transmission. In Lesotho, a high HIV prevalence country in which a large proportion of the population has never tested for HIV,…

  15. Transmission route and reasons for HIV testing among recently diagnosed HIV patients in HIV-TR cohort, 2011–2012

    Directory of Open Access Journals (Sweden)

    Basak Dokuzoguz

    2014-11-01

    Full Text Available Introduction: Routes of transmission and reasons for HIV testing are important epidemiologic data to analyze the epidemic and to tailor the response to AIDS. The aim of this study was to analyze reasons for testing and transmission ways of HIV among recently diagnosed HIV patients registered in the multicenter HIV-TR cohort in Turkey. Methods: Transmission ways and reasons for testing of all patients diagnosed in 2011 and 2012 were recorded on a web-based data collection system and were analyzed retrospectively. Results: The study included 693 patients (561 male, 132 female from 24 sites. Reason for HIV testing was available in 640 patients (92%. The most common reason for HIV testing was diagnostic workout for other conditions or illness followed by patient-initiated testing. The reasons for testing were listed in Table 1. The most common routes of HIV transmission were heterosexual intercourse (62.7% and sex among men who have sex with men (MSM (22.6%. At the time of HIV diagnosis, the mean CD4 lymphocyte cell count was 355/mm3 (3–1433/mm3. Primary HIV infection was determined in 42/693 (6% patients and 9/693 (% 1, 2 cases were considered “probable primary HIV infection.” The majority of the cases presented to a clinic for follow-up right after the diagnosis. On the other hand 32/616 (5.2% patients delayed their presentation for more than 3 months. The longest delay was 11 months. Conclusions: The results of the database suggest that targeted testing is lacking in the country. The shift toward homosexual transmission during the last 2 years emphasizes the need for targeted interventions. Patients present relatively late and HIV infection could only be diagnosed when immunosuppression related findings appeared. Patient-initiated testing,an indicator of awareness, was very low suggesting a need to scale-up awareness raising interventions.

  16. Healthcare workers’ experiences of HIV testing in Tshwane, South Africa

    Directory of Open Access Journals (Sweden)

    Mamakwa S. Mataboge

    2014-02-01

    Full Text Available Background: In an era when antiretroviral (ARV therapy has become part of the Human Immunodeficiency Virus (HIV prevention strategy, early testing and introduction to ARVs iscritical for improving public health outcomes in general and, in particular, the lives of people living with HIV. South Africa has the highest number of people living with HIV as compared with the rest of the world. Initiated voluntary HIV counselling and testing and provider initiated counselling and testing (PICT are required in order to increase the uptake of HIV testing.Objectives: To explore and describe the experiences of healthcare workers who are themselves in need of HIV testing.Method: A descriptive, exploratory design was used. In-depth interviews were conducted with the 26 healthcare workers who were involved in HIV testing in the Tshwane district of South Africa. The participants were sampled purposively from two healthcare settings. A thematic framework was used for data analysis.Results: There was a complication with regard to PICT as healthcare workers felt they could not initiate HIV testing for themselves and or their work colleagues without their confidentiality being compromised. This was complicated further by both the perceived and actual fear of stigmatisation and discrimination. It was difficult for qualified staff to support and encourage the uptake of HIV testing by students nurses as this was seen, albeit incorrectly, as targeting the students in a negative manner.Conclusion: There is a need for accessible HIV testing policies for healthcare workers in order to increase access to HIV testing and prevent the progression of the disease

  17. How Do We Get Partners to Test for HIV?: Predictors of Uptake of Partner HIV Testing Following Individual Outpatient Provider Initiated HIV Testing in Rural Uganda.

    Science.gov (United States)

    Kiene, Susan M; Gbenro, Olumide; Sileo, Katelyn M; Lule, Haruna; Wanyenze, Rhoda K

    2017-08-01

    In a sample of outpatients (152 females, 152 males) receiving individual provider-initiated HIV testing and counselling (PITC) we aimed to identify factors associated with subsequent uptake of partner HIV testing. Purposively sampled outpatients receiving PITC at a Ugandan hospital completed a questionnaire immediately prior to testing for HIV, and then at 3 and 6 months post-test. By 6-month follow-up 96% of participants reported disclosing their HIV test results to their partner and 96.4% reported asking their partner to test. 38.8% of women and 78.9% of men reported that their partner tested and they knew their results. Recent (men AOR 5.84, 95.0% CI 1.90-17.99; women AOR 6.19, 95.0% CI 2.74-13.59) or any previous testing by the partner (women AOR 4.01, 95% CI 1.06-15.10) predicted uptake of partner testing by the 6-month follow-up. Among women, perceiving greater social support from their partner, which perhaps reflects better relationship quality, was predictive of their male partner testing for HIV (AOR 2.37, 95% CI 1.22-4.58). Notably intimate partner violence showed no negative association with partner testing. Our findings demonstrate that women are at a disadvantage compared to men in their ability to influence their partner to test for HIV, and that improving social support in intimate relationships should be a focus of HIV partner testing interventions. However, more research on interventions to improve partner testing is needed, particularly in identifying effective ways to support women in engaging their partners to test.

  18. Factors Associated with Recent HIV Testing among Heterosexuals at High-Risk for HIV Infection in New York City

    Directory of Open Access Journals (Sweden)

    Marya eGwadz

    2016-04-01

    Full Text Available Background. The CDC recommends persons at high-risk for HIV infection in the United States receive annual HIV testing to foster early HIV diagnosis and timely linkage to health care. Heterosexuals make up a significant proportion of incident HIV infections (>25%, but test for HIV less frequently than those in other risk categories. Yet factors that promote or impede annual HIV testing among heterosexuals are poorly understood. The present study examines individual/attitudinal-, social-, and structural-level factors associated with past-year HIV testing among heterosexuals at high-risk for HIV. Methods. Participants were African American/Black and Hispanic heterosexual adults (N=2307 residing in an urban area with both high poverty and HIV prevalence rates. Participants were recruited by respondent-driven sampling (RDS in 2012-2015 and completed a computerized structured assessment battery covering background factors, multi-level putative facilitators of HIV testing, and HIV testing history. Separate logistic regression analysis for males and females identified factors associated with past-year HIV testing.Results. Participants were mostly male (58%, African American/Black (75%, and 39 years old on average (SD = 12.06 years. Lifetime homelessness (54% and incarceration (62% were common. Half reported past-year HIV testing (50% and 37% engaged in regular, annual HIV testing. Facilitators of HIV testing common to both genders included sexually transmitted infection (STI testing or STI diagnosis, peer norms supporting HIV testing, and HIV testing access. Among women, access to general medical care and extreme poverty further predicted HIV testing, while recent drug use reduced the odds of past-year HIV testing. Among men, past-year HIV testing was also associated with lifetime incarceration and substance use treatment.Conclusions. The present study identified gaps in rates of HIV testing among heterosexuals at high-risk for HIV, and both common and

  19. Home-based HIV counselling and testing in Western Kenya ...

    African Journals Online (AJOL)

    Background. Objective: To describe our experience with the feasibility and acceptance of home-based HIV counselling and testing (HBCT) in two large, rural, administrative divisions of western Kenya. Design: Setting: Results: Conclusion. : Home-based HIV counselling and testing was feasible among this rural population ...

  20. Utilization of HIV Testing and Counseling in Ghana: Implications for ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    Yawson et al. HIV Testing in Ghana. African Journal of Reproductive Health March 2014; 18(1): 145. ORIGINAL RESEARCH ARTICLE. Utilization of HIV Testing and Counseling in Ghana: Implications for Universal Coverage. Alfred E Yawson. 1, 2*. , Phyllis Dako-Gyeke. 3. , Stephen Ayisi Addo. 1. , Bernard T Dornoo. 1.

  1. Knowledge, Attitudes and Practices about HIV Testing and ...

    African Journals Online (AJOL)

    During FGDs some students did not test because they feared their parents would think they were sexually promiscuous. This study demonstrates the need for intensive campaigns among adolescent girls and their parents to create awareness about the importance of HIV testing as this is an entry point for all HIV and AIDS ...

  2. Determinants of acceptance of voluntary HIV testing among ...

    African Journals Online (AJOL)

    Bernt Lindtjorn

    Back ground: Voluntary Counseling and Testing (VCT) is one of the best interventions to reduce mother to child transmission of HIV. ... Objective: The objective of this study was to identify factors that determine the acceptance of voluntary HIV testing ... Recently, child mortality has fallen in some countries as a result of.

  3. Sexual Orientation Differences in HIV Testing Motivation among College Men

    Science.gov (United States)

    Kort, Daniel N.; Samsa, Gregory P.; McKellar, Mehri S.

    2017-01-01

    Objective: To investigate sexual orientation differences in college men's motivations for HIV testing. Participants: 665 male college students in the Southeastern United States from 2006 to 2014. Methods: Students completed a survey on HIV risk factors and testing motivations. Logistic regressions were conducted to determine the differences…

  4. Behavioural Precursors and HIV Testing Behaviour among African American Women

    Science.gov (United States)

    Uhrig, Jennifer D.; Davis, Kevin C.; Rupert, Doug; Fraze, Jami

    2012-01-01

    Objective: To examine whether there is an association between knowledge, attitudes and beliefs, reported intentions to get an HIV test, and reported HIV testing behaviour at a later date among a sample of African American women. Design: Secondary analysis of data collected from October 2007 through March 2008 for a randomized controlled experiment…

  5. Barriers to accessibility and utilization of HIV testing and counseling ...

    African Journals Online (AJOL)

    Introduction: While HIV testing and counseling (HTC) services remain to be amongst the effective strategies in slowing HIV transmission, its accessibility and uptake in Tanzania is low. In 2011, 50% of adults have been ever tested and received their results. We conducted this study to assess barriers to accessibility and ...

  6. Objective and Subjective Knowledge and HIV Testing among College Students

    Science.gov (United States)

    Hou, Su-I

    2004-01-01

    Little research has been conducted on the knowledge domain specifically related to HIV testing among college students. Students (age 18-24) were recruited from a major university in the southeastern United States to participate in a Web-based survey during spring 2003 (N=440). About 21% of the students reported previous voluntary HIV tests.…

  7. Determinants of HIV Testing Among Tuberculosis Patients on DOTS ...

    African Journals Online (AJOL)

    The main aim of the study was to assess determinants of HIV testing among Tuberculosis patients on DOTS in East Wollega zone, Ethiopia. Institution based case control study was conducted from January – March 2011. Cases were tuberculosis patients who have not accepted HIV testing while the controls were those who ...

  8. willingness to accept hiv testing among caretakers with a child ...

    African Journals Online (AJOL)

    Esem

    treatment and care they require. In spite of all efforts put ... more than half the HIV knowledge questions were significantly .... The study finding of high levels of willingness to accept. HIV testing of .... and testing among pregnant women living in North. Uganda AIDS ... patients at university teaching hospital, Lusaka,. Zambia: ...

  9. Behavioral and Psychological Responses to HIV Antibody Testing.

    Science.gov (United States)

    Jacobsen, Paul B.; And Others

    1990-01-01

    Considers effects of informing individuals of their antibody status as determined by human immunodeficiency virus (HIV) antibody testing. Reviews research examining changes in psychological distress and in behaviors associated with HIV infections among individuals who have undergone antibody testing. Identifies methodological issues in studying…

  10. HIV Testing in Recent College Students: Prevalence and Correlates

    Science.gov (United States)

    Caldeira, Kimberly M.; Singer, Barbara J.; O'Grady, Kevin E.; Vincent, Kathryn B.; Arria, Amelia M.

    2012-01-01

    Prevalence and correlates of HIV testing were examined in a sample of 957 unmarried recent college students in the United States. Participants were asked about HIV testing, past-six-months sexual activities, lifetime treatment for sexually transmitted infections (STI), past-year health service utilization, and DSM-IV criteria for alcohol and other…

  11. Knowledge, Attitudes and Practices about HIV Testing and ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    Abstract. The major objective of this study was to determine knowledge, attitudes and practices about HIV testing services and the uptake ... Sixty nine per cent of the girls who did not go for the HIV test was mainly because either they were not sexually active or they ..... was not possible to get parental consent; hence this.

  12. Acceptability of routine HIV counselling and testing among a sample ...

    African Journals Online (AJOL)

    Routine HIV counseling and testing (RCT) is a necessary first step in accessing health care for persons who may test HIV-positive. Despite the availability of RCT in many South African settings, uptake has often been low. We sought to determine whether the main components of the Health Belief Model (HBM), namely ...

  13. A European multicientre study on the comparison of HIV-1 viral loads between VERIS HIV-1 Assay and Roche COBAS® TAQMAN® HIV-1 test, Abbott RealTime HIV-1 Assay, and Siemens VERSANT HIV-1 Assay.

    Science.gov (United States)

    Braun, Patrick; Delgado, Rafael; Drago, Monica; Fanti, Diana; Fleury, Hervé; Hofmann, Jörg; Izopet, Jacques; Kühn, Sebastian; Lombardi, Alessandra; Mancon, Alessandro; Marcos, Mª Angeles; Mileto, Davide; Sauné, Karine; O'Shea, Siobhan; Pérez-Rivilla, Alfredo; Ramble, John; Trimoulet, Pascale; Vila, Jordi; Whittaker, Duncan; Artus, Alain; Rhodes, Daniel

    2017-07-01

    Viral load monitoring is essential for patients under treatment for HIV. Beckman Coulter has developed the VERIS HIV-1 Assay for use on the novel, automated DxN VERIS Molecular Diagnostics System. ¥ OBJECTIVES: Evaluation of the clinical performance of the new quantitative VERIS HIV-1 Assay at multiple EU laboratories. Method comparison with the VERIS HIV-1 Assay was performed with 415 specimens at 5 sites tested with COBAS ® AmpliPrep/COBAS ® TaqMan ® HIV-1 Test, v2.0, 169 specimens at 3 sites tested with RealTime HIV-1 Assay, and 202 specimens from 2 sites tested with VERSANT HIV-1 Assay. Patient monitoring sample results from 4 sites were also compared. Bland-Altman analysis showed the average bias between VERIS HIV-1 Assay and COBAS HIV-1 Test, RealTime HIV-1 Assay, and VERSANT HIV-1 Assay to be 0.28, 0.39, and 0.61 log 10 cp/mL, respectively. Bias at low end levels below 1000cp/mL showed predicted bias to be HIV-1 Assay versus COBAS HIV-1 Test and RealTime HIV-1 Assay, and HIV-1 Assay. Analysis on 174 specimens tested with the 0.175mL volume VERIS HIV-1 Assay and COBAS HIV-1 Test showed average bias of 0.39 log 10 cp/mL. Patient monitoring results using VERIS HIV-1 Assay demonstrated similar viral load trends over time to all comparators. The VERIS HIV-1 Assay for use on the DxN VERIS System demonstrated comparable clinical performance to COBAS ® HIV-1 Test, RealTime HIV-1 Assay, and VERSANT HIV-1 Assay. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. HIV/AIDS testing sites and locator services

    Data.gov (United States)

    U.S. Department of Health & Human Services — The HIV Testing Sites & Care Services Locator is a first-of-its-kind, location-based search tool that allows you to search for testing services, housing...

  15. Evaluation of supplemental testing with the Multispot HIV-1/HIV-2 Rapid Test and APTIMA HIV-1 RNA Qualitative Assay to resolve specimens with indeterminate or negative HIV-1 Western blots.

    Science.gov (United States)

    Linley, Laurie; Ethridge, Steven F; Oraka, Emeka; Owen, S Michele; Wesolowski, Laura G; Wroblewski, Kelly; Landgraf, Kenneth M; Parker, Monica M; Brinson, Myra; Branson, Bernard M

    2013-12-01

    The use of Western blot (WB) as a supplemental test after reactive sensitive initial assays can lead to inconclusive or misclassified HIV test results, delaying diagnosis. To determine the proportion of specimens reactive by immunoassay (IA) but indeterminate or negative by WB that could be resolved by alternative supplemental tests recommended under a new HIV diagnostic testing algorithm. Remnant HIV diagnostic specimens that were reactive on 3rd generation HIV-1/2 IA and either negative or indeterminate by HIV-1 WB from 11 health departments were tested with the Bio-Rad Multispot HIV-1/HIV-2 Rapid Test (Multispot) and the Gen-Probe APTIMA HIV-1 RNA Qualitative Assay (APTIMA). According to the new testing algorithm, 512 (89.8%) specimens were HIV-negative, 55 (9.6%) were HIV-1 positive (including 19 [3.3%] that were acute HIV-1 and 9 [1.6%] that were positive for HIV-1 by Multispot but APTIMA-negative), 2 (0.4%) were HIV-2 positive, and 1 (0.2%) was HIV-positive, type undifferentiated. 47 (21.4%) of the 220 WB-indeterminate and 8 (2.3%) of the 350 WB-negative specimens were HIV-1 positive. Applying the new HIV diagnostic algorithm retrospectively to WB-negative and indeterminate specimens, the HIV infection status could be established for nearly all of the specimens. IA-reactive HIV-infected persons with WB-negative results had been previously misclassified as uninfected, and HIV diagnosis was delayed for those with WB-indeterminate specimens. These findings underscore the limitations of the WB to confirm HIV infection after reactive results from contemporary 3rd or 4th generation IAs that can detect HIV antibodies several weeks sooner than the WB. Published by Elsevier B.V.

  16. Causes of false-positive HIV rapid diagnostic test results

    OpenAIRE

    Klarkowski, Derryck; O?Brien, Daniel P.; Shanks, Leslie; Singh, Kasha P.

    2014-01-01

    HIV rapid diagnostic tests have enabled widespread implementation of HIV programs in resource-limited settings. If the tests used in the diagnostic algorithm are susceptible to the same cause for false positivity, a false-positive diagnosis may result in devastating consequences. In resource-limited settings, the lack of routine confirmatory testing, compounded by incorrect interpretation of weak positive test lines and use of tie-breaker algorithms, can leave a false-positive diagnosis undet...

  17. Testing in the HIV Counselling and Testing (HCT) campaign, HIV risk behaviours and ART enrolment in South Africa.

    Science.gov (United States)

    Onoya, D; Mohlabane, N; Maduna, V; van Zyl, J; Sewpaul, R; Naidoo, Y

    2016-07-01

    To examine the association between testing in the 2010 HIV Testing and Counselling (HCT) campaign with HIV risk behaviours and enrolment on ART. Data for this study were collected as part of a nationally representative cross-sectional household survey conducted in 2012 in South Africa. Consenting participants completed a structured questionnaire and provided a dry blood spot specimen which was tested for HIV antibodies and antiretroviral drugs. Multinomial logistic regression was used to examine the association between HIV testing history and explanatory variables of interest. There was no association between testing in the 2010 HCT campaign and condom use at last sex, number of sexual partnerships or HIV knowledge. Individuals who tested in the HCT campaign were more likely to disclose their status (COR 2.6, 95% CI: 1.71-3.8) and those who tested HIV positive in the campaign were more likely to be receiving ART (COR 1.8, 95% CI: 1.1-2.9). Testing in the HCT campaign was associated with having received both pretest and post-test counselling while testing before the campaign was associated with having received HIV results with no counselling (COR 2.1, 95% CI: 1.2-3.8). We highlight the success of the 2010 HCT campaign in improving HIV status disclosure and enrolment on ART as well as shortcomings on HIV risk behaviours and HIV knowledge. These may be related to issues of quality assurance in the counselling process. Our results further highlight possible HCT counselling inconsistencies across sectors requiring stronger public-private partnership in the delivery of HCT in South Africa. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  18. HIV and Hepatitis Testing: Global Progress, Challenges, and Future Directions.

    Science.gov (United States)

    Easterbrook, Philippa; Johnson, Cheryl; Figueroa, Carmen; Baggaley, Rachel

    2016-01-01

    HIV infection and viral hepatitis due to HBV and HCV infection are major causes of chronic disease worldwide, and share some common routes of transmission, epidemiology, initial barriers faced in treatment access, and in strategies for a global public health response. Testing and diagnosis of HIV, HBV, and HCV infection is the gateway for access to both care and treatment and prevention services, and crucial for an effective HIV and hepatitis epidemic response. In this review article, we first summarize the common goals and guiding principles in a public health approach to HIV and hepatitis testing. We summarize the impressive global progress in HIV testing scale-up and evolution of approaches, with expansion of provider-initiated testing and counseling in clinical settings (particularly antenatal and tuberculosis clinics), the introduction of more community based testing services, and use of rapid diagnostic tests enabling provision of same-day test results. However, 46% of all people living with HIV are still unaware of their serostatus, and many continue to be diagnosed and start antiretroviral therapy late. As testing and treatment scale-up accelerates for an "treat all" approach, other challenges to address include how to better focus testing and reach those yet undiagnosed and most at risk, especially key populations, men, adolescents, and children. We summarize future directions in HIV testing to speed scale-up and close gaps that are addressed in the WHO 2015 consolidated HIV testing guidelines. In contrast to HIV, action in hepatitis testing and treatment has been fragmented and limited to a few countries, and there remains a large burden of undiagnosed cases globally. We summarize key challenges in the hepatitis testing response, including lack of simple, reliable, and low-cost diagnostic tests, laboratory capacity, and testing facilities; inadequate data to guide country specific hepatitis testing approaches and who to screen; stigmatization and social

  19. Visual Turing test for computer vision systems.

    Science.gov (United States)

    Geman, Donald; Geman, Stuart; Hallonquist, Neil; Younes, Laurent

    2015-03-24

    Today, computer vision systems are tested by their accuracy in detecting and localizing instances of objects. As an alternative, and motivated by the ability of humans to provide far richer descriptions and even tell a story about an image, we construct a "visual Turing test": an operator-assisted device that produces a stochastic sequence of binary questions from a given test image. The query engine proposes a question; the operator either provides the correct answer or rejects the question as ambiguous; the engine proposes the next question ("just-in-time truthing"). The test is then administered to the computer-vision system, one question at a time. After the system's answer is recorded, the system is provided the correct answer and the next question. Parsing is trivial and deterministic; the system being tested requires no natural language processing. The query engine employs statistical constraints, learned from a training set, to produce questions with essentially unpredictable answers-the answer to a question, given the history of questions and their correct answers, is nearly equally likely to be positive or negative. In this sense, the test is only about vision. The system is designed to produce streams of questions that follow natural story lines, from the instantiation of a unique object, through an exploration of its properties, and on to its relationships with other uniquely instantiated objects.

  20. Performance of a Fourth-Generation HIV Screening Assay and an Alternative HIV Diagnostic Testing Algorithm

    Science.gov (United States)

    Nasrullah, Muazzam; Wesolowski, Laura G.; Meyer, William A.; Owen, S. Michele; Masciotra, Silvina; Vorwald, Craig; Becker, William J.; Branson, Bernard M.

    2015-01-01

    Objective We evaluated the performance of the GS fourth-generation antigen/antibody assay and compared CDC’s proposed alternative algorithm (repeatedly reactive [RR] fourth-generation immunoassay [IA] followed by an HIV-1/HIV-2 differentiation IA and, if needed, nucleic acid testing [NAT]) with the current algorithm (RR third-generation IA followed by HIV-1 Western blot [WB]). Design A convenience sample of the following four specimen sets was acquired: 10,014 from insurance applicants, 493 known WB-positive, 20 known WB-indeterminate specimens, and 230 specimens from 26 HIV-1 seroconverters. Methods Specimens were tested with the GS third- and fourth-generation IAs, the Multispot HIV-1/HIV-2 differentiation IA, NAT, and WB. We applied the two algorithms using these results. Results Among insurance specimens, 13 (0.13%) specimens were IA RR: 2 were HIV-positive (RR by third- and fourth-generation IAs, and WB and Multispot positive); 2 third-generation RR and 9 fourth-generation RR specimens were false-positive. Third- and fourth-generation specificities were 99.98% (95%CI: 99.93%–100%) and 99.91% (95%CI: 99.84%–99.96%) respectively. All HIV-1 WB-positive specimens were RR by third- and fourth-generation IAs. By Multispot, 491 (99.6%) were HIV-1 positive and 2 (0.4%) were HIV-2 positive. Only eight (40%) WB-indeterminate specimens were fourth-generation RR: 6 were Multispot and NAT negative and 2 were Multispot HIV-1 positive but NAT negative. The alternative algorithm correctly classified as positive 102 seroconverter specimens with the third-generation IA and 130 with the fourth-generation IA compared with 56 using the WB with either IA. Conclusions The alternative testing algorithm improved early infection sensitivity and identified HIV-2 infections. Two potential false-positive algorithm results occurred with WB-indeterminate specimens. PMID:23135170

  1. Testing the hypothesis that treatment can eliminate HIV

    DEFF Research Database (Denmark)

    Okano, Justin T; Robbins, Danielle; Palk, Laurence

    2016-01-01

    . The elimination threshold is one new HIV infection per 1000 individuals. Here, we test the hypothesis that TasP can substantially reduce epidemics and eliminate HIV. We estimate the impact of TasP, between 1996 and 2013, on the Danish HIV epidemic in men who have sex with men (MSM), an epidemic UNAIDS has...... identified as a priority for elimination. METHODS: We use a CD4-staged Bayesian back-calculation approach to estimate incidence, and the hidden epidemic (the number of HIV-infected undiagnosed MSM). To develop the back-calculation model, we use data from an ongoing nationwide population-based study......: the Danish HIV Cohort Study. FINDINGS: Incidence, and the hidden epidemic, decreased substantially after treatment was introduced in 1996. By 2013, incidence was close to the elimination threshold: 1·4 (median, 95% Bayesian credible interval [BCI] 0·4-2·1) new HIV infections per 1000 MSM and there were only...

  2. Implementing a Routine, Voluntary HIV Testing Program in a Massachusetts County Prison

    OpenAIRE

    Liddicoat, Rebecca V.; Zheng, Hui; Internicola, Jeanne; Werner, Barbara G.; Kazianis, Arthur; Golan, Yoav; Rubinstein, Eric P.; Kenneth A Freedberg; Walensky, Rochelle P.

    2006-01-01

    Although U.S. prison inmates have higher rates of HIV infection than the general population, most inmates are not routinely tested for HIV infection at prison entry. The study objective was to implement a routine, voluntary HIV testing program in a Massachusetts county prison. During admission, inmates were given group HIV pre-test counseling and were subsequently offered private HIV testing. This intervention was compared to a control period during which HIV testing was provided only upon in...

  3. False negative HIV antibody test in HIV infected children who receive early antiretroviral treatment in a resource-limited setting

    Directory of Open Access Journals (Sweden)

    Gerardo Alvarez-Uria

    2012-01-01

    Full Text Available With the implementation of 2010 World Health Organization guidelines, the number of infants from developing countries who will initiate antiretroviral therapy (ART will increase considerably. In this study we describe the HIV antibody tests of 14 HIV infected children who initiated ART at age less than one year in a rural setting of India. The HIV rapid test was negative in seven and indeterminate in two cases, whereas the HIV enzyme-linked immunosorbent assay (ELISA antibody test was negative in three and indeterminate in one case. In one child who had both negative HIV rapid test and ELISA initially, HIV serology turned positive after having a virological failure to ART, suggesting the possibility of utilizing HIV serology for monitoring ART effectiveness in children who experience HIV seroreversion. In conclusion, HIV seroreversion of children with early initiation of ART is common and should be considered for avoiding misdiagnosis of HIV infection. 

  4. Sneller overgaan tot HIV-test

    NARCIS (Netherlands)

    Brinkman, Kees; van Bergen, Jan E. A. M.

    2013-01-01

    In the Netherlands it is estimated that around 35% of people with HIV have not yet been diagnosed, although many of them belong to well-described risk groups. Furthermore, even though early in their disease course these people often present with symptoms that should trigger suspicion of an HIV

  5. Evolution of HIV counselling and testing

    African Journals Online (AJOL)

    that is conducting a multisite cluster randomised trial of an HIV prevention intervention for HIV-positive patients delivered in the context of ongoing clinical care in ... He also has certificates in Community Health Management, Epidemiology, Health Services ... inpatient, antenatal, sexually transmitted infection, tuberculosis.

  6. Indications for HIV testing in paediatric surgical patients | Masache ...

    African Journals Online (AJOL)

    HIV testing is done in paediatric surgical patients at Queen Elizabeth Central Hospital, when HIV infection is suspected to be the underlying cause of the clinical presentation or contributing to morbidity. We conducted a retrospective, descriptive analysis of children with surgical conditions under the age of 15 who underwent ...

  7. Low HIV testing rates among tuberculosis patients in Kampala, Uganda

    NARCIS (Netherlands)

    I. Sendagire (Ibrahim); I. Schreuder (Imke); M. Mubiru (Mesach); M.S. van der Loeff (Maarten); F.G.J. Cobelens (Frank); J. Konde-Lule (Joseph)

    2010-01-01

    textabstractBackground: HIV testing among tuberculosis patients is critical in improving morbidity and mortality as those found to be HIV positive will be offered a continuum of care including ART if indicated. We conducted a cross-sectional study in three Kampala City primary care clinics: to

  8. Awareness, willingness and use of Voluntary HIV testing and ...

    African Journals Online (AJOL)

    Background: HIV testing and counseling (HTC) is the entry point to HIV prevention, treatment, care, and support services. HTC can be voluntary or mandatory. This study aimed to determine the awareness, willingness, and use of voluntary HTC (VHTC) services by students of the Niger Delta University, Bayelsa State Nigeria ...

  9. Low HIV testing rates among tuberculosis patients in Kampala, Uganda

    NARCIS (Netherlands)

    Sendagire, I.; Schreuder, I.; Mubiru, M.; van der Loeff, M.S.; Cobelens, F.; Konde-Lule, J.

    2010-01-01

    Background: HIV testing among tuberculosis patients is critical in improving morbidity and mortality as those found to be HIV positive will be offered a continuum of care including ART if indicated. We conducted a cross-sectional study in three Kampala City primary care clinics: to assess the level

  10. HIV Voluntary Counselling and Testing: A Qualitative Assessment of ...

    African Journals Online (AJOL)

    An intervention workshop was organised by a community-based project with aim to promote HIV Voluntary Counselling and Testing (VCT) and assess the perception of participants about the benefits of VCT and knowing their HIV status. The intervention workshop was conducted on a group of thirty teachers who consented ...

  11. South African HIV self-testing policy and guidance considerations

    Directory of Open Access Journals (Sweden)

    Francois Venter

    2017-10-01

    Full Text Available The gap in HIV testing remains significant and new modalities such as HIV self-testing (HIVST have been recommended to reach key and under-tested populations. In December 2016, the World Health Organization (WHO released the Guidelines on HIV Self-Testing and Partner Notification: A Supplement to the Consolidated Guidelines on HIV Testing Services (HTS and urged member countries to develop HIVST policy and regulatory frameworks. In South Africa, HIVST was included as a supplementary strategy in the National HIV Testing Services Policy in 2016, and recently, guidelines for HIVST were included in the South African National Strategic Plan for HIV, sexually transmitted infections and tuberculosis 2017–2022. This document serves as an additional guidance for the National HIV Testing Services Policy 2016, with specific focus on HIVST. It is intended for policy advocates, clinical and non-clinical HTS providers, health facility managers and healthcare providers in private and public health facilities, non-governmental, community-based and faith-based organisations involved in HTS and outreach, device manufacturers, workplace programmes and institutes of higher education.

  12. The four-meter confrontation visual field test.

    Science.gov (United States)

    Kodsi, S R; Younge, B R

    1992-01-01

    The 4-m confrontation visual field test has been successfully used at the Mayo Clinic for many years in addition to the standard 0.5-m confrontation visual field test. The 4-m confrontation visual field test is a test of macular function and can identify small central or paracentral scotomas that the examiner may not find when the patient is tested only at 0.5 m. Also, macular sparing in homonymous hemianopias and quadrantanopias may be identified with the 4-m confrontation visual field test. We recommend use of this confrontation visual field test, in addition to the standard 0.5-m confrontation visual field test, on appropriately selected patients to obtain the most information possible by confrontation visual field tests. PMID:1494829

  13. A review of the impact of cost and quality of HIV kits on HIV testing in ...

    African Journals Online (AJOL)

    Objectives: This present retospective study is to review the impact of cost and quality of HIV reagent kits in the two periods A and B on the patients and confidence on the health care provider. Methods: We collated and compared laboratory records for both periods of HIV antibodies testing at Aminu Kano Teaching Hospital ...

  14. The impact of HIV/AIDS stigma on HIV counseling and testing in a ...

    African Journals Online (AJOL)

    AIDS Counseling and Testing (HCT) is low in sub-Saharan Africa, where the disease continues to be a serious public health problem. This has in part been attributed to HIV/AIDS related stigma. Objective: To assess the level of HIV/AIDS related ...

  15. Uptake of prenatal HIV testing in Hai Phong Province, Vietnam

    DEFF Research Database (Denmark)

    Nguyen, Lan; Christoffersen, Sarah Vigh; Rasch, Vibeke

    2010-01-01

    The objective of the study is to describe the uptake of prenatal HIV testing among Vietnamese women. Exit interviews were conducted among 300 women who had delivered at Hai Phong obstetrical hospital. Information about socioeconomic characteristics and HIV testing was obtained through structured...... questionnaire interviews. It was found that 45% of the women were tested for HIV before the end of 34 weeks of gestation, 5% in 35 to 40 weeks of gestation, and 55% at labor. Low educational levels, being a farmer or worker, having a low income, and living close to the hospital were associated with being tested...... at labor. When adjusting for possible confounders, however, living more than 15 km from the hospital was the only factor, which remained significantly associated with HIV testing during labor (odds ratio = 2.15; confidence interval = 1.14-4.04). The results suggest that many Vietnamese women are not tested...

  16. Prevalence and Correlates of HIV Infection and HIV Testing Among Transgender Women in Jamaica.

    Science.gov (United States)

    Logie, Carmen H; Lacombe-Duncan, Ashley; Wang, Ying; Jones, Nicolette; Levermore, Kandasi; Neil, Ava; Ellis, Tyrone; Bryan, Nicolette; Harker, Sheldon; Marshall, Annecka; Newman, Peter A

    2016-09-01

    Transgender women are overrepresented in the Caribbean HIV epidemic. The study objective was to examine correlates of HIV infection and HIV testing among transgender women in Jamaica. We implemented a cross-sectional survey with transgender women in Kingston and Ocho Rios, Jamaica. We conducted multivariable logistic regression to identify factors associated with HIV testing and HIV infection. Among 137 transgender women [mean age 24.0; standard deviation (SD) 5.5], three-quarters (n = 103, 75.7%) had received an HIV test. Of these, one-quarter (n = 26, 25.2%) were HIV positive. In multivariable analyses, HIV testing was associated with: perceived HIV risk [adjusted odds ratio (AOR) 2.42, confidence interval (CI) 1.36-4.28], depression (AOR 1.34, CI 1.01-1.77), forced sex (AOR 3.83, CI 1.42-10.35), physical abuse (AOR 4.11, CI 1.44-11.72), perceived transgender stigma (AOR 1.23, 1.06-1.42), having a healthcare provider (AOR 5.89, CI 1.46-23.77), and lower HIV-related stigma (AOR 0.96, CI 0.92-0.99), incarceration (AOR 0.28, CI 0.10-0.78), and drug use (AOR 0.74, CI 0.58-0.95). HIV infection was associated with the following: homelessness (AOR 5.94, CI 1.27-27.74), perceived HIV risk (AOR 1.67, CI 1.02-2.72), depression (AOR 1.39, CI 1.06-1.82), STI history (AOR 56.79, CI 5.12-630.33), perceived (AOR 1.26, CI 1.06-1.51) and enacted (AOR 1.16, CI 1.04-1.29) transgender stigma, forced sex (AOR 4.14, CI 1.49-11.51), physical abuse (AOR 3.75, CI 1.39-10.12), and lower self-rated health (AOR 0.55, CI 0.30-0.98) and social support (AOR 0.79, CI 0.64-0.97). Transgender women in Jamaica experience high HIV infection rates and suboptimal HIV testing. Combination HIV prevention approaches should address transgender women's social and structural vulnerabilities.

  17. Rapid HIV testing for developing countries: the challenge of false-negative tests

    Science.gov (United States)

    Yogev, Ram

    2012-06-01

    It is a common practice in resource-constrained countries to accept two positive rapid HIV antibody test results as diagnostic for HIV infection. Because these tests are inexpensive and results are obtained quickly, they are recommended by the WHO to "scale-up" HIV testing to increase the number of people tested. The negative predictive value of rapid HIV tests is so high that negative results are considered conclusive despite the fact that false-negative results can occur in several situations. While the specificity and sensitivity of rapid HIV tests in resource-rich countries is acceptable, there are only limited data about their performance in resource-constrained countries. The challenges of rapid HIV testing in these situations will be discussed.

  18. Response to "Rapid tests for HIV type discrimination in West Africa may perform differently"

    National Research Council Canada - National Science Library

    Tchounga, Boris K; Ekouevi, Didier K; Eholie, Serge P

    2015-01-01

    ... test used for the initial discrimination of HIV-positive patients. Our team previously conducted in 2004 a field evaluation of rapid HIV serologic tests in Cote d'Ivoire and highlighted the lower accuracy of Genie II for differentiating between HIV-1, HIV-2 and dually reactive patients [4]. In our most recent study, the initial HIV diagnostic te...

  19. Global HIV Prevention, Testing, and Counseling in Military Populations.

    Science.gov (United States)

    Grillo, Michael P; Sloan, Margo; Wankie, Che; Woodland, Kelly; Reader, Elizabeth; Porter, Bruce; Shaffer, Richard; Macera, Caroline A; Bulterys, Marc

    2017-01-01

    Compared with the general population in low- and middle-income countries, military members tend to be male, young, travel more frequently away from their main sexual partners, drink more alcohol and have a consistent source of income. All of these factors may lead to an increased risk of contracting HIV. In response, the Department of Defense HIV/AIDS Prevention Program advocates for the integration of HIV prevention "building blocks" into military health services to reduce the risk of acquiring HIV among foreign uniformed services. The building blocks include basic HIV education including outreach, condom promotion, enabling HIV policies, HIV testing services, screening for sexually transmitted infections, voluntary medical male circumcision where appropriate, prevention of mother-to-child transmission, and other supportive services. The Department of Defense HIV/AIDS Prevention Programs supports implementation of these building blocks though partnerships with foreign militaries. This comprehensive prevention package, when closely linked with HIV treatment services, is the cornerstone of creating an HIVfree generation in military and surrounding communities worldwide. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  20. Accounting for False Positive HIV Tests: Is Visceral Leishmaniasis Responsible?

    Directory of Open Access Journals (Sweden)

    Leslie Shanks

    Full Text Available Co-infection with HIV and visceral leishmaniasis is an important consideration in treatment of either disease in endemic areas. Diagnosis of HIV in resource-limited settings relies on rapid diagnostic tests used together in an algorithm. A limitation of the HIV diagnostic algorithm is that it is vulnerable to falsely positive reactions due to cross reactivity. It has been postulated that visceral leishmaniasis (VL infection can increase this risk of false positive HIV results. This cross sectional study compared the risk of false positive HIV results in VL patients with non-VL individuals.Participants were recruited from 2 sites in Ethiopia. The Ethiopian algorithm of a tiebreaker using 3 rapid diagnostic tests (RDTs was used to test for HIV. The gold standard test was the Western Blot, with indeterminate results resolved by PCR testing. Every RDT screen positive individual was included for testing with the gold standard along with 10% of all negatives. The final analysis included 89 VL and 405 non-VL patients. HIV prevalence was found to be 12.8% (47/ 367 in the VL group compared to 7.9% (200/2526 in the non-VL group. The RDT algorithm in the VL group yielded 47 positives, 4 false positives, and 38 negatives. The same algorithm for those without VL had 200 positives, 14 false positives, and 191 negatives. Specificity and positive predictive value for the group with VL was less than the non-VL group; however, the difference was not found to be significant (p = 0.52 and p = 0.76, respectively.The test algorithm yielded a high number of HIV false positive results. However, we were unable to demonstrate a significant difference between groups with and without VL disease. This suggests that the presence of endemic visceral leishmaniasis alone cannot account for the high number of false positive HIV results in our study.

  1. Accounting for False Positive HIV Tests: Is Visceral Leishmaniasis Responsible?

    Science.gov (United States)

    Shanks, Leslie; Ritmeijer, Koert; Piriou, Erwan; Siddiqui, M Ruby; Kliescikova, Jarmila; Pearce, Neil; Ariti, Cono; Muluneh, Libsework; Masiga, Johnson; Abebe, Almaz

    2015-01-01

    Co-infection with HIV and visceral leishmaniasis is an important consideration in treatment of either disease in endemic areas. Diagnosis of HIV in resource-limited settings relies on rapid diagnostic tests used together in an algorithm. A limitation of the HIV diagnostic algorithm is that it is vulnerable to falsely positive reactions due to cross reactivity. It has been postulated that visceral leishmaniasis (VL) infection can increase this risk of false positive HIV results. This cross sectional study compared the risk of false positive HIV results in VL patients with non-VL individuals. Participants were recruited from 2 sites in Ethiopia. The Ethiopian algorithm of a tiebreaker using 3 rapid diagnostic tests (RDTs) was used to test for HIV. The gold standard test was the Western Blot, with indeterminate results resolved by PCR testing. Every RDT screen positive individual was included for testing with the gold standard along with 10% of all negatives. The final analysis included 89 VL and 405 non-VL patients. HIV prevalence was found to be 12.8% (47/ 367) in the VL group compared to 7.9% (200/2526) in the non-VL group. The RDT algorithm in the VL group yielded 47 positives, 4 false positives, and 38 negatives. The same algorithm for those without VL had 200 positives, 14 false positives, and 191 negatives. Specificity and positive predictive value for the group with VL was less than the non-VL group; however, the difference was not found to be significant (p = 0.52 and p = 0.76, respectively). The test algorithm yielded a high number of HIV false positive results. However, we were unable to demonstrate a significant difference between groups with and without VL disease. This suggests that the presence of endemic visceral leishmaniasis alone cannot account for the high number of false positive HIV results in our study.

  2. Detection of Early Sero-Conversion HIV Infection Using the INSTITM HIV-1 Antibody Point-of-Care Test

    OpenAIRE

    Cook, Darrel; Gilbert, Mark; DiFrancesco, Lillo; Krajden, Mel

    2010-01-01

    We compared the INSTITM HIV-1 Antibody Point-of-Care (POC) Test to laboratory-based tests for detection of early sero-conversion (i.e. acute) HIV infections. Fifty-three (53) individuals with early HIV infection, (i.e. 3rd generation anti-HIV EIA non-reactive or reactive, HIV-1 Western Blot non-reactive or indeterminate and HIV-1 p24 antigen reactive) were tested by INSTITM. The INSTITM test was reactive for 34/49 (sensitivity 69.4%; 95% confidence interval 54.6-81.8%) early-infected individu...

  3. HIV testing of pregnant women: an ethical analysis.

    Science.gov (United States)

    Johansson, Kjell Arne; Pedersen, Kirsten Bjerkreim; Andersson, Anna-Karin

    2011-12-01

    Recent global advances in available technology to prevent mother-to-child HIV transmission necessitate a rethinking of contemporary and previous ethical debates on HIV testing as a means to preventing vertical transmission. In this paper, we will provide an ethical analysis of HIV-testing strategies of pregnant women. First, we argue that provider-initiated opt-out HIV testing seems to be the most effective HIV test strategy. The flip-side of an opt-out strategy is that it may end up as involuntary testing in a clinical setting. We analyse this ethical puzzle from a novel perspective, taking into account the moral importance of certain hypothetical preferences of the child, as well as the moral importance of certain actual preferences of the mother. Finally, we balance the conflicting concerns and try to arrive at an ethically sound solution to this dilemma. Our aim is to introduce a novel perspective from which to analyse testing strategies, and to explore the implications and possible benefits of our proposal. The conclusion from our analysis is that policies that recommend provider-initiated opt-out HIV testing of pregnant mothers, with a risk of becoming involuntary testing in a clinical setting, are acceptable. The rationale behind this is that the increased availability of very effective and inexpensive life-saving drugs makes the ethical problems raised by the possible intrusiveness of HIV testing less important than the child's hypothetical preferences to be born healthy. Health care providers, therefore, have a duty to offer both opt-out HIV testing and available PMTCT (preventing mother-to-child transmission) interventions. © 2011 Blackwell Publishing Ltd.

  4. Introducing visual participatory methods to develop local knowledge on HIV in rural South Africa

    OpenAIRE

    Brooks, Chloe; D’Ambruoso, Lucia; Kazimierczak, Karolina; Ngobeni, Sizzy; Twine, Rhian; Tollman, Stephen; Kahn, Kathleen; Byass, Peter

    2017-01-01

    Introduction South Africa is a country faced with complex health and social inequalities, in which HIV/AIDS has had devastating impacts. The study aimed to gain insights into the perspectives of rural communities on HIV-related mortality. Methods A participatory action research (PAR) process, inclusive of a visual participatory method (Photovoice), was initiated to elicit and organise local knowledge and to identify priorities for action in a rural subdistrict underpinned by the Agincourt Hea...

  5. Identifying HIV infection in South African women: How does a fourth generation HIV rapid test perform?

    Directory of Open Access Journals (Sweden)

    Kapila Bhowan

    2011-12-01

    Full Text Available Background: HIV rapid tests (RT play an important role in tackling the HIV pandemic in South Africa. Third generation RT that detect HIV antibodies are currently used to diagnose HIV infection at the point of care. Determine Combo (DC is the first fourth generation RT that detects both p24 antigen (p24Ag and HIV antibodies (Ab, theoretically reducing the window period and increasing detection rates. Early detection of maternal HIV infection is important to mitigate the high risk of vertical transmission associated with acute maternal infection. Objectives: We assessed the performance of the DC RT against third generation RT in antenatal and post-partum women. Methods: Third generation RT Advance Quality and Acon were used in a serial algorithm to diagnose HIV infection in antenatal and post-partum women over six months at a tertiary hospital in Johannesburg, South Africa. This data provided the reference against which the DC RT was compared on plasma and whole blood samples. Results: The 1019 participants comprised 345 (34% antenatal and 674 (66% post-partum women. Ninety women (8.8% tested HIV-positive of whom 59 (66% were tested antenatally, and 31 (34% post-partum yielding prevalence rates of 17.1% and 4.6% respectively. The sensitivity and specificity of the Ab component of DC on plasma antenatally was 100% (93.8% – 100% and 100% (98.6% – 100% respectively and post-partum was 100% (88.9% – 100% and 99.6% (98.8% – 99.9% respectively. One false positive and not a single true positive p24Ag was detected. Of 505 post-partum women who tested HIV-negative 6–12 months prior to enrolment, 12 (2.4% seroconverted. Conclusion: The fourth generation DC offered no advantage over current third generation RT in the diagnosis of HIV infection.

  6. An Adaptive Approach to Locating Mobile HIV Testing Services.

    Science.gov (United States)

    Gonsalves, Gregg S; Crawford, Forrest W; Cleary, Paul D; Kaplan, Edward H; Paltiel, A David

    2017-07-01

    Public health agencies suggest targeting "hotspots" to identify individuals with undetected HIV infection. However, definitions of hotspots vary. Little is known about how best to target mobile HIV testing resources. We conducted a computer-based tournament to compare the yield of 4 algorithms for mobile HIV testing. Over 180 rounds of play, the algorithms selected 1 of 3 hypothetical zones, each with unknown prevalence of undiagnosed HIV, in which to conduct a fixed number of HIV tests. The algorithms were: 1) Thompson Sampling, an adaptive Bayesian search strategy; 2) Explore-then-Exploit, a strategy that initially draws comparable samples from all zones and then devotes all remaining rounds of play to HIV testing in whichever zone produced the highest observed yield; 3) Retrospection, a strategy using only base prevalence information; and; 4) Clairvoyance, a benchmarking strategy that employs perfect information about HIV prevalence in each zone. Over 250 tournament runs, Thompson Sampling outperformed Explore-then-Exploit 66% of the time, identifying 15% more cases. Thompson Sampling's superiority persisted in a variety of circumstances examined in the sensitivity analysis. Case detection rates using Thompson Sampling were, on average, within 90% of the benchmark established by Clairvoyance. Retrospection was consistently the poorest performer. We did not consider either selection bias (i.e., the correlation between infection status and the decision to obtain an HIV test) or the costs of relocation to another zone from one round of play to the next. Adaptive methods like Thompson Sampling for mobile HIV testing are practical and effective, and may have advantages over other commonly used strategies.

  7. Confrontation visual field testing in routine ophthalmic practice ...

    African Journals Online (AJOL)

    Background: Visual field testing, aids in detecting, localizing and monitoring diseases of the visual pathway. Early detection may help to preserve the patient's sight or life. In some situations, standard perimetry may not be possible. Aim: To highlight the relevance of confrontation visual field testing (CVF) in routine ...

  8. Quality assurance of HIV counselling and testing for the prevention ...

    African Journals Online (AJOL)

    child transmission of HIV in Rivers State, Nigeria. ... Similarly, other resources for counselling such as television and video sets, posters and banners were in short supply. Important issues in post-test counselling such as information about ...

  9. Evaluation of current rapid HIV test algorithms in Rakai, Uganda.

    Science.gov (United States)

    Galiwango, Ronald M; Musoke, Richard; Lubyayi, Lawrence; Ssekubugu, Robert; Kalibbala, Sarah; Ssekweyama, Viola; Mirembe, Viola; Nakigozi, Gertrude; Reynolds, Steven J; Serwadda, David; Gray, Ronald H; Kigozi, Godfrey

    2013-09-01

    Rapid HIV tests are a crucial component of HIV diagnosis in resource limited settings. In Uganda, the Ministry of Health allows both serial and parallel HIV rapid testing using Determine, Stat-Pak and Uni-Gold. In serial testing, a non-reactive result on Determine ends testing. The performance of serial and parallel algorithms with Determine and Stat-Pak test kits was assessed. A cross-sectional diagnostic test accuracy evaluation using three rapid HIV test kits as per the recommended parallel test algorithm was followed by EIA-WB testing with estimates of the performance of serial testing algorithm. In 2520 participants tested by parallel rapid algorithms, 0.6% had weakly reactive result. Parallel testing had 99.7% sensitivity and 99.8% specificity. If Stat-Pak was used as the first screening test for a serial algorithm, the sensitivity was 99.6% and specificity was 99.7%. However, if Determine was used as the screening test, sensitivity was 97.3% and specificity was 99.9%. Serial testing with Stat-Pak as the initial screening test performed as well as parallel testing, but Determine was a less sensitive screen. Serial testing could be cost saving. Copyright © 2013 Elsevier B.V. All rights reserved.

  10. Sexual behaviors and HIV/syphilis testing among transgender individuals in China: implications for expanding HIV testing services.

    Science.gov (United States)

    Best, John; Tang, Weiming; Zhang, Ye; Han, Larry; Liu, Fengying; Huang, Shujie; Yang, Bin; Wei, Chongyi; Tucker, Joseph D

    2015-05-01

    HIV and syphilis are disproportionately common among transgender individuals globally, yet few studies have investigated transgender HIV/syphilis risk and testing in low- and middle-income nations. We conducted an online survey of men who have sex with men (MSM) and transgender individuals to examine sexual behaviors and HIV/syphilis testing in China. We recruited MSM and transgender individuals from 2 major Chinese lesbian, gay, bisexual, and transgender Web platforms. χ Test and logistic regression were used to compare risk behaviors, HIV and syphilis testing history, and prevalence between transgender individuals and other MSM. Among the 1320 participants, 52 (3.9%) self-identified as transgender. Demographics, including education, employment, and marital status, were similar between both groups, whereas transgender individuals were older. Condomless anal intercourse rate was comparable between the groups. Transgender individuals were less likely to report ever testing for HIV (34.6% vs. 62.0%) and syphilis (15.7% vs. 31.2%) with adjusted odds ratios of 0.36 (95% confidence interval, 0.20-0.65) and 0.42 (95% confidence interval, 0.20-0.91), respectively. We found a trend toward a higher HIV prevalence among transgender individuals (11.1% vs. 5.7%, P = 0.12). Transgender individuals have suboptimal HIV and syphilis testing rates in China. Given the substantial risk behaviors and burden of HIV/STI in the general Chinese MSM population and a lack of knowledge about transgender individuals, enhanced HIV/syphilis testing programs for transgender individuals in China are needed.

  11. Interactive Data Visualization for HIV Cohorts: Leveraging Data Exchange Standards to Share and Reuse Research Tools.

    Directory of Open Access Journals (Sweden)

    Meridith Blevins

    Full Text Available To develop and disseminate tools for interactive visualization of HIV cohort data.If a picture is worth a thousand words, then an interactive video, composed of a long string of pictures, can produce an even richer presentation of HIV population dynamics. We developed an HIV cohort data visualization tool using open-source software (R statistical language. The tool requires that the data structure conform to the HIV Cohort Data Exchange Protocol (HICDEP, and our implementation utilized Caribbean, Central and South America network (CCASAnet data.This tool currently presents patient-level data in three classes of plots: (1 Longitudinal plots showing changes in measurements viewed alongside event probability curves allowing for simultaneous inspection of outcomes by relevant patient classes. (2 Bubble plots showing changes in indicators over time allowing for observation of group level dynamics. (3 Heat maps of levels of indicators changing over time allowing for observation of spatial-temporal dynamics. Examples of each class of plot are given using CCASAnet data investigating trends in CD4 count and AIDS at antiretroviral therapy (ART initiation, CD4 trajectories after ART initiation, and mortality.We invite researchers interested in this data visualization effort to use these tools and to suggest new classes of data visualization. We aim to contribute additional shareable tools in the spirit of open scientific collaboration and hope that these tools further the participation in open data standards like HICDEP by the HIV research community.

  12. Sensitivity and specificity of rapid HIV testing of pregnant women in India.

    Science.gov (United States)

    Bhore, A V; Sastry, J; Patke, D; Gupte, N; Bulakh, P M; Lele, S; Karmarkar, A; Bharucha, K E; Shrotri, A; Pisal, H; Suryawanshi, N; Tripathy, S; Risbud, A R; Paranjape, R S; Shankar, A V; Kshirsagar, A; Phadke, M A; Joshi, P L; Brookmeyer, R S; Bollinger, R C

    2003-01-01

    Efforts to prevent HIV transmission from mother to infants in settings like India may benefit from the availability of reliable methods for rapid and simple HIV screening. Data from India on the reliability of rapid HIV test kits are limited and there are no data on the use of rapid HIV tests for screening of pregnant women. Pregnant women attending an antenatal clinic and delivery room in Pune agreed to participate in an evaluation of five rapid HIV tests, including (a) a saliva brush test (Oraquick HIV-1/2, Orasure Technologies Inc.), (b) a rapid plasma test (Oraquick HIV-1/2) and (c) three rapid finger prick tests (Oraquick HIV-1/2; HIV-1/2 Determine, Abbott; NEVA HIV-1/2 Cadila). Results of the rapid tests were compared with three commercial plasma enzyme immunoassay (EIA) tests (Innotest HIV AB EIA, Lab systems/ELISCAN HIV AB EIA, UBI HIV Ab EIA). Between September 2000 and October 1, 2001, 1258 pregnant women were screened for HIV using these rapid tests. Forty-four (3.49%) of the specimens were HIV-antibody-positive by at least two plasma EIA tests. All of the rapid HIV tests demonstrated excellent specificity (96-100%). The sensitivity of the rapid tests ranged from 75-94%. The combined sensitivity and specificity of a two-step algorithm for rapid HIV testing was excellent for a number of combinations of the five rapid finger stick tests. In this relatively low HIV prevalence population of pregnant women in India, the sensitivity of the rapid HIV tests varied, when compared to a dual EIA algorithm. In general, the specificity of all the rapid tests was excellent, with very few false positive HIV tests. Based upon these data, two different rapid HIV tests for screening pregnant women in India would be highly sensitive, with excellent specificity to reliably prevent inappropriate use of antiretroviral therapy for prevention of vertical HIV transmission.

  13. Evaluation of the automated 'Enzymen-Test Anti HIV-1 + 2' and 'Enzymen-Test Anti HIV-1/2 selective' for the combined detection and differentiation of anti-HIV-1 and anti-HIV-2 antibodies.

    Science.gov (United States)

    Weber, B; Hess, G; Koberstein, R; Doerr, H W

    1993-10-01

    A new, modular automated ELISA (test 1) for HIV-1 and HIV-2 antibody detection and differentiation (Enzymun-Test Anti HIV-1 + 2; anti HIV 1/2 selective, Boehringer Mannheim) was compared with 3 alternative enzyme immunoassays (Abbott recombinant HIV-1/HIV-2 3rd generation EIA, Abbott (test 2); Enzygnost HIV 1 + 2, Behringwerke (test 3); and Wellcozyme HIV recombinant, Murex (test 4)) and Western blot (New LAV I Blot and New LAV II Blot; Diagnostics Pasteur). 380 serum samples from HIV-1 and HIV-2 seropositive patients at different stages of disease, high risk individuals, patients with conditions unrelated to AIDS and from healthy blood donors were used in this evaluation along with 6 seroconversion panels, 6 serum dilution series and 'tricky' sera (repeatedly positive results in ELISA, but negative or undeterminate in Western blot; n = 67). Using the Western blot as reference assay, the overall sensitivity of the four ELISAs was 100%. Test 4 showed the highest sensitivity for antibody detection in seroconversion and dilution series. A high specificity was achieved with test 1 (100%) and test 2 (99.4%). A relatively high rate of false positive results were obtained with test 2 (n = 12) and test 3 (n = 10) by testing 'tricky' sera or samples obtained from healthy blood donors. In comparison to Western blot, a clear differentiation between HIV-1 and HIV-2 antibody serum samples was achieved with the Enzymun-Test. The results of the present study show that the Enzymun-Test provides reliable selective HIV-1 and HIV-2 antibody detection at a cost which is significantly lower than the costs of Western blot tests. Furthermore, the evaluation of test 1 suggests, that it is a highly specific assay for HIV antibody detection.

  14. Visually impaired children and haptic intelligence test scores: intelligence test for visually impaired children (ITVIC).

    Science.gov (United States)

    Dekker, R

    1993-06-01

    This paper reports the results of verbal and haptic intelligence tests for the whole population of the visually impaired, braille-educated Dutch children and Dutch-speaking children in Belgium. The scores of children with and without usable vision generally confirmed expectations. Children with usable vision had higher spatial test scores. Those without usable vision did better on verbal memory tests and school-achievement tests for writing accuracy and technical reading. Children in regular or integrated education scored higher on verbal, reasoning and school-achievement tests. Evaluation of the effect of systematically varied task factors in four spatial tests indicated that, for two of the tests, having usable vision interacted with the task factors.

  15. Telephone communication of HIV testing results for improving knowledge of HIV infection status.

    Science.gov (United States)

    Tudor Car, Lorainne; Gentry, Sarah; van-Velthoven, Michelle H M M T; Car, Josip

    2013-01-31

    This is one of three Cochrane reviews that examine the role of the telephone in HIV/AIDS services. Both in developed and developing countries there is a large proportion of people who do not know they are infected with HIV. Knowledge of one's own HIV serostatus is necessary to access HIV support, care and treatment and to prevent acquisition or further transmission of HIV. Using telephones instead of face-to-face or other means of HIV test results delivery could lead to more people receiving their HIV test results. To assess the effectiveness of telephone use for delivery of HIV test results and post-test counselling.To evaluate the effectiveness of delivering HIV test results by telephone, we were interested in whether they can increase the proportion of people who receive their HIV test results and the number of people knowing their HIV status. We searched The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, PubMed Central, PsycINFO, ISI Web of Science, Cumulative Index to Nursing & Allied Health (CINAHL), WHOs The Global Health Library and Current Controlled Trials from 1980 to June 2011. We also searched grey literature sources such as Dissertation Abstracts International,CAB Direct Global Health, OpenSIGLE, The Healthcare Management Information Consortium, Google Scholar, Conference on Retroviruses and Opportunistic Infections, International AIDS Society and AEGIS Education Global Information System, and reference lists of relevant studies for this review. Randomised controlled trials (RCTs), quasi-randomised controlled trials (qRCTs), controlled before and after studies (CBAs), and interrupted time series (ITS) studies comparing the effectiveness of telephone HIV test results notification and post-test counselling to face-to-face or other ways of HIV test result delivery in people regardless of their demographic characteristics and in all settings. Two reviewers independently searched, screened, assessed study quality and extracted data. A

  16. The four-meter confrontation visual field test.

    OpenAIRE

    Kodsi, S R; Younge, B R

    1992-01-01

    The 4-m confrontation visual field test has been successfully used at the Mayo Clinic for many years in addition to the standard 0.5-m confrontation visual field test. The 4-m confrontation visual field test is a test of macular function and can identify small central or paracentral scotomas that the examiner may not find when the patient is tested only at 0.5 m. Also, macular sparing in homonymous hemianopias and quadrantanopias may be identified with the 4-m confrontation visual field test....

  17. Quality of HIV laboratory testing in Tanzania: a situation analysis ...

    African Journals Online (AJOL)

    Source and level of customer satisfaction of HIV test kits supply was established. Of 12 laboratories, nine used rapid tests for screening and two used rapid tests for diagnosis. In the 12 laboratories, four used double ELISA and five used single ELISA and three did not use ELISA. Confirmatory tests observed were Western ...

  18. Detection of acute HIV infections in an urban HIV counseling and testing population in the United States.

    Science.gov (United States)

    Priddy, Frances H; Pilcher, Christopher D; Moore, Renee H; Tambe, Pradnya; Park, Mahin N; Fiscus, Susan A; Feinberg, Mark B; del Rio, Carlos

    2007-02-01

    The southeastern United States has an increasing burden of HIV, particularly among blacks, women, and men who have sex with men. To evaluate HIV nucleic acid amplification testing (NAAT) and antibody-based algorithms in determination of HIV incidence, detection of acute HIV infections, and surveillance of drug-resistant virus transmission in the urban southeastern United States, we conducted a cross-sectional analysis of prospectively collected data from 2202 adults receiving HIV testing and counseling at 3 sites in Atlanta, GA from October 2002 through January 2004. After standard testing with an HIV enzyme immunoassay (EIA) and Western blot confirmation, HIV-positive specimens were tested with 2 standardized assays to detect recent infection. HIV antibody-negative specimens were pooled and screened for HIV using NAAT. Seventy (3.2%) of 2202 subjects were HIV infected. Only 66 were positive on the standard HIV antibody test; 4 were antibody-negative but acutely HIV infected. The overall annual HIV incidence was 1.1% (95% confidence interval [CI]: 0.4 to 1.8) based on the Vironostika-LS assay and 1.3% (95% CI: 0.6 to 2.1) based on the BED Incidence Enzyme Immunoassay (EIA). The prevalence of acute HIV infection was 1.8 per 1000 persons (95% CI: 0.7 to 4.6). The sensitivity of the current testing algorithm using an EIA and Western blot test for detectable infections was only 94.3% (95% CI: 86.2 to 97.8). All 3 of the acutely infected subjects genotyped had drug resistance mutations, and 1 had multiclass resistance. Adding NAAT-based screening to standard HIV antibody testing increased case identification by 6% and uncovered the first evidence of multidrug-resistant HIV transmission in Atlanta. Antibody tests alone are insufficient for public health practice in high-risk urban HIV testing settings.

  19. Opt-out HIV testing in prison: informed and voluntary?

    Science.gov (United States)

    Rosen, David L; Golin, Carol E; Grodensky, Catherine A; May, Jeanine; Bowling, J Michael; DeVellis, Robert F; White, Becky L; Wohl, David A

    2015-01-01

    HIV testing in prison settings has been identified as an important mechanism to detect cases among high-risk, underserved populations. Several public health organizations recommend that testing across health-care settings, including prisons, be delivered in an opt-out manner. However, implementation of opt-out testing within prisons may pose challenges in delivering testing that is informed and understood to be voluntary. In a large state prison system with a policy of voluntary opt-out HIV testing, we randomly sampled adult prisoners in each of seven intake prisons within two weeks after their opportunity to be HIV tested. We surveyed prisoners' perception of HIV testing as voluntary or mandatory and used multivariable statistical models to identify factors associated with their perception. We also linked survey responses to lab records to determine if prisoners' test status (tested or not) matched their desired and perceived test status. Thirty-eight percent (359/936) perceived testing as voluntary. The perception that testing was mandatory was positively associated with age less than 25 years (adjusted relative risk [aRR]: 1.45, 95% confidence interval [CI]: 1.24, 1.71) and preference that testing be mandatory (aRR: 1.81, 95% CI: 1.41, 2.31) but negatively associated with entry into one of the intake prisons (aRR: 0.41 95% CI: 0.27, 0.63). Eighty-nine percent of prisoners wanted to be tested, 85% were tested according to their wishes, and 82% correctly understood whether or not they were tested. Most prisoners wanted to be HIV tested and were aware that they had been tested, but less than 40% understood testing to be voluntary. Prisoners' understanding of the voluntary nature of testing varied by intake prison and by a few individual-level factors. Testing procedures should ensure that opt-out testing is informed and understood to be voluntary by prisoners and other vulnerable populations.

  20. Late HIV Testing in a Cohort of HIV-Infected Patients in Puerto Rico.

    Science.gov (United States)

    Tossas-Milligan, Katherine Y; Hunter-Mellado, Robert F; Mayor, Angel M; Fernández-Santos, Diana M; Dworkin, Mark S

    2015-09-01

    Late HIV testing (LT), defined as receiving an AIDS diagnosis within a year of one's first positive HIV test, is associated with higher HIV transmission, lower HAART effectiveness, and worse outcomes. Latinos represent 36% of LT in the US, yet research concerning LT among HIV cases in Puerto Rico is scarce. Multivariable logistic regression analysis was used to identify factors associated with LT, and a Cochran‒Armitage test was used to determine LT trends in an HIV-infected cohort followed at a clinic in Puerto Rico specialized in the management and treatment of HIV. From 2000 to 2011, 47% of eligible patients were late testers, with lower median CD4 counts (54 vs. 420 cells/mm3) and higher median HIV viral load counts (253,680 vs. 23,700 copies/mL) than non-LT patients. LT prevalence decreased significantly, from 47% in 2000 to 37% in 2011. In a mutually adjusted logistic regression model, males, older age at enrollment and past history of IDU significantly increased LT odds, whereas having a history of amphetamine use decreased LT odds. When the data were stratified by mode of transmission, it became apparent that only the category men who have sex with men (MSM) saw a significant reduction in the proportion of LT, falling from 67% in 2000 to 33% in 2011. These results suggest a gap in early HIV detection in Puerto Rico, a gap that decreased only among MSM. An evaluation of the manner in which current HIV-testing guidelines are implemented on the island is needed.

  1. Introducing visual participatory methods to develop local knowledge on HIV in rural South Africa.

    Science.gov (United States)

    Brooks, Chloe; D'Ambruoso, Lucia; Kazimierczak, Karolina; Ngobeni, Sizzy; Twine, Rhian; Tollman, Stephen; Kahn, Kathleen; Byass, Peter

    2017-01-01

    South Africa is a country faced with complex health and social inequalities, in which HIV/AIDS has had devastating impacts. The study aimed to gain insights into the perspectives of rural communities on HIV-related mortality. A participatory action research (PAR) process, inclusive of a visual participatory method (Photovoice), was initiated to elicit and organise local knowledge and to identify priorities for action in a rural subdistrict underpinned by the Agincourt Health and Socio-Demographic Surveillance System (HDSS). We convened three village-based discussion groups, presented HDSS data on HIV-related mortality, elicited subjective perspectives on HIV/AIDS, systematised these into collective accounts and identified priorities for action. Framework analysis was performed on narrative and visual data, and practice theory was used to interpret the findings. A range of social and health systems factors were identified as causes and contributors of HIV mortality. These included alcohol use/abuse, gender inequalities, stigma around disclosure of HIV status, problems with informal care, poor sanitation, harmful traditional practices, delays in treatment, problems with medications and problematic staff-patient relationships. To address these issues, developing youth facilities in communities, improving employment opportunities, timely treatment and extending community outreach for health education and health promotion were identified. Addressing social practices of blame, stigma and mistrust around HIV-related mortality may be a useful focus for policy and planning. Research that engages communities and authorities to coproduce evidence can capture these practices, improve communication and build trust. Actions to reduce HIV should go beyond individual agency and structural forces to focus on how social practices embody these elements. Initiating PAR inclusive of visual methods can build shared understandings of disease burdens in social and health systems contexts

  2. HIV Testing and awareness of HIV status among people who inject drugs in greater Kuala Lumpur, Malaysia.

    Science.gov (United States)

    Bazazi, Alexander R; Vijay, Aishwarya; Crawford, Forrest W; Heimer, Robert; Kamarulzaman, Adeeba; Altice, Frederick L

    2018-01-01

    HIV testing services are the gateway into HIV treatment and are critical for monitoring the epidemic. HIV testing is recommended at least annually in high-risk populations, including people who inject drugs (PWID). In Malaysia, the HIV epidemic is concentrated among PWID, but their adherence to testing recommendations and the proportion of HIV-positive PWID who are aware of their status remain unknown. We recruited 460 PWID in Greater Kuala Lumpur using respondent-driven sampling and conducted HIV testing. We examined past testing behaviors, estimating testing frequency, correlates of testing in the past 12 months, and the proportion of those living with HIV who were aware of their status. Results showed that most PWID living with HIV (90.4%, 95% CI: 83.6%-95.9%) were aware of their status. Among those never previously diagnosed with HIV, few had accessed HIV testing in the past 12 months (14.3%, 95% CI: 11.1%-18.0%). Prison (57.0%) and compulsory drug detention centers (36.1%) were the primary locations where PWID reported ever being HIV tested, and the main correlate of recent testing in regression was recent criminal justice involvement. Although awareness of HIV status may be high among PWID living with HIV in Kuala Lumpur, testing occurs primarily in prisons and compulsory drug detention centers, where it is involuntary and linkage to care is limited. A shift in HIV testing policy is needed to align health and human rights objectives, replacing mandatory testing with voluntary testing in settings where individuals can be rapidly linked to HIV care.

  3. HIV Viral Load Testing in Laos

    OpenAIRE

    Paboriboune, Phimpha; Ngin, S.; Kieffer, A.; Phimphachanh, C.; Bouchard, B; Fan, P. Ho; Steenkeste, N.; Viretto, G; Fernandez, M.; Longuet, C.; Babin, F.X.; Nerrienet, E.

    2013-01-01

    The number of people living with HIV/AIDS in the People’s Democratic Republic of Laos (also known as Laos PDR) is estimated at 13,600 and the number of people in need of antiretroviral therapy at 8,000. Today, around 3,200 HIV infected individuals receive treatment in seven centres throughout the country. Until recently, antiretroviral treated patients were followed-up only on the basis of clinical and immunological criteria. In 2009 the Centre d'Infectiologie Christophe Mérieux in Laos PDR (...

  4. Causes of false-positive HIV rapid diagnostic test results.

    Science.gov (United States)

    Klarkowski, Derryck; O'Brien, Daniel P; Shanks, Leslie; Singh, Kasha P

    2014-01-01

    HIV rapid diagnostic tests have enabled widespread implementation of HIV programs in resource-limited settings. If the tests used in the diagnostic algorithm are susceptible to the same cause for false positivity, a false-positive diagnosis may result in devastating consequences. In resource-limited settings, the lack of routine confirmatory testing, compounded by incorrect interpretation of weak positive test lines and use of tie-breaker algorithms, can leave a false-positive diagnosis undetected. We propose that heightened CD5+ and early B-lymphocyte response polyclonal cross-reactivity are a major cause of HIV false positivity in certain settings; thus, test performance may vary significantly in different geographical areas and populations. There is an urgent need for policy makers to recognize that HIV rapid diagnostic tests are screening tests and mandate confirmatory testing before reporting an HIV-positive result. In addition, weak positive results should not be recognized as valid except in the screening of blood donors.

  5. Karma: a Visualization Test-Bed

    Science.gov (United States)

    Gooch, Richard

    Visualization is becoming increasingly important to the astronomer. This paper gives an overview of the Karma library {http://wwwatnf.atnf.csiro.au/karma/} which provides both a toolkit to ease development of visualization applications and a suitable environment for ``production'' tools.

  6. Testing the visual consistency of web sites

    NARCIS (Netherlands)

    van der Geest, Thea; Loorbach, N.R.

    2005-01-01

    Consistency in the visual appearance of Web pages is often checked by experts, such as designers or reviewers. This article reports a card sort study conducted to determine whether users rather than experts could distinguish visual (in-)consistency in Web elements and pages. The users proved to

  7. The rise of targeted HIV oral rapid testing in Australia.

    Science.gov (United States)

    Chan, Derek; Stewart, Michael; Smith, Maggie; Price, Tony; Lusk, Jo; Ooi, Catriona; Read, Phillip; Finlayson, Robert

    2015-03-16

    To assess the performance and acceptability of the OraQuick Advance Rapid HIV-1/2 Antibody Test (ORT) in Australia. Cross-sectional study of 1074 men who have sex with men (MSM) and individuals aged 18 years or older at high risk of acquiring HIV infection who attended five public HIV or sexual health services, two general practices and one community clinic in Sydney from 1 January to 31 December 2013. One ORT confirmed by fourth-generation HIV enzyme immunoassay (EIA). ORT sensitivity and specificity compared with EIA; acceptabiity of the ORT to participants. 83.5% of participants were MSM, 90.3% were aged under 50 years, and 9% had never been tested for HIV. There were 11 true-positive ORT results, two false-negative (non-reactive) results (both were early infections), and one false-positive (reactive) result (due to reader error). Sensitivity and specificity were 84.6% and 99.8%, respectively (compared with a sensitivity of 99.3% and specificity of 99.8% listed by the manufacturer). Three quarters of participants (74.0%; 730/987) found the ORT less stressful than venous sampling. Those who usually had tests at intervals of greater than 3 months deemed the ORT less stressful than those who had quarterly tests (77.5% v 64.8%; Ptesting. ORT sensitivity is reduced in early HIV infection. The test is highly acceptable and less stressful than venous sampling. Participants are keen to be tested with the ORT in future, would recommend it to peers and would have tests more frequently if the ORT were licensed. TGA approval of this test might slow increasing HIV infection rates among MSM and others by facilitating diagnosis and treatment.

  8. A Rorschach Test for Visual Classification Strategies

    Science.gov (United States)

    Watson, Andrew B.; Rosenholtz, Ruth; Null, Cynthia H. (Technical Monitor)

    1996-01-01

    Contemporary models of pattern, detection and discrimination often employ template matching, but there have been few direct tests of this proposition. Adopting a method developed by Ahumada, we have analyzed how human observers discriminate between two letters of the alphabet ('c' and 'x'). The stimulus consisted of a one degree tall letter plus a four degree field of static white noise, both displayed for 16 frames at a 67 Hz frame rate. Our font and display dimensions approximated those of Solomon and Pelli. The observer identified the letter presented. A QUEST staircase varied letter contrast to maintain a 75% correct rate. For each trial, we preserved the information required to reconstruct the noise field. Possible trial categories based on (signal, response) pairs are: (c,c), (c,x), (x,c), (x,x). Noise fields were averaged separately for each category, and a final classification image was obtained by averaging the four mean images after inverting the sign of categories in which x was the response. If the observer employs a template, it should be revealed in the classification image. The lowpass-filtered classification image derived from 2048 responses of one observer is shown here, along with the corresponding ideal template. An approximation to the ideal template can be seen appropriately located within the classification image. We have also simulated and will discuss the classification images expected from various discrimination models in this experimental context. The construction of classification images appears to be a powerful tool for studying classification strategies used by human observers. Like a Rorschach test, it surreptitiously discovers the inner desires of the visual system.

  9. Proposal of Testing Diagrams for Visualizing Test Cases in Software Testing

    OpenAIRE

    浦田, 聖也; 片山, 徹郎

    2013-01-01

    A software system becomes a large scale in recent years. As a result, test cases used in software testing have become a large scale. It is difficult to understand where the software system is tested by a large quantity of test cases. For this reason, testing diagrams to visualize test cases are proposed. To generate the testing diagrams, the test case and UML (Unified Modeling Language) diagram are compared and their common information is added to the UML diagram. This paper uses communicatio...

  10. Lack of HIV Testing and Awareness of HIV Infection among Men Who Have Sex with Men, Beijing, China

    Science.gov (United States)

    Choi, Kyung-Hee; Lui, Hui; Guo, Yaqi; Han, Lei; Mandel, Jeffrey S.

    2006-01-01

    In China, men who have sex with men (MSM) are at high risk for HIV. However, little is known about their HIV testing behavior. From September 2001 to January 2002, we recruited 482 men through social networks and MSM venues. We conducted HIV testing and counseling, and anonymous, standardized face-to-face interviews. Eighty-two percent of…

  11. Incentives for HIV testing at the workplace in the automotive industry ...

    African Journals Online (AJOL)

    Comprehensive HIV and AIDS workplace programmes made use of substantial lottery incentives in HIV counselling and testing drives to promote HIV testing at four companies in the automotive industry in the Nelson Mandela Bay Municipality. The main aim was to use lottery incentives to increase uptake for HIV testing.

  12. Mandatory HIV testing and uptake of ante-natal services in a primary ...

    African Journals Online (AJOL)

    Background: The Nigeria\\'s national policy on HIV/AIDS did not allow for mandatory HIV testing. But several health institutions in Nigeria insist on an HIV test before certain services are given. Fears have been expressed that such mandatory HIV testing might lead to poorer uptake of associated services. Aim: To assess the ...

  13. Proactive HIV testing strategies in primary care

    NARCIS (Netherlands)

    Joore, I.K.C.W.

    2017-01-01

    After the introduction of therapy, HIV changed from a deadly disease to a chronic treatable infection, with those infected – if treated in time – having almost the same life expectancy as those not infected. Also, other studies have reported that early initiation of therapy greatly reduces the risk

  14. HIV testing and informed consent - ethical considerations

    African Journals Online (AJOL)

    In the case of a cadaver donor, relatives, before granting consent, must be ... Exposures carrying a significant risk - the high-risk exposures, as they are called - are hollow needle-stick injuries, or injuries that are more traumatic still. The ground for this ... and health care workers from exposure to HIV-infective material (blood ...

  15. Quadratic recycling amplification for label-free and sensitive visual detection of HIV DNA.

    Science.gov (United States)

    Zhou, Wenjiao; Gong, Xue; Xiang, Yun; Yuan, Ruo; Chai, Yaqin

    2014-05-15

    Visual detections have attracted great research attentions recently due to their convenient monitoring of the target analytes without using any advanced instruments. However, achieving visual detection of trace amounts of biomolecules with PCR-like sensitivity remains a major challenge. In current work, we describe a new quadratic signal amplification strategy for sensitive visual detection of HIV DNA biomarkers based on exonuclease III (Exo III)-assisted DNA recycling amplification and DNAzymes. The presence of the target HIV DNA leads to two independent and simultaneous DNA recycling processes to achieve quadratic signal amplification with the assistance of Exo III. This quadratic signal amplification results in catalytic cleavage of the G-quadruplex sequence-locked hairpin probes to release numerous active G-quadruplex sequences, which further associate with hemin to form DNAzymes and cause significantly intensified color change for sensitive and visual detection of HIV DNA down to 2.5 pM. The proposed visual detection method employs un-modified hairpin DNA as probes, avoids using any complex and expensive instruments for signal transduction and is essentially simple. This method also shows single-base mismatch discrimination capability as well. All these features make our developed DNA detection method holds great potential for visual monitoring of various DNA biomarkers at ultralow levels with careful and proper probe designs. Copyright © 2013 Elsevier B.V. All rights reserved.

  16. Predictors of HIV Testing and Intention to Test Among Hispanic Farmworkers in South Florida

    Science.gov (United States)

    Fernandez, M. Isabel; Collazo, Jose B.; Bowen, G. Stephen; Varga, Leah M.; Hernandez, Nilda; Perrino, Tatiana

    2005-01-01

    Context and Purpose: This study examined the predictors of HIV testing and factors associated with intention to accept a free HIV test among 244 Hispanic migrant/seasonal farmworkers in South Florida. Methods: Time and space sampling procedures were used to recruit participants in public venues. Bilingual staff interviewed eligible respondents in…

  17. Evaluation of the Bio-Rad Multispot HIV-1/HIV-2 Rapid Test as an alternative to Western blot for confirmation of HIV infection.

    Science.gov (United States)

    Cárdenas, Ana María; Baughan, Eleonore; Hodinka, Richard L

    2013-12-01

    In the United States, a new HIV diagnostic algorithm has been proposed that uses an HIV-1/HIV-2 antibody differentiation immunoassay instead of Western blot or immunofluoresence for confirmatory testing. To evaluate the Multispot HIV-1/HIV-2 Rapid Test (Multispot) as an alternative to Western blot analysis for confirmation of HIV infection. A series of 205 serum and plasma specimens positive for HIV-1 or HIV-2 were used to compare the performance of Multispot to a standard HIV-1 Western blot. Positive samples included 63 specimens from patients>18 months of age, 33 proficiency survey specimens, and 109 specimens from nine commercial seroconversion and performance panels. In addition, 63 specimens from 51 HIV-exposed, uninfected children≤18 months of age in various stages of seroreversion and 192 HIV-negative samples were tested. Specimens were initially screened using a 4th generation HIV Ag/Ab Combo assay. Multispot readily discriminated between individuals with HIV-1 or HIV-2 infection and those who were uninfected. Of the 205 samples repeatedly reactive by the 4th generation screening assay, infection status was correctly confirmed by Multispot in 83.9% (172/205) compared to 68.8% (141/205) for Western blot. Multispot detected HIV-1 earlier in 27.6% of low-titer antibody specimens called indeterminate by Western blot, and effectively reduced the number of indeterminate results in seroreverting HIV-1 exposed, uninfected infants and for HIV-2 infections misinterpreted as indeterminate or positive by HIV-1 Western blot. Multispot offers speed and simplicity over Western blot and has an excellent performance for differentiation and confirmation of antibodies to HIV-1 and HIV-2. Copyright © 2013 Elsevier B.V. All rights reserved.

  18. and hiv testing in sub-saharan africa

    African Journals Online (AJOL)

    threat to confidentiality and the right not to HIV seropositivity: a prospective cohort study know. AIDS 1999; 13:2469-2474. in Burkina Faso: J Acqzn'r Immune Dq/ic. Syndr 2001; 28: 367—372. . Tcmmerman M, Ndinya-Achola I, Ambani .1,. I'iot P. The right not to know HIV-Test re- 19. Keogh P, Allen S, Almcdal C, Temahagili ...

  19. An Examination of Three Tests of Visual-Motor Integration.

    Science.gov (United States)

    Aylward, Elizabeth H.; Schmidt, Steven

    1986-01-01

    Kindergarten children (N=103) were administered three tests of visual-motor integration: Bender Gestalt Test, Beery Developmental Test of Visual Motor Integration and Geometric Design subtest of the Wechsler Preschool and Primary Scale of Intelligence. Issues discussed include interscorer reliabilities, correlations among scores, correlations…

  20. Performance of a fourth-generation HIV screening assay and an alternative HIV diagnostic testing algorithm.

    Science.gov (United States)

    Nasrullah, Muazzam; Wesolowski, Laura G; Meyer, William A; Owen, S Michele; Masciotra, Silvina; Vorwald, Craig; Becker, William J; Branson, Bernard M

    2013-03-13

    We evaluated the performance of the GS fourth-generation antigen/antibody assay and compared Centers for Disease Control and Prevention's (CDC's) proposed alternative algorithm [repeatedly reactive fourth-generation immunoassay followed by an HIV-1/HIV-2 differentiation immunoassay and, if needed, nucleic acid test (NAT)] with the current algorithm (repeatedly reactive third-generation immunoassay followed by HIV-1 western blot). A convenience sample of the following four specimen sets was acquired: 10 014 from insurance applicants, 493 known western blot-positive, 20 known western blot-indeterminate specimens, and 230 specimens from 26 HIV-1 seroconverters. Specimens were tested with the GS third-generation and fourth-generation immunoassays, the Multispot HIV-1/HIV-2 differentiation immunoassay, NAT, and western blot. We applied the two algorithms using these results. Among insurance specimens, 13 (0.13%) specimens were immunoassay repeatedly reactive: two were HIV-positive (repeatedly reactive by third-generation and fourth-generation immunoassays, and western blot and Multispot positive); two third-generation repeatedly reactive and nine fourth-generation repeatedly reactive specimens were false-positive. Third-generation and fourth-generation specificities were 99.98% [95% confidence interval (CI) 99.93-100%] and 99.91% (95% CI 99.84-99.96%), respectively.All HIV-1 western blot-positive specimens were repeatedly reactive by third-generation and fourth-generation immunoassays. By Multispot, 491 (99.6%) were HIV-1-positive and two (0.4%) were HIV-2-positive.Only eight (40%) western blot-indeterminate specimens were fourth-generation repeatedly reactive: six were Multispot and NAT-negative and two were Multispot HIV-1-positive but NAT-negative.The alternative algorithm correctly classified as positive 102 seroconverter specimens with the third-generation immunoassay and 130 with the fourth-generation immunoassay compared with 56 using the western blot with

  1. HIV prevalence in voluntary counseling and testing centers compared with national HIV serosurvey data in Uganda.

    Science.gov (United States)

    Baryarama, Fulgentius; Bunnell, Rebecca E; Montana, Livia; Hladik, Wolfgang; Opio, Alex; Musinguzi, Joshua; Kirungi, Wilford; Waswa-Bright, Laban; Mermin, Jonathan H

    2008-10-01

    To compare HIV prevalence from routine voluntary counseling and testing (VCT) data with a population-based serosurvey in Uganda and to assess the utility of VCT data as a supplemental data source for HIV surveillance. We analyzed HIV testing data from 75,640 unique VCT clients aged 15-59 years collected from August 2004 to January 2005 at 160 VCT sites. We excluded clients who reported illness as the reason for testing. During the same time period, 18,525 adults aged 15-59 years were tested for HIV in the Uganda HIV/AIDS Sero-Behavioral Survey (UHSBS). We compared UHSBS HIV prevalence with age-standardized VCT prevalence, overall and among stand-alone and facility-based VCT sites. HIV prevalence in urban areas was similar overall [UHSBS: 9.7%, 95% confidence interval (CI) 8.6 to 10.7; VCT: 10.1%, CI 9.8 to 10.5] and for both men (UHSBS: 6.3%, CI 4.9 to 7.6; VCT: 7.1, CI 6.6 to 7.5) and women (UHSBS: 12.2%, CI 10.6 to 13.7; VCT: 12.9%, CI 12.3 to 13.4). Urban prevalence from UHSBS (9.7%, CI 8.6 to 10.7), VCT stand-alone sites (10.3% CI 9.8 to 10.8), and VCT sites in health facility settings (10.0%, CI 9.5 to 10.4) was similar. However, in rural areas where VCT coverage is much lower than in urban areas (10% versus 31%), HIV prevalence was much higher among rural VCT clients (8.2%, CI 7.9% to 8.4%) than among rural UHSBS participants (5.2%, CI 4.8% to 5.5%). This resulted in overall higher HIV prevalence among all VCT clients (8.8%, CI 8.7 to 9.1) compared with all survey participants (5.9%, CI 5.6 to 6.2). After excluding clients who give illness as a reason for testing, VCT data may be used without further adjustment to monitor the HIV epidemic among urban Ugandans using either VCT data from stand-alone or health facility-based sites. However, monitoring rural and overall HIV prevalence using VCT data may not be appropriate until the uptake of VCT in rural areas is significantly improved or an adjustment factor is applied.

  2. "HIV is still real": Perceptions of HIV testing and HIV prevention among black men who have sex with men in New York City.

    Science.gov (United States)

    Nanín, José; Osubu, Tokes; Walker, Ja'Nina; Powell, Borris; Powell, Donald; Parsons, Jeffrey

    2009-06-01

    Rising HIV infection rates have been recently occurring among Black men who have sex with men (BMSM) in the United States. As a result, promoting HIV testing among members of this population is now considered a priority among local and federal health officials. A study was conducted to explore concerns about HIV testing among BMSM in New York City. In early 2006, data were gathered from focus groups with 29 BMSM. Discussions revealed factors affecting HIV testing, including stigma, sexuality, religion, race, and class, emphasizing responsibility, testing concerns, and media influences, among others. Recommendations were submitted to New York City health officials to inform HIV testing and prevention efforts.

  3. Tuberculin skin testing in intravenous drug users: differences between HIV-seropositive and HIV-seronegative subjects.

    Science.gov (United States)

    Portu, José J; Aldamiz-Etxebarria, Mikel; Agud, José M; Arévalo, José M; Almaraz, María J; Ayensa, Cándido

    2002-04-01

    The prevalence of tuberculin skin test reactions among intravenous drug abusers and differences in tuberculin skin test positivity between HIV-seropositive and HIV-seronegative subjects were evaluated in a cross-sectional study of 1131 subjects. They were recruited from a therapeutic community, from those who attended the centre for the treatment of drug addiction and from those who visited for any reason an acute tertiary-care hospital in Vitoria-Gasteiz, Basque Country (Spain). All subjects underwent skin testing with purified protein derivative (PPD) tuberculin and testing for HIV antibodies. CD4(+) T-lymphocyte count was determined in HIV-seropositive individuals. Positive PPD tests were recorded in 35% of drug users who were HIV-seropositive and in 65% in those who were HIV-seronegative. In the HIV-infected group, there was a significant association between results of the tuberculin test and CD4(+) T-lymphocyte count. When the CD4(+) T-lymphocyte count was > or = 500 cells/mm(3), percentages of positive PPD tests were similar in HIV-seropositives and HIV-seronegatives (47% versus 65%) but when the CD4(+) count was < 500 cells/mm(3), positive PPD tests occurred in only 21% of HIV-seropositives. The PPD test showed a decreased sensitivity for detecting tuberculosis infection in HIV-infected intravenous drug users with CD4(+) T-lymphocyte counts fewer than 500 cells/mm(3).

  4. Simplifying consent for HIV testing is associated with an increase in HIV testing and case detection in highest risk groups, San Francisco January 2003-June 2007.

    Directory of Open Access Journals (Sweden)

    Nicola M Zetola

    2008-07-01

    Full Text Available Populations at highest risk for HIV infection face multiple barriers to HIV testing. To facilitate HIV testing procedures, the San Francisco General Hospital Medical Center eliminated required written patient consent for HIV testing in its medical settings in May 2006. To describe the change in HIV testing rates in different hospital settings and populations after the change in HIV testing policy in the SFDH medical center, we performed an observational study using interrupted time series analysis.Data from all patients aged 18 years and older seen from January 2003 through June 2007 at the San Francisco Department of Public Health (SFDPH medical care system were included in the analysis. The monthly HIV testing rate per 1000 had patient-visits was calculated for the overall population and stratified by hospital setting, age, sex, race/ethnicity, homelessness status, insurance status and primary language.By June 2007, the average monthly rate of HIV tests per 1000 patient-visits increased 4.38 (CI, 2.17-6.60, p<0.001 over the number predicted if the policy change had not occurred (representing a 44% increase. The monthly average number of new positive HIV tests increased from 8.9 (CI, 6.3-11.5 to 14.9 (CI, 10.6-19.2, p<0.001, representing a 67% increase. Although increases in HIV testing were seen in all populations, populations at highest risk for HIV infection, particularly men, the homeless, and the uninsured experienced the highest increases in monthly HIV testing rates after the policy change.The elimination of the requirement for written consent in May 2006 was associated with a significant and sustained increase in HIV testing rates and HIV case detection in the SFDPH medical center. Populations facing the higher barriers to HIV testing had the highest increases in HIV testing rates and case detection in response to the policy change.

  5. Aspects of the Italian legislation related to HIV testing

    Directory of Open Access Journals (Sweden)

    Stefania D'Amato

    2010-03-01

    Full Text Available Italy has adhered to international declarations regarding the prevention, care, and treatment of HIV/AIDS and has adopted the fundamental interventions for surveillance and control; access to testing is defined by Law 135 of 5 June 1990. At the time, the Ministry of Health issued decrees to define national epidemiological surveillance systems for new HIV infections. The decree provides indications on the data to be collected, data flow, the modes of data transmission respecting security measures and some recommendations regarding access to HIV testing. It is thus necessary to develop national recommendations on appropriate methods for considering the diverse phases of access to testing in relation to the level of awareness of the minor, the outcome and divulging of the test.

  6. A randomized trial comparing the diagnostic accuracy of visual inspection with acetic acid to Visual Inspection with Lugol's Iodine for cervical cancer screening in HIV-infected women.

    Directory of Open Access Journals (Sweden)

    Megan J Huchko

    Full Text Available Visual inspection with Acetic Acid (VIA and Visual Inspection with Lugol’s Iodine (VILI are increasingly recommended in various cervical cancer screening protocols in low-resource settings. Although VIA is more widely used, VILI has been advocated as an easier and more specific screening test. VILI has not been well-validated as a stand-alone screening test, compared to VIA or validated for use in HIV-infected women. We carried out a randomized clinical trial to compare the diagnostic accuracy of VIA and VILI among HIV-infected women. Women attending the Family AIDS Care and Education Services (FACES clinic in western Kenya were enrolled and randomized to undergo either VIA or VILI with colposcopy. Lesions suspicious for cervical intraepithelial neoplasia 2 or greater (CIN2+ were biopsied. Between October 2011 and June 2012, 654 were randomized to undergo VIA or VILI. The test positivity rates were 26.2% for VIA and 30.6% for VILI (p = 0.22. The rate of detection of CIN2+ was 7.7% in the VIA arm and 11.5% in the VILI arm (p = 0.10. There was no significant difference in the diagnostic performance of VIA and VILI for the detection of CIN2+. Sensitivity and specificity were 84.0% and 78.6%, respectively, for VIA and 84.2% and 76.4% for VILI. The positive and negative predictive values were 24.7% and 98.3% for VIA, and 31.7% and 97.4% for VILI. Among women with CD4+ count < 350, VILI had a significantly decreased specificity (66.2% compared to VIA in the same group (83.9%, p = 0.02 and compared to VILI performed among women with CD4+ count ≥ 350 (79.7%, p = 0.02. VIA and VILI had similar diagnostic accuracy and rates of CIN2+ detection among HIV-infected women.

  7. An economic evaluation of mandatory premarital testing for HIV.

    Science.gov (United States)

    McKay, N L; Phillips, K M

    1991-01-01

    This study provides a comprehensive assessment of mandatory premarital testing for HIV. We incorporate new evidence about the assumptions underlying an economic evaluation of premarital testing, use standard methods of program evaluation (cost-effectiveness analysis and cost-benefit analysis), and carefully evaluate how changes in the various assumptions affect the results. The cost-effectiveness results show that, under the most likely conditions, the cost per case of HIV infection prevented by mandatory premarital testing would be between $70,000 and $127,000. In the cost-benefit analysis, the benefit-cost ratio in the most likely scenarios ranges between 3.1 and 28.2.

  8. FAITH - Fast Assembly Inhibitor Test for HIV

    Czech Academy of Sciences Publication Activity Database

    Hadravová, Romana; Rumlová, Michaela; Ruml, T.

    2015-01-01

    Roč. 486, Dec (2015), s. 78-87 ISSN 0042-6822 R&D Projects: GA ČR(CZ) GA14-15326S; GA MŠk LO1302; GA MŠk(CZ) LO1304 Institutional support: RVO:61388963 Keywords : retrovirus * HIV * assembly * assay * inhibitor Subject RIV: EE - Microbiology, Virology Impact factor: 3.200, year: 2015 http://www.sciencedirect.com/science/article/pii/S0042682215003864

  9. Evaluation of four rapid tests for diagnosis and differentiation of HIV-1 and HIV-2 infections in Guinea-Conakry, West Africa.

    OpenAIRE

    Chaillet, Pascale; Tayler-Smith, Katie; Zachariah, Rony; Duclos, Nanfack; Moctar, Diallo; Beelaert, Greet; Fransen, Katrien

    2010-01-01

    With both HIV-1 and HV-2 prevalent in Guinea-Conakry, accurate diagnosis and differentiation is crucial for treatment purposes. Thus, four rapid HIV tests were evaluated for their HIV-1 and HIV-2 diagnostic and discriminative capacity for use in Guinea-Conakry. These included SD Bioline HIV 1/2 3.0 (Standard Diagnostics Inc.), Genie II HIV1/HIV2 (Bio-Rad), First Response HIV Card Test 1-2.0 (PMC Medical) and Immunoflow HIV1-HIV2 (Core Diagnostics). Results were compared with gold standard tes...

  10. TestMeEast: a campaign to increase HIV testing in hospitals and to reduce late diagnosis.

    Science.gov (United States)

    Bath, R; O'Connell, R; Lascar, M; Ferrand, R; Strachan, S; Matin, N; Bassnet, I; Orkin, C

    2016-01-01

    Late diagnosis occurs in almost half of those diagnosed in the UK (HIV Prevention England, 2013. Retrieved June 22, 2014, from HIV Prevention England: http://www.hivpreventionengland.org.uk/Campaigns-Current/National-HIV-Testing-Week ). Testing occurs mainly in sexual health and antenatal clinics despite recommendations to test more broadly [Ellis, S., & Curtis, H. (2012). HIV diagnoses and missed opportunities. Results of the British HIV association (BHIVA) National Audit 2010. Clinical Medicine, 12(5), 430-434]. We report the findings of an HIV-testing week campaign to offer testing to those who have blood tests as part of routine care within outpatient clinics and emergency departments of six London hospitals. The campaign target was to test 500 patients a day during the 2013 National HIV Testing Week (NHTW). Clinic staff and medical students were trained to offer routine HIV testing. Linkage to care was arranged for those who tested HIV-positive. During NHTW we tested 2402 of the planned 2500 test target. 2402/4317 (55.6% 95% CI 54.1-57.1%) of those who had routine blood tests were tested for HIV. There were eight HIV-positive tests; three were new diagnoses (all linked to care). The campaign hashtag #TestMeEast achieved a total Twitter "reach" of 238, 860 and the campaign had widespread news coverage. Our campaign showed that staff and students could be trained and mobilised to do thousands of routine HIV tests during a campaign.

  11. Determinants of HIV testing among young people aged 18 – 24 ...

    African Journals Online (AJOL)

    Background: Although recent estimates of the HIV/AIDS burden in South Africa show the particular vulnerability of youth to HIV, HIV testing and its determinants are largely understudied in this age group. Objective: To investigate the prevalence and determinants of HIV testing among young people aged 18 to 24 years, ...

  12. Improved HIV testing coverage after scale-up of ... - Lusaka

    African Journals Online (AJOL)

    % (99/100) received post-test counseling and 99.1% (98 of 99) learned their status. In 2003 ... Hospital-based HIV testing is an essential clinical service in high prevalence settings and can serve further as a surveillance system to help track the ...

  13. HIV counselling and testing utilisation and attitudes of male inmates ...

    African Journals Online (AJOL)

    Lelaka C Motshabi MPH , Professor Supa Pengpid MSc DrPH MBA a & Professor Karl Peltzer PhD DrHabil b kpeltzer@hsrc.ac.za

    2011-09-03

    Sep 3, 2011 ... UNAIDS (2002). HIV Voluntary Counselling and Testing. Geneva: UNAIDS. UNAIDS (2004). Voluntary Counselling and Testing and operational guidelines. 2004. Geneva: UNAIDS. Uys, L., Chirwa, M., Kohi, T., Greeff, M., Naidoo, J., Makoae, L., Dlamini, P.,. Durrheim, K., Cuca, Y., & Holzemer, W.L. (2009).

  14. Detection of Early Sero-Conversion HIV Infection Using the INSTI HIV-1 Antibody Point-of-Care Test.

    Science.gov (United States)

    Cook, Darrel; Gilbert, Mark; Difrancesco, Lillo; Krajden, Mel

    2010-12-30

    We compared the INSTI(TM) HIV-1 Antibody Point-of-Care (POC) Test to laboratory-based tests for detection of early sero-conversion (i.e. acute) HIV infections. Fifty-three (53) individuals with early HIV infection, (i.e. 3(rd) generation anti-HIV EIA non-reactive or reactive, HIV-1 Western Blot non-reactive or indeterminate and HIV-1 p24 antigen reactive) were tested by INSTI(TM). The INSTI(TM) test was reactive for 34/49 (sensitivity 69.4%; 95% confidence interval 54.6-81.8%) early-infected individuals whose laboratory-based 3(rd) generation HIV EIA test was reactive. Four (4) were non-reactive by both the laboratory-based EIA and INSTI(TM )tests, but were p24 antigen reactive. The INSTI(TM )POC test performs well compared with other POC tests for the detection of early sero-conversion HIV infection, but it may miss 20% to 30% of those detected by laboratory-based 3(rd) generation anti-HIV tests. Both POC and laboratory-based anti-HIV tests will fail to detect a proportion of infected individuals in the first weeks after infection.

  15. HIV health literacy, sexual behaviour and self-reports of having tested for HIV among students.

    Science.gov (United States)

    Naidoo, Saloshni; Taylor, Myra

    2015-01-01

    The HIV prevalence among young South African adults makes it important to understand their HIV knowledge, sexual behaviour and HIV counselling and testing (HCT) behaviour in this group. This paper presents the demographics, knowledge, sexual behaviour and cues to action as reported by sexually active students' who had HCT. A cross-sectional study conducted in 10 high schools in the eThekwini and Ugu districts, KwaZulu-Natal, surveyed students' HIV knowledge, sexual behaviour and HCT behaviour. Complete information was available from 1 114 (97.9%) students who participated in the survey. Of these, 378 (33.9%) were sexually active and were included in this analysis. Logistic regression models tested for significant associations between the independent and the dependent variables under study, nesting the students within schools and controlling for age, sex, grade and school location (urban/rural).The median age of students was 17 years (range: 14-23 years) with most being male (n=287; 75.9%). The lifetime median number of sexual partners of students was 3 (range: 1-27). Students who used condoms with their regular partners were more likely to have had counselling for HIV (OR :1.79; 95% CI: 1.06-3.01). Those students who were more likely to have been tested for HIV were female (OR: 44.90; 95% CI: 7.77-259.38), those who had always used a condom with their non-regular partner (OR: 2.75; 95% CI: 1.01-7.47), and those who knew a person who had tested for HIV (OR: 15.28; 95% CI: 5.16-45.23). Targeting students, especially males early in adolescence and reinforcing safe sex behaviour messages through their high school years, can encourage HCT among students.

  16. HIV (human immunodeficiency virus) testing and prevention in the cruise industry.

    Science.gov (United States)

    Dahl, Eilif

    2011-01-01

    There are no internationally recognized guidelines regarding HIV for employees on cruise ships. The aim of the study was to survey and compare current practices for crews in the cruise industry regarding HIV testing and prevention. Medical representatives from cruise companies were invited to complete a questionnaire on their company's practices regarding HIV-related issues. Fifteen of 18 invited representatives completed the questionnaire on behalf of 24 companies with a total of 155 ships. All 8 companies with a medical department had a written HIV policy, versus 4 of 16 companies that handled medical crew issues through independent medical consultant services. Thirteen companies required pre-sea HIV testing, 12 had a written HIV policy regarding HIV testing and prevention, and 18 had free condoms for the crew. A positive HIV test would result in revocation of the employment offer from 5 companies and in another 6 companies establish HIV as a pre-existing condition. Eight companies required HIV+ seafarers to demonstrate stability at regular intervals as a condition for sailing. Cruise companies have different practices regarding HIV in crew. Large cruise lines with medical departments are more likely to have a written HIV policy than companies using independent medical consultants. About half the companies required pre-sea HIV testing; some to avoid hiring HIV+ seafarers, others to establish HIV as a pre-existing condition or to ensure proper follow-up of their HIV+ seafarers. This report may provide input for company discussions about present or future HIV policies.

  17. Finger-stick whole blood HIV-1/-2 home-use tests are more sensitive than oral fluid-based in-home HIV tests.

    Directory of Open Access Journals (Sweden)

    Marie Jaspard

    Full Text Available Several countries have recently recommended the expansion of anti-human immunodeficiency virus (HIV antibody testing, including self-testing with rapid tests using oral fluid (OF. Several tests have been proposed for at-home use, but their diagnostic accuracy has not been fully evaluated.To evaluate the performance of 5 rapid diagnostic tests for the detection of anti-HIV-1/2 antibodies, with 4 testing OF and 1 testing whole blood.Prospective multi-center study in France. HIV-infected adults and HIV-uninfected controls were systematically screened with 5 at-home HIV tests using either OF or finger-stick blood (FSB specimens. Four OF tests (OraQuick Advance Rapid HIV-1/2, Chembio DPP HIV 1/2 Assay, test A, and test B and one FSB test (Chembio Sure Check HIV1/2 Assay were performed by trained health workers and compared with laboratory tests.In total, 179 HIV-infected patients (M/F sex ratio: 1.3 and 60 controls were included. Among the HIV-infected patients, 67.6% had an undetectable HIV viral load in their plasma due to antiretroviral therapy. Overall, the sensitivities of the OF tests were 87.2%, 88.3%, 58.9%, and 28% (for OraQuick, DPP, test A, and test B, respectively compared with 100% for the FSB test Sure Check (p50 copies/mL, reaching 94.8%, 96.5%, 90%, and 53.1% (for OraQuick, DPP, test A, and test B, respectively. The specificities of the four OF tests were 98.3%, 100%, 100%, and 87.5%, respectively, compared with 100% for the FSB test.An evaluation of candidates for HIV self-testing revealed unexpected differences in performance of the rapid tests: the FSB test showed a far greater reliability than OF tests.

  18. Why Take an HIV Test? Concerns, Benefits, and Strategies to Promote HIV Testing among Low-Income Heterosexual African American Young Adults

    Science.gov (United States)

    Wallace, Scyatta A.; McLellan-Lemal, Eleanor; Harris, Muriel J.; Townsend, Tiffany G.; Miller, Kim S.

    2011-01-01

    A qualitative study examined perceptions of HIV testing and strategies to enhance HIV testing among HIV-negative African American heterosexual young adults (ages 18-25 years). Twenty-six focus groups (13 male groups, 13 female groups) were conducted in two low-income communities (urban and rural). All sessions were audio-recorded and transcribed.…

  19. HIV/AIDS knowledge and uptake of HIV counselling and testing among undergraduate private university students in Accra, Ghana.

    Science.gov (United States)

    Oppong Asante, Kwaku

    2013-03-28

    HIV Counselling and Testing (VCT) and knowledge about HIV are some key strategies in the prevention and control of HIV/AIDS in Ghana. However, HIV knowledge and utilization of VCT services among university students is low. The main objective was to determine the level of HIV/AIDS knowledge and to explore factors associated with the use HIV counselling and testing among private university students in Accra, Ghana. A cross-sectional study was conducted using structured questionnaires among 324 conveniently selected students enrolled at a privately owned tertiary institution in Accra, Ghana. The respondents consisted of 56.2% males and 43.8% females aged 17 - 37 years. The mean HIV/AIDS knowledge score of was 7.70. There was a significant difference in knowledge of HIV/AIDS by gender where female students had more knowledge about HIV/AIDS than males [t (322) = 2.40, p = 0.017]. The ANOVA results showed that there was a significant difference in HIV/AIDS knowledge according to the age groups [F (3, 321) = 6.26, p = 0. 0001] and marital status [F (3, 321) = 4.86, p = 0. 008] of the sample. Over half of the participants had not tested for HIV, although over 95% of them knew where to access counseling and testing services. The study also revealed a significant association between demographic variables, testing for HIV and intention to test in the future. Participants who were never married (single), aged 17 - 20 years and had knowledge of two routes of HIV transmission were more likely to have taken an HIV test. Males were more likely to take an HIV test in the future than females. Majority of the students receive HIV/AIDS information from both print and electronic media, but few of them received such information from parents. The students HIV knowledge was very good, yet HIV testing were low. Health education and HIV intervention programmes must not only provide accurate information, but must be made to help to equip private university students

  20. Self-reported HIV-positive status but subsequent HIV-negative test result using rapid diagnostic testing algorithms among seven sub-Saharan African military populations.

    Directory of Open Access Journals (Sweden)

    Judith Harbertson

    Full Text Available HIV rapid diagnostic tests (RDTs combined in an algorithm are the current standard for HIV diagnosis in many sub-Saharan African countries, and extensive laboratory testing has confirmed HIV RDTs have excellent sensitivity and specificity. However, false-positive RDT algorithm results have been reported due to a variety of factors, such as suboptimal quality assurance procedures and inaccurate interpretation of results. We conducted HIV serosurveys in seven sub-Saharan African military populations and recorded the frequency of personnel self-reporting HIV positivity, but subsequently testing HIV-negative during the serosurvey. The frequency of individuals who reported they were HIV-positive but subsequently tested HIV-negative using RDT algorithms ranged from 3.3 to 91.1%, suggesting significant rates of prior false-positive HIV RDT algorithm results, which should be confirmed using biological testing across time in future studies. Simple measures could substantially reduce false-positive results, such as greater adherence to quality assurance guidelines and prevalence-specific HIV testing algorithms as described in the World Health Organization's HIV testing guidelines. Other measures to improve RDT algorithm specificity include classifying individuals with weakly positive test lines as HIV indeterminate and retesting. While expansion of HIV testing in resource-limited countries is critical to identifying HIV-infected individuals for appropriate care and treatment, careful attention to potential causes of false HIV-positive results are needed to prevent the significant medical, psychological, and fiscal costs resulting from individuals receiving a false-positive HIV diagnosis.

  1. Self-reported HIV-positive status but subsequent HIV-negative test result using rapid diagnostic testing algorithms among seven sub-Saharan African military populations.

    Science.gov (United States)

    Harbertson, Judith; Hale, Braden R; Tran, Bonnie R; Thomas, Anne G; Grillo, Michael P; Jacobs, Marni B; McAnany, Jennifer; Shaffer, Richard A

    2017-01-01

    HIV rapid diagnostic tests (RDTs) combined in an algorithm are the current standard for HIV diagnosis in many sub-Saharan African countries, and extensive laboratory testing has confirmed HIV RDTs have excellent sensitivity and specificity. However, false-positive RDT algorithm results have been reported due to a variety of factors, such as suboptimal quality assurance procedures and inaccurate interpretation of results. We conducted HIV serosurveys in seven sub-Saharan African military populations and recorded the frequency of personnel self-reporting HIV positivity, but subsequently testing HIV-negative during the serosurvey. The frequency of individuals who reported they were HIV-positive but subsequently tested HIV-negative using RDT algorithms ranged from 3.3 to 91.1%, suggesting significant rates of prior false-positive HIV RDT algorithm results, which should be confirmed using biological testing across time in future studies. Simple measures could substantially reduce false-positive results, such as greater adherence to quality assurance guidelines and prevalence-specific HIV testing algorithms as described in the World Health Organization's HIV testing guidelines. Other measures to improve RDT algorithm specificity include classifying individuals with weakly positive test lines as HIV indeterminate and retesting. While expansion of HIV testing in resource-limited countries is critical to identifying HIV-infected individuals for appropriate care and treatment, careful attention to potential causes of false HIV-positive results are needed to prevent the significant medical, psychological, and fiscal costs resulting from individuals receiving a false-positive HIV diagnosis.

  2. HIV testing among pregnant women living with HIV in India: are private healthcare providers routinely violating women's human rights?

    Science.gov (United States)

    Madhivanan, Purnima; Krupp, Karl; Kulkarni, Vinay; Kulkarni, Sanjeevani; Vaidya, Neha; Shaheen, Reshma; Philpott, Sean; Fisher, Celia

    2014-03-24

    In India, approximately 49,000 women living with HIV become pregnant and deliver each year. While the government of India has made progress increasing the availability of prevention of mother-to-child transmission of HIV (PMTCT) services, only about one quarter of pregnant women received an HIV test in 2010, and about one-in-five that were found positive for HIV received interventions to prevent vertical transmission of HIV. Between February 2012 to March 2013, 14 HIV-positive women who had recently delivered a baby were recruited from HIV positive women support groups, Government of India Integrated Counseling and Testing Centers, and nongovernmental organizations in Mysore and Pune, India. In-depth interviews were conducted to examine their general experiences with antenatal healthcare; specific experiences around HIV counseling and testing; and perceptions about their care and follow-up treatment. Data were analyzed thematically using the human rights framework for HIV testing adopted by the United Nations and India's National AIDS Control Organization. While all of the HIV-positive women in the study received HIV and PMTCT services at a government hospital or antiretroviral therapy center, almost all reported attending a private clinic or hospital at some point in their pregnancy. According to the participants, HIV testing often occurred without consent; there was little privacy; breaches of confidentiality were commonplace; and denial of medical treatment occurred routinely. Among women living with HIV in this study, violations of their human rights occurred more commonly in private rather than public healthcare settings. There is an urgent need for capacity building among private healthcare providers to improve standards of practice with regard to informed consent process, HIV testing, patient confidentiality, treatment, and referral of pregnant women living with HIV.

  3. Real-time, universal screening for acute HIV infection in a routine HIV counseling and testing population.

    Science.gov (United States)

    Pilcher, Christopher D; McPherson, J Todd; Leone, Peter A; Smurzynski, Marlene; Owen-O'Dowd, Judy; Peace-Brewer, Amy L; Harris, Juanita; Hicks, Charles B; Eron, Joseph J; Fiscus, Susan A

    2002-07-10

    Acute human immunodeficiency virus (HIV) infection cannot be diagnosed by routine antibody tests and is rarely diagnosed in clinical practice. However, HIV nucleic acid-based testing is widely used to screen for antibody-negative acute infection among low-risk blood donors. To assess the feasibility of screening in high-volume laboratories for acute and long-term HIV infection in a routine HIV testing population, in which HIV infection prevalence is low, using specimen pooling and HIV RNA reverse transcriptase-polymerase chain reaction (RT-PCR) tests. Clinical diagnostic performance evaluation at a state-funded public health virology and serology laboratory. A total of 8505 consecutive individuals presenting for routine HIV counseling and testing during a total of 20 business days to simulate a month of testing in August and December 2001 at 110 publicly funded testing sites in North Carolina. Prevalence of acute and long-term HIV infection. Serum specimens negative by HIV enzyme immunoassay (EIA) were screened in pools by an ultrasensitive HIV RNA RT-PCR test. Results for individual HIV RNA-positive specimens were reclassified as true or false according to results of confirmatory testing. Of the 8505 individuals screened, 8194 had not previously tested HIV positive and had sufficient serum to complete the testing protocol. Of those, 39 had long-term HIV infection (prevalence, 47.6 per 10,000 at-risk persons [95% confidence interval, 33.8-65.0 per 10,000]). Of the 8155 at-risk individuals whose antibody tests were negative, 5 were HIV RNA positive. Four of those had true-positive acute infection (prevalence, 4.9 per 10,000 [95% confidence interval, 1.3-12.5 per 10,000]). All 4 were women; 2 developed symptoms consistent with an acute retroviral syndrome in the week after testing. Screening all specimens required 147 HIV RNA tests. Overall specificity of the strategy was 0.9999. These findings suggest the widespread diagnosis of acute HIV infections in a routine

  4. Decliners of provider-initiated HIV testing and counselling: Characteristics of participants who refused HIV testing in a population survey in Zambia

    Directory of Open Access Journals (Sweden)

    Pascalina Chanda-Kapata

    2015-08-01

    Conclusions: Strategies to improve HIV testing acceptance are necessary. Qualitative research is recommended to understand the reasons for testing refusals so that remedial interventions can be implemented.

  5. Evaluation Of Algorithms Of Anti- HIV Antibody Tests

    Directory of Open Access Journals (Sweden)

    Paranjape R.S

    1997-01-01

    Full Text Available Research question: Can alternate algorithms be used in place of conventional algorithm for epidemiological studies of HIV infection with less expenses? Objective: To compare the results of HIV sero- prevalence as determined by test algorithms combining three kits with conventional test algorithm. Study design: Cross â€" sectional. Participants: 282 truck drivers. Statistical analysis: Sensitivity and specificity analysis and predictive values. Results: Three different algorithms that do not include Western Blot (WB were compared with the conventional algorithm, in a truck driver population with 5.6% prevalence of HIV â€"I infection. Algorithms with one EIA (Genetic Systems or Biotest and a rapid test (immunocomb or with two EIAs showed 100% positive predictive value in relation to the conventional algorithm. Using an algorithm with EIA as screening test and a rapid test as a confirmatory test was 50 to 70% less expensive than the conventional algorithm per positive scrum sample. These algorithms obviate the interpretation of indeterminate results and also give differential diagnosis of HIV-2 infection. Alternate algorithms are ideally suited for community based control programme in developing countries. Application of these algorithms in population with low prevalence should also be studied in order to evaluate universal applicability.

  6. Challenges in implementing HIV load testing in South Africa.

    Science.gov (United States)

    Stevens, Wendy S; Marshall, Theresa M

    2010-04-15

    The South African antiretroviral treatment guidelines recommend the use of human immunodeficiency virus type 1 (HIV-1) load testing for patient monitoring and, in particular, to assist in switching to second-line treatment regimens. There are significant challenges to implementing HIV load testing on the scale that is required in South Africa. To put this in context, approximately 560,000 HIV-infected individuals are receiving antiretroviral therapy, and program recommendations include viral load testing twice per year. Currently, a 3-tiered laboratory infrastructure exists with tertiary facilities and, to some extent, secondary laboratories able to implement quantitative HIV nucleic acid testing. Challenges include high sample volumes, transportation logistics from remote sites, costs, phlebotomy in children, a national skills shortage, and sample throughput of technology platforms. Several approaches are thus being explored simultaneously: (1) the feasibility of establishing higher throughput and more automated central laboratories; (2) improvement of current sample collection, transportation, and storage techniques; (3) alternative viral load technologies, including flow-based marker screening approaches to reduce testing volumes, and (4) point-of-care viral load testing strategies for clinics. The development of appropriate solutions for each laboratory tier in South Africa will require close collaboration between researchers in the field and partners in industry.

  7. Rationale and design of FORTH: a randomised controlled trial assessing the effectiveness of HIV self-testing in increasing HIV testing frequency among gay and bisexual men.

    Science.gov (United States)

    Jamil, Muhammad S; Prestage, Garrett; Fairley, Christopher K; Smith, Kirsty S; Kaldor, John M; Grulich, Andrew E; McNulty, Anna M; Chen, Marcus; Holt, Martin; Conway, Damian P; Wand, Handan; Keen, Phillip; Batrouney, Colin; Bradley, Jack; Bavinton, Benjamin R; Ryan, Dermot; Russell, Darren; Guy, Rebecca J

    2015-12-10

    Gay and bisexual men (GBM) are a major risk group for HIV acquisition, yet the majority of higher-risk GBM test for HIV less often than recommended (3-6 monthly). HIV self-testing has the potential to increase testing frequency and improve awareness of personal HIV status. HIV self-tests have been approved in some countries, however there are concerns whether self-testing would increase HIV testing frequency enough to compensate for the reduced sensitivity of self-tests in early infection. We describe here a randomised controlled trial to assess the effectiveness of self-testing in increasing HIV testing frequency among higher-risk GBM, and its acceptability. Participants are higher-risk HIV negative GBM (>5 partners or condomless anal intercourse in previous 3 months; n = 350), including 50 GBM who tested for HIV over two years ago or never tested before ('infrequent-testers'). Participants are recruited from sexual health clinics and community-based organisations, and randomised 1:1 to either self-testing or standard-care (routine clinic-based testing) arms. The trial employs a wait-list control design: participants in the standard-care arm switch to self-testing arm in the second year, and gain access to self-test kits. Participants in the self-testing arm receive four oral-fluid self-test kits at enrolment, with additional kits provided on request. Demographics, sexual behaviour and HIV testing preferences are collected at baseline, and the frequency and pattern of HIV and sexually transmissible infection (STI) testing is collected via online 3-monthly questionnaires. The acceptability of self-testing is assessed at 12 months via an online questionnaire and in-depth interviews. A 24-h telephone support is provided, with expedited follow-up of those with reactive self-test results. The primary outcome is HIV testing frequency (mean number of HIV tests per person) over 12 months, and the secondary outcomes are: mean number of STI tests (chlamydia

  8. A rapid ultrasound particle agglutination method for HIV antibody detection: Comparison with conventional rapid HIV tests.

    Science.gov (United States)

    Bystryak, Simon; Ossina, Natalya

    2017-11-01

    We present the results of the feasibility and preliminary studies on analytical performance of a rapid test for detection of human immunodeficiency virus (HIV) antibodies in human serum or plasma that is an important advance in detecting HIV infection. Current methods for rapid testing of antibodies against HIV are qualitative and exhibit poor sensitivity (limit of detection). In this paper, we describe an ultrasound particle agglutination (UPA) method that leads to a significant increase of the sensitivity of conventional latex agglutination tests for HIV antibody detection in human serum or plasma. The UPA method is based on the use of: 1) a dual mode ultrasound, wherein a first single-frequency mode is used to accelerate the latex agglutination process, and then a second swept-frequency mode of sonication is used to disintegrate non-specifically bound aggregates; and 2) a numerical assessment of results of the agglutination process. The numerical assessment is carried out by optical detection and analysis of moving patterns in the resonator cell during the swept-frequency mode. The single-step UPA method is rapid and more sensitive than the three commercial rapid HIV test kits analyzed in the study: analytical sensitivity of the new UPA method was found to be 510-, 115-, and 80-fold higher than that for Capillus™, Multispot™ and Uni-Gold™ Recombigen HIV antibody rapid test kits, respectively. The newly developed UPA method opens up additional possibilities for detection of a number of clinically significant markers in point-of-care settings. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Bedside paediatric HIV testing in Malawi: Impact on testing rates

    African Journals Online (AJOL)

    2017-05-25

    May 25, 2017 ... Centre for Medical Education, Queens University Belfast, Belfast, United Kingdom. Introduction. HIV prevalence in children under the age of 15 in Malawi in 2015 was estimated to be 84,000.1 Sixty-one percent of children eligible for antiretroviral therapy (ART) actually received this intervention, compared ...

  10. Structural inequalities drive late HIV diagnosis: The role of black racial concentration, income inequality, socioeconomic deprivation, and HIV testing

    Science.gov (United States)

    Ransome, Yusuf; Kawachi, Ichiro; Braunstein, Sarah; Nash, Denis

    2017-01-01

    In the United States, research is limited on the mechanisms that link socioeconomic and structural factors to HIV diagnosis outcomes. We tested whether neighborhood income inequality, socioeconomic deprivation, and black racial concentration were associated with gender-specific rates of HIV in the advanced stages of AIDS (i.e., late HIV diagnosis). We then examined whether HIV testing prevalence and accessibility mediated any of the associations above. Neighborhoods with highest (relative to lowest) black racial concentration had higher relative risk of late HIV diagnosis among men (RR=1.86; 95%CI=1.15, 3.00) and women (RR=5.37; 95% CI=3.16, 10.43) independent of income inequality and socioeconomic deprivation. HIV testing prevalence and accessibility did not significantly mediate the associations above. Research should focus on mechanisms that link black racial concentration to HIV diagnosis outcomes. PMID:27770671

  11. Stage of HIV presentation at initial clinic visit following a community-based HIV testing campaign in rural Kenya

    OpenAIRE

    Haskew, John; Turner, Kenrick; Rø, Gunnar; Ho, Andrew; Kimanga, Davies; Sharif, Shahnaaz

    2015-01-01

    Background The Kenyan Ministry of Health and partners implemented a community-based integrated prevention campaign (IPC) in Western Kenya in 2008. The aim of this study was to determine whether the IPC, compared to Voluntary Counselling and Testing (VCT) services, was able to identify HIV positive individuals earlier in the clinical course of HIV infection following testing. Methods A total of 1,752 adults aged over 15 years who tested HIV positive through VCT services or the IPC, and subsequ...

  12. Acceptability of routine offer of HIV testing (opt-out approach) among ...

    African Journals Online (AJOL)

    Background: With the introduction of the opt out HIV testing policy in Ghana, the HIV test is offered routinely to all pregnant women unless they decline testing. Objective: To assess acceptability of the routine offer of HIV testing antenatal clinic (ANC) clients in the Wa municipality, Ghana. Design: Cross-sectional study of 270 ...

  13. Measuring Health Literacy Among Adults with HIV Infection in Mozambique: Development and Validation of the HIV Literacy Test.

    Science.gov (United States)

    Tique, José A; Howard, Leigh M; Gaveta, Sandra; Sidat, Mohsin; Rothman, Russell L; Vermund, Sten H; Ciampa, Philip J

    2017-03-01

    The role of health literacy on HIV outcomes has not been evaluated widely in Africa, in part because few appropriate literacy measures exist. We developed a 16-item scale, the HIV Literacy Test (HIV-LT) to assess literacy-related tasks needed to participate in HIV care. Items were scored as correct or incorrect; higher scores indicated higher literacy skill (range 0-100 %). We tested internal reliability (Kuder-Richardson coefficient) of the HIV-LT in a convenience sample of 319 Portuguese-speaking, HIV infected adults on antiretroviral treatment in Maputo, Mozambique. Construct validity was assessed by a hypothetical model developed a priori. The HIV-LT was reliable and valid to measure participants' literacy skills. The mean HIV-LT score was 42 %; literacy skills applicable to HIV care were challenging for many participants. The HIV-LT could be used to assess the relationship of literacy and HIV-related outcomes in diverse settings, and evaluate interventions to improve health communication for those in HIV care.

  14. HIV Testing Among Teens Attending Therapeutic Schools: Having a Personal Source of Information About HIV/AIDS Matters!

    Science.gov (United States)

    Swenson, Rebecca R; Houck, Christopher; Sarfati, David; Emerson, Erin; Donenberg, Geri; Brown, Larry K

    2015-06-01

    Being informed and using positive coping strategies are associated with engaging in health-promoting behaviors. We assessed whether the type of information source about HIV (personal or impersonal) and coping strategies (optimism, avoidance, or emotion-focused) are associated with HIV testing among adolescents attending therapeutic schools. Participants were 417 adolescents, ages 13-19, who attended one of 20 therapeutic day schools for emotionally/behaviorally disordered youth in two US cities (Providence, RI and Chicago, IL) and completed a baseline assessment for an HIV prevention study. Among adolescents in the study, 29% reported having been tested for HIV. Adolescents were more likely to have been tested if they were older, female, Hispanic, identified as non-heterosexual, came from lower SES households, and had recently had unprotected sex. Additionally, youth who endorsed greater use of optimistic thinking and emotion-focused coping, and who reported having been informed about HIV by more personal sources, were also more likely to have been tested for HIV. In a multivariate analysis, having had recent unprotected sex and having more personal sources of information about HIV/AIDS were independently associated with HIV testing. Study findings suggest that, controlling for sociodemographic background, sexual risk behavior, and coping strategy, HIV testing among adolescents with emotional and behavioral problems may be increased when adolescents learn about HIV/AIDS from personal sources such as their healthcare providers, family, and friends.

  15. Cost-effectiveness of a repeat HIV test in pregnancy in India.

    Science.gov (United States)

    Joshi, Smita; Kulkarni, Vinay; Gangakhedkar, Raman; Mahajan, Uma; Sharma, Sushma; Shirole, Devendra; Chandhiok, Nomita

    2015-06-11

    To evaluate cost-effectiveness of second HIV test in pregnancy. Current strategy of single HIV test during pregnancy in India can miss new HIV infections acquired after the first test or those HIV infections that were missed in the first test due to a false-negative HIV test. Between August 2011 and April 2013, 9097 pregnant HIV uninfected women were offered a second HIV test near term (34 weeks or beyond) or within 4 weeks of postpartum period. A decision analysis model was used to evaluate cost-effectiveness of a second HIV test in pregnant women near term. Our key outcome measures include programme cost with addition of second HIV test in pregnant women and quality-adjusted life years (QALYs) gained. We detected 4 new HIV infections in the second test. Thus HIV incidence among pregnant women was 0.12 (95% 0.032 to 0.297) per 100 person women years (PWY). Current strategy of a single HIV test is 8.2 times costlier for less QALYs gained as compared to proposed repeat HIV testing of pregnant women who test negative during the first test. Our results warrant consideration at the national level for including a second HIV test of all pregnant women in the national programme. However prior to allocation of resources for a second HIV test in pregnancy, appropriate strategies will have to be planned for improving compliance for prevention of mother-to-child transmission of HIV and reducing loss-to-follow-up of those women detected with HIV. CTRI/2013/12/004183. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  16. Rethinking HIV exceptionalism: the ethics of opt-out HIV testing in sub-Saharan Africa

    Science.gov (United States)

    2010-01-01

    Abstract Opt-out testing for the human immunodeficiency virus (HIV) incorporates testing as a routine part of health care for all patients unless they refuse. The ethics of this approach to testing in sub-Saharan Africa is a source of controversy. Opt-out HIV testing is expected to improve survival by increasing case detection and thus linking more HIV-infected people to earlier treatment, provided there is effective patient follow-up and programme sustainability. At the population level, these benefits will likely outweigh the potential negative consequences of individuals experiencing HIV-related stigma. These justifications appeal to consequentialist moral theories that the acceptability of an action depends upon its outcomes. On the other hand, liberal moral theories state that the autonomy of individuals should always be protected unless restricting autonomy is necessary to protect the welfare of others. Opt-out consent may restrict autonomy and it is unclear whether it would benefit people other than those being tested. Yet, the doctrine of libertarian paternalism proposes that it is justifiable and desirable to use unobtrusive mechanisms to help individuals make choices to maximize their own welfare. Central to this idea are the premises featured by supporters of opt-out consent that individuals will not always make the best choices for their own welfare but they may be influenced to do so in ways that will not compromise their freedom of choice. Also important is the premise that all policies inevitably exert some such influence: opt-in consent encourages test refusal just as opt-out consent encourages acceptance. Based on these premises, opt-out testing may be an effective and ethically acceptable policy response to Africa’s HIV epidemic. PMID:20865076

  17. Ocular dominance and visual function testing

    OpenAIRE

    D. Lopes-Ferreira; Neves, H; A. Queiros; Faria-Ribeiro, M.; Peixoto-de-Matos, S. C.; J. M. González-Méijome

    2013-01-01

    To show the distribution of ocular dominance as measured with sensory and eye sighting methods and its potential relationship with high and low contrast LogMAR visual acuity in presbyopic subjects. Method. Forty-four presbyopes (48.5 ± 3.5 years) participated in this study. Ocular dominance was determined by eye sighting (hole-in-card) and sensorial (+1.50 D lens induced blur) methods. According to the dominance detected with each method (RE: right eye or LE: left eye), patients were classifi...

  18. HIV testing among patients infected with Neisseria gonorrhoeae: STD Surveillance Network, United States, 2009-2010.

    Science.gov (United States)

    Bradley, Heather; Asbel, Lenore; Bernstein, Kyle; Mattson, Melanie; Pathela, Preeti; Mohamed, Mukhtar; Samuel, Michael C; Schwebke, Jane; Stenger, Mark; Tabidze, Irina; Zenilman, Jonathan; Dowell, Deborah; Weinstock, Hillard

    2013-03-01

    We used data from the STD Surveillance Network to estimate HIV testing among patients being tested or treated for gonorrhea. Of 1,845 gonorrhea-infected patients identified through nationally notifiable disease data, only 51% were tested for HIV when they were tested or treated for gonorrhea. Among the 10 geographic sites in this analysis, the percentage of patients tested for HIV ranged from 22-63% for men and 20-79% for women. Nearly 33% of the un-tested patients had never been previously HIV-tested. STD clinic patients were more likely to be HIV-tested than those in other practice settings.

  19. Specificity of two HIV screening tests detecting simultaneously HIV-1 p24 antigen and antibodies to HIV-1 and -2.

    Science.gov (United States)

    Blaich, Annette; Buser, Andreas; Stöckle, Marcel; Gehringer, Christian; Hirsch, Hans H; Battegay, Manuel; Klimkait, Thomas; Frei, Reno

    2017-11-01

    This study aimed at assessing the specificity of the Elecsys® HIV combi PT in comparison to the ARCHITECT® HIV Ag/Ab Combo. With both of these assays, 3997 unselected sera from patients of a tertiary health care centre in Basel, Switzerland, were screened for HIV. Reactive sera were reanalysed on the VIDAS® HIV Duo Ultra to identify false-reactive specimens prior to confirmation by quantitative PCR and line immunoassay. The Elecsys® compared to the ARCHITECT® shows a similar specificity (99.7% versus 99.8%) but a slightly lower positive predictive value (71.8% versus 80%). Samples tested with a cut-off index (COI) between 0.91 and 4.85 (cut-off false-reactive. There was no false-reactive result with the VIDAS®. Of the false-reactive samples, 66.7% could be related to patient-specific underlying conditions. The HIV two-tiered diagnostic algorithm proposed in this work improved the positive predictive values of the Elecsys® or ARCHITECT® to 100% when the results of the VIDAS® were included. Values just above the cut-off are highly suspicious to be false-reactive and high COI or S/CO ratios are associated with true positivity. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. HIV test counselling at a tertiary hospital | Louw | South African ...

    African Journals Online (AJOL)

    A questionnaire was distributed to 64 of the 78 interns working at a teaching hospital in Cape Town in August 1992 to examine their attitudes and practice in respect of HIV test counselling. The questionnaire was completed by 61 interns. Thirteen per cent of those who responded counselled all patients, 49% counselled ...

  1. Barriers and facilitators associated with HIV testing uptake in South ...

    African Journals Online (AJOL)

    Major barriers to HCT uptake comprise being scared of finding out one's HIV test result or what people may say, shyness or embarrassment, avoidance of divulging personal information to health workers and fear of death. In multivariate analysis the age group 55 years and older, and not being recommended to have an HIV ...

  2. Legal and ethical implications of opt-out HIV testing.

    Science.gov (United States)

    Hanssens, Catherine

    2007-12-15

    New guidelines from the Centers for Disease Control and Prevention recommend that opt-out screening for human immunodeficiency virus (HIV) without written patient consent be part of routine clinical care and imply that state HIV-associated laws in conflict with this approach should be amended. However, HIV testing and treatment issues are governed by a range of federal and state laws, common law principles, constitutional provisions, and various codes of ethics. Patient testing protocols should satisfy the legal definition of informed consent, to reduce risk of liability for providers (i.e., health care professionals and facilities). Rigid application of the new guidelines may trigger legal claims, especially if there is no link to care for persons with a positive test result, no proof of informed consent, or inadequate counseling. Ensuring confidentiality, better test training for providers, and provider collaboration with HIV service organizations can reduce the risk of patient claims, but state and federal laws, codes of ethics, and concerns about provider liability should temper reflexive wholesale adoption of guidelines that recommend opt-out screening.

  3. HIV counseling and testing uptake among adults in Amhara region ...

    African Journals Online (AJOL)

    A secondary data analysis was carried out on Ethiopian Demographic and Health Survey 2005 and 2011 records. In the study 6564 (age 15-49 years) study subjects were included. Spatial data of Amhara region was integrated and analyzed with data mining techniques. HIV testing uptake coverage was much lower (2%) in ...

  4. Willingness to accept HIV testing among caretakers with a child ...

    African Journals Online (AJOL)

    Objective: To determine the willingness to accept HIV testing among caretakers who bring a child to the University Teaching Hospital Paediatric department. Design: This was a descriptive cross-sectional study that was conducted over a period of two months from September 2009 to October 2009 in the Paediatrics ...

  5. Determinants of HIV Testing Among Sexually Active Young People ...

    African Journals Online (AJOL)

    This study used data from the 2013 Zambia Demographic Health Survey (ZDHS) based on a nationally representative sample carried out by Central Statistical Office of Zambia. This paper analyzed a special module designed to collect information on the extent of the uptake of HIV testing by sexually active young people in ...

  6. hiv testing and arv prophylaxis for newborns without their mothers

    African Journals Online (AJOL)

    2008-06-19

    Jun 19, 2008 ... HIV TESTING AND ARV PROPHYLAXIS FOR. NEWBORNS WITHOUT THEIR MOTHERS'. CONSENT. AN ETHICAL AND RIGHTS-BASED APPROACH. A woman's constitutional rights to privacy, reproductive choice and bodily autonomy are all too often violated and require adequate legal protection. Also ...

  7. Attitude towards mandatory pre-marital HIV testing among ...

    African Journals Online (AJOL)

    This study assessed the attitude of unmarried youths towards Mandatory Premarital HIV Testing (MPHT) in Ibadan Northwest Local Government Area. A three-stage sampling technique was used to select 571unmarried youths from households. A validated questionnaire was used for the collection of the data. Descriptive ...

  8. Attitude Towards Mandatory Pre-Marital HIV Testing Among ...

    African Journals Online (AJOL)

    Erah

    This study assessed the attitude of unmarried youths towards Mandatory Premarital HIV Testing (MPHT) in Ibadan. Northwest Local Government Area. A three-stage sampling technique was used to select 571unmarried youths from households. A validated questionnaire was used for the collection of the data. Descriptive ...

  9. Determinants of acceptance of voluntary HIV testing among ...

    African Journals Online (AJOL)

    2006-09-10

    Objective: The objective of this study was to identify factors that determine the acceptance of voluntary HIV testing among pregnant women attending antenatal care at Dil Chora Hospital in Dire Dawa. Method: The study employed unmatched case control study which was conducted from August 20 to September 10, 2006.

  10. Barriers to HIV testing among adolescents in Spain

    Directory of Open Access Journals (Sweden)

    Alexandra Morales

    2016-12-01

    Full Text Available Most teenagers and young people do not consistently use condoms during sex, exposing themselves to HIV. Early diagnosis of the virus increases the survival rate and reduces new infections. Attitude towards HIV testing (HT and the main barriers to testing remain unknown. The main objective of the study was to explore the attitude towards HT and identify the main barriers of those who had never undergone HT before. This study involved 992 adolescents (16-20 years, who were recruited from 4 autonomous regions of Spain. The mean age was 16.84 (SD=.92 and 54.6% were women. The attitude towards HT was very favorable, especially in women. 79.2% of sexually active participants did not consistently use condoms during sex; however only 1% (n=11 reported having undergone HT. The main perceived barriers were related to not having received the offer to get tested (49%, low risk perception (32.6% and trust between sexual partners (29.1%. Facilitating access of the HIV screening test to adolescents with high sexual risk is crucial to the success of early detection campaigns, and curb the spread of the HIV.

  11. Quality of HIV laboratory testing in Tanzania: a situation analysis

    African Journals Online (AJOL)

    December 2004 to February 2005 in 12 laboratories which were conveniently selected to represent all the zones of Tanzania. The questionnaires comprised of questions on laboratory particulars, internal and external quality control for HIV testing and quality control of reagents. Source and level of customer satisfaction of ...

  12. Mantoux skin test reactivity among household contacts of hiv ...

    African Journals Online (AJOL)

    Objective: To compare the prevalence of Tuberculosis (TB) infection as demonstrated by a positive Mantoux skin test (MST) among household contacts of sputum smear positive (SSP) HIV infected and un-infected TB patients. Methods: A cross-sectional study of household contacts of patients with TB (index cases) attending ...

  13. Utilization of HIV Testing and Counseling in Ghana: Implications for ...

    African Journals Online (AJOL)

    HIV testing and counselling (HTC) is a gateway to all systems of AIDS-related care. This study examined national programme data to highlight gaps in HTC service utilization, regional differences and differential use of various HTC programs in Ghana in the period, 2007-2010. Analysis showed HTC increased rapidly across ...

  14. Effects of mortality salience and perceived vulnerability on HIV testing intentions and behaviour.

    Science.gov (United States)

    Grover, Kristin W; Miller, Carol T

    2014-01-01

    Research indicates that death thoughts that occur in response to health threats affect subsequent health behaviour. The present study examined the effects of mortality salience on HIV testing. After reading an article that was intended to make them perceive that they had high or low vulnerability to HIV, participants wrote about death or an aversive control topic. Participants then indicated their intentions to get tested for HIV and were given the opportunity to take an HIV test at the end of the study. Results showed that mortality salience increased testing behaviour among participants who were made to feel vulnerable to HIV, but decreased testing behaviour among participants who were not made to feel vulnerable to HIV infection. This research suggests that HIV prevention programmes must carefully consider how the association many people make between HIV and death may interact with people's perceptions of their vulnerability to HIV infection to affect their willingness to engage in preventative behaviours.

  15. Perceptions of door-to-door HIV counselling and testing in Botswana ...

    African Journals Online (AJOL)

    to-door HIV testing, including convenience, confidentiality, capacity to increase the number of people tested, and opportunities to increase knowledge of HIV transmission, prevention and care through provision of correct information to ...

  16. Evaluation of the Bio-Rad Geenius HIV-1/2 test as a confirmatory assay.

    Science.gov (United States)

    Montesinos, Isabel; Eykmans, Joelle; Delforge, Marie-Luce

    2014-08-01

    We have evaluated the recently Conformité Européenne (CE)-marked Bio-Rad Geenius human immunodeficiency virus (HIV)1/2 as a rapid and simple alternative to western blot for confirmation of HIV screening results. A total of 160 serum samples were tested: 44 HIV-1 reactive samples by a fourth-generation Murex HIV Ag/Ab and/or Vidas HIV Duo Ultra, five HIV-2 reactive samples, 15 HIV-1 non-B subtype samples and 11 confirmed HIV-1 early seroconversion samples, 72 nonreactive samples, eight indeterminate samples by MP HIV BLOT 2.2 confirmed negative after follow-up and five low-reactive samples by enzyme immunoassay (EIA) negative by MP HIV BLOT 2.2. The samples were tested according to the manufacturer's guidelines. The overall sensitivity for Bio-Rad Geenius HIV1/2 assay was 92%. Five out of 11 early seroconversion samples were tested positive, four negative and two indeterminate. All HIV-1 non-B subtype samples were tested positive. Two out of the five HIV-2 reactive samples were tested positive HIV-2, two positive HIV-2 with HIV-1 cross-reaction and one HIV positive untypable. After excluding early seroconversion samples, the sensitivity of Bio-Rad Geenius HIV1/2 assay reached 100%. Overall specificity was 96%. All HIV negative serums by fourth-generation EIA were tested negative. All five low-reactive samples by EIA, negative by HIV BLOT 2.2 were tested negative by Bio-Rad Geenius HIV1/2. Two out of the eight indeterminate samples by MP HIV BLOT 2.2 that were confirmed negative after follow-up were tested indeterminate and one invalid, the other five were negative. After excluding these last 13 samples, the specificity of Bio-Rad Geenius HIV1/2 assay reached 100%. In comparison with MP HIV BLOT 2.2, the Bio-Rad Geenius HIV1/2 assay was markedly time saving, allowed full traceability, automatic reading and interpretation. The Bio-Rad Geenius HIV1/2 confirmatory system represents a reliable alternative to other confirmatory assays in HIV testing algorithms and

  17. The Subjective Visual Vertical: Validation of a Simple Test

    Science.gov (United States)

    Tesio, Luigi; Longo, Stefano; Rota, Viviana

    2011-01-01

    The study sought to provide norms for a simple test of visual perception of verticality (subjective visual vertical). The study was designed as a cohort study with a balanced design. The setting was the Rehabilitation Department of a University Hospital. Twenty-two healthy adults, of 23-58 years, 11 men (three left handed) and 11 women (three left…

  18. False-negative post-18-month confirmatory HIV tests in HIV DNA PCR-positive children: a retrospective analysis.

    Science.gov (United States)

    Garcia-Prats, Anthony J; Draper, Heather R; Sanders, Jill E; Agrawal, Anurag K; Mohapi, Edith Q; Schutze, Gordon E

    2012-09-24

    The WHO guidelines for children less than 18 months old diagnosed with HIV based on presumptive clinical diagnosis or one virologic test recommend confirmatory HIV antibody testing after 18 months of age. This study describes post-18-month HIV test results following this WHO-recommended confirmatory testing strategy. Case series and retrospective review of routine program data. Children enrolled at the Baylor Children's Clinical Center of Excellence, a pediatric and family HIV clinic in Maseru, Lesotho from December 2005 through January 2009 with a positive HIV DNA PCR at less than 18 months of age and HIV rapid test results after 18 months of age were included. Post-18-month confirmatory HIV test results are described. Factors associated with non-positive confirmatory rapid tests were determined using binary logistic regression. Of the 109 children meeting inclusion criteria, 22 (20.2%) had negative and 27 (24.8%) discordant confirmatory rapid tests. Forty-six of these 49 were on antiretroviral therapy (ART). Among these 49, 11 of 24 post-18-month HIV DNA PCRs were negative, whereas nine of 10 post-18-month HIV ELISAs were positive; 29 were definitively and 17 probably HIV-infected, two were uninfected, and one had undetermined status. Only age less than 9 months at ART initiation (odds ratio 4.25, P = 0.002) was associated with non-positive rapid tests. False-negative post-18-month confirmatory rapid tests and HIV DNA PCRs in children on ART are common, associated with early ART initiation, and may lead to inappropriate ART discontinuation and discharge from care of truly HIV-infected children.

  19. Test Review: The Beery Developmental Test of Visual-Motor Integration

    Science.gov (United States)

    McCrimmon, Adam W.; Altomare, Alyssa A.; Matchullis, Ryan L.; Jitlina, Katia

    2012-01-01

    This article presents a review of the "Beery Developmental Test of Visual-Motor Integration" (6th edition). The "Beery Developmental Test of Visual-Motor Integration" is a newly updated measure of visual-motor abilities for individuals aged 2 to 100 years that principally represents a normative update from the fifth edition.…

  20. HIV Testing and Awareness of Partner's HIV Status Among Chinese Men Who Have Sex with Men in Main Partnerships.

    Science.gov (United States)

    Wei, Chongyi; Yan, Hongjing; Raymond, H Fisher; Shi, Ling-En; Li, Jianjun; Yang, Haitao; McFarland, Willi

    2016-04-01

    Many men who have sex with men (MSM) do not use condoms with their main partners, especially if both parties are of the same HIV status. However, significant proportions of MSM have never tested or recently tested and are unaware of their main partners' HIV status. A cross-sectional survey was conducted among 524 MSM in Jiangsu, China in 2013-2014. Time-location sampling and online convenience sampling were used to recruit participants. We compared awareness of HIV status and recent HIV testing between participants who had main partners versus those who did not, and identified factors associated with recent HIV testing among men in main partnerships. Participants in main partnerships were significantly more likely to report recent HIV testing and being HIV-negative instead of HIV-unknown compared to participants in casual partnerships only. Overall, 74.5 % of participants were aware of their main partners' HIV status. Among participants in main partnerships, those who had 2-5 male anal sex partners in the past 6 months and those who reported that their partners were HIV-negative had 2.36 (95 % CI 1.12, 4.97) and 4.20 (95 % CI 2.03, 8.70) fold greater odds of being tested in the past year compared to those who had main partners only and those whose partners were HIV-positive/unknown, respectively. Chinese MSM in main partnerships might be practicing serosorting and may be at lower risk for HIV infection due to increased awareness of main partners' HIV status and higher uptake of recent testing.

  1. Assessment of HIV-related stigma in a US faith-based HIV education and testing intervention

    Directory of Open Access Journals (Sweden)

    Jannette Y Berkley-Patton

    2013-11-01

    Full Text Available Introduction: The African American church is a highly influential institution with the potential to greatly increase the reach of HIV prevention interventions and address HIV-related stigma in US African American communities. However, there are few studies on HIV-related stigma and African American church populations. This study explored HIV-related stigma among church and community members participating in an HIV education and testing intervention pilot study in African American churches, named Taking It to the Pews. Methods: Four African American churches located in Kansas City, MO and KS, were randomized to either intervention or comparison groups. Churches assigned to the intervention group received religiously tailored HIV education, testing and compassion messages/activities (e.g. sermons, brochures/church bulletins, testimonials via the Taking It to the Pews HIV Tool Kit. Comparison churches received non-religiously tailored HIV information. HIV-related stigma was assessed with 543 church members and with community members served through church outreach services (e.g. food/clothing pantries, social services in the four churches. Participants completed surveys at baseline, 6 months and 12 months to assess their HIV-related stigma beliefs, exposure to intervention components and satisfaction with the study. Results: At baseline, HIV-related stigma beliefs were similar across experimental groups and were quite low. Mean HIV-related stigma scores were not significantly different between experimental groups at 6 months (p=0.92 or at 12 months (p=0.70. However, mean HIV-related stigma scores within both groups showed decreasing trends at six months, which approached significance. Analysis of previously studied HIV-related stigma factors (e.g. age, gender, income, HIV knowledge, religiosity did not yield changes in the null findings. Intervention group participants were highly exposed to several intervention components (sermons, HIV resource

  2. "Inside These Fences Is Our Own Little World": Prison-Based HIV Testing and HIV-Related Stigma Among Incarcerated Men and Women.

    Science.gov (United States)

    Muessig, Kathryn E; Rosen, David L; Farel, Claire E; White, Becky L; Filene, Eliza J; Wohl, David A

    2016-04-01

    Correctional facilities offer opportunities to provide comprehensive HIV services including education, testing, treatment, and coordination of post- release care. However, these services may be undermined by unaddressed HIV stigma. As part of a prison-based HIV testing study, we interviewed 76 incarcerated men and women from the North Carolina State prison system. The sample was 72% men, median age 31.5 years (range: 19 to 60). Thematic analysis revealed high levels of HIV-related fear and stigma, homophobia, incomplete HIV transmission knowledge, beliefs that HIV is highly contagious within prisons ("HIV miasma"), and the View of HIV testing as protective. Interviewees described social distancing behaviors and coping mechanisms they perceived to be protective, including knowing their HIV status and avoiding contact with others and shared objects. Interviewees endorsed universal testing, public HIV status disclosure, and segregation of HIV-positive inmates. Intensified education and counseling efforts are needed to ameliorate entrenched HIV-transmission fears and stigmatizing beliefs.

  3. The impact of HIV/AIDS stigma on HIV counseling and testing in a ...

    African Journals Online (AJOL)

    EB

    Men aged 15-54 and women aged 15-49 were selected for the study because these are the ages most at risk to HIV/AIDS. Data on socio-demographic, sexual and ..... UNGASS Country. Progress Report Uganda, January 2008-. December 2009, March 2010. 12. Sebudde S, Nangendo F. Voluntary counselling and testing ...

  4. "HIV Testing Is so Gay": The Role of Masculine Gender Role Conformity in HIV Testing among Men Who Have Sex with Men

    Science.gov (United States)

    Parent, Mike C.; Torrey, Carrie; Michaels, Matthew S.

    2012-01-01

    Men who have sex with men (MSM) account for more than half of all new cases of HIV infection in the United States. Yet, many MSM are unaware of their HIV serostatus. Consistent with research indicating that gender role conformity impacts health behaviors, this study examined how masculine norms may influence HIV testing among MSM in the United…

  5. Initial Accuracy of HIV Rapid Test Kits Stored in Suboptimal Conditions and Validity of Delayed Reading of Oral Fluid Tests.

    Science.gov (United States)

    Choko, Augustine T; Taegtmeyer, Miriam; MacPherson, Peter; Cocker, Derek; Khundi, McEwen; Thindwa, Deus; Sambakunsi, Rodrick S; Kumwenda, Moses K; Chiumya, Kondwani; Malema, Owen; Makombe, Simon D; Webb, Emily L; Corbett, Elizabeth L

    2016-01-01

    To evaluate the effect of storing commonly used rapid diagnostic tests above manufacturer-recommended temperature (at 37°C), and the accuracy of delayed reading of oral fluid kits with relevance to HIV self-testing programmes. A quality assurance study of OraQuick (OraSure), Determine HIV 1/2™ (Alere) and Uni-Gold™ (Recombigen®). Consecutive adults (≥18y) attending Ndirande Health Centre in urban Blantyre, Malawi in January to April 2012 underwent HIV testing with two of each of the three rapid diagnostic test kits stored for 28 days at either 18°C (optimally-stored) or at 37°C (pre-incubated). Used OraQuick test kits were stored in a laboratory for delayed day 1 and subsequent monthly re-reading was undertaken for one year. Of 378 individuals who underwent parallel testing, 5 (1.3%) were dropped from the final analysis due to discordant or missing reference standard results (optimally-stored Determine and Uni-Gold). Compared to the diagnostic reference standard, OraQuick had a sensitivity of 97.2% (95% CI: 93.6-99.6). There were 7 false negative results among all test kits stored at 37°C and three false negatives among optimally stored kits. Excellent agreement between pre-incubated tests and optimally-stored tests with Kappa values of 1.00 for Determine and Uni-Gold; and 0.97 (95% CI: 0.95; 1.00) for OraQuick were observed. There was high visual stability on re-reading of OraQuick, with only 1/375 pre-incubated and 1/371 optimally-stored OraQuick kits changing from the initial result over 12 months. Erroneous results observed during HIV testing in low income settings are likely to be due to factors other than suboptimal storage conditions. Re-reading returned OraQuick kits may offer a convenient and accurate quality assurance approach, including in HIV self-testing programmes.

  6. Spillover effects of HIV testing policies: changes in HIV testing guidelines and HCV testing practices in drug treatment programs in the United States

    Directory of Open Access Journals (Sweden)

    Jemima A. Frimpong

    2016-07-01

    Full Text Available Abstract Background To examine the extent to which state adoption of the Centers for Disease Control and Prevention (CDC 2006 revisions to adult and adolescent HIV testing guidelines is associated with availability of other important prevention and medical services. We hypothesized that in states where the pretest counseling requirement for HIV testing was dropped from state legislation, substance use disorder treatment programs would have higher availability of HCV testing services than in states that had maintained this requirement. Methods We analyzed a nationally representative sample of 383 opioid treatment programs from the 2005 and 2011 National Drug Abuse Treatment System Survey (NDATSS. Data were collected from program directors and clinical supervisors through telephone surveys. Multivariate logistic regression models were used to measure associations between state adoption of CDC recommended guidelines for HIV pretest counseling and availability of HCV testing services. Results The effects of HIV testing legislative changes on HCV testing practices varied by type of opioid treatment program. In states that had removed the requirement for HIV pretest counseling, buprenorphine-only programs were more likely to offer HCV testing to their patients. The positive spillover effect of HIV pretest counseling policies, however, did not extend to methadone programs and did not translate into increased availability of on-site HCV testing in either program type. Conclusions Our findings highlight potential positive spillover effects of HIV testing policies on HCV testing practices. They also suggest that maximizing the benefits of HIV policies may require other initiatives, including resources and programmatic efforts that support systematic integration with other services and effective implementation.

  7. Performance of the Liaison XL Murex HIV Ab/Ag Test on Clinical Samples Representing Current Epidemic HIV Variants

    OpenAIRE

    Lemee, Véronique; Leoz, Marie; Etienne, Manuel; De Oliveira, Fabienne; Plantier, Jean-Christophe

    2014-01-01

    Screening for HIV infection has improved since the first immunoassays. Today, diagnosis of HIV infection can be performed with fourth-generation tests that track both the patient's antibodies and HIV antigen. The objective of this study was to evaluate the clinical sensitivity and specificity of the new DiaSorin Liaison XL Murex HIV Ab/Ag assay compared to another fourth-generation assay, the Abbott Architect HIV Ag/Ab Combo kit. This work was performed on a large panel of 900 samples, includ...

  8. Research Protocol - An Evaluation of False Positive HIV Results due to Testing Errors

    OpenAIRE

    Maparo, Tatenda; Mungofa, Stanley; Bara, Hilda T.; Chirisa, Florence

    2014-01-01

    An unacceptably high frequency of false positive HIV test results has been reported in various settings. Given the severity and implications of an HIV+ diagnosis, a false positive result is likely to be psychologically traumatic and may result in inappropriate and potentially harmful treatment. The current HIV testing algorithm being used in Zimbabwe does not include repeat testing for HIV positive results, and it is not currently known whether testing errors are leading to false positive dia...

  9. Evidence-based guidelines for universal counselling and offering of HIV testing in pregnancy in Canada

    OpenAIRE

    Samson, L; King, S.

    1998-01-01

    OBJECTIVE: To provide Canadian health care workers with evidence-based guidelines for universal counselling about HIV testing and the offering of such testing to all pregnant women. OPTIONS: Universal counselling and offering of HIV testing to all pregnant women versus targeted testing of only pregnant women at high risk for HIV infection. Antiretroviral treatment protocols for HIV-positive mothers and their infants are discussed as the intervention to reduce mother-to-child transmission rate...

  10. HIV testing and counselling for migrant populations living in high-income countries: a systematic review

    OpenAIRE

    Alvarez-del Arco, Debora; Monge, Susana; Azcoaga, Amaya; Rio, Isabel; Hernando, Victoria; Gonzalez, Cristina; Alejos, Belen; Caro, Ana Maria; Perez-Cachafeiro, Santiago; Ramirez-Rubio, Oriana; Bolumar, Francisco; Noori, Teymur; Del Amo, Julia

    2012-01-01

    Background: The barriers to HIV testing and counselling that migrants encounter can jeopardize proactive HIV testing that relies on the fact that HIV testing must be linked to care. We analyse available evidence on HIV testing and counselling strategies targeting migrants and ethnic minorities in high-income countries. Methods: Systematic literature review of the five main databases of articles in English from Europe, North America and Australia between 2005 and 2009. Results: Of 1034 abstrac...

  11. HIV and STI knowledge, testing, and risk among adult crack users in Mexico city: baseline findings from a feasibility study.

    Science.gov (United States)

    Cepeda, Alice; Frankeberger, Jessica; Bailey, Jennifer L; Nowotny, Kathryn M; Natera-Rey, Guillermina; Valdez, Avelardo

    2017-03-01

    Recent research has documented crack cocaine's increasing spread in Mexico, which is likely to contribute to the rapid transmission of HIV and other sexually transmitted infections (STIs). In Mexico, crack use is increasing most rapidly in vulnerable, hard-to-reach populations, where little is known about risk behaviors. This report aims to present baseline data regarding HIV and STI knowledge and testing prevalence from an innovative projection mapping HIV intervention, in which 3-D illusions, animation, and visual text graphics and sound are projected onto buildings with health messages that were designed to disrupt everyday life and connect with the target population. Fifty-eight men and women who used crack in the past month without receiving drug treatment were recruited and interviewed before the projection mapping intervention took place. Testing instruments included a sociodemographic assessment, drug use and treatment profile, HIV and STI knowledge questionnaires, and a sex and drug risk assessment. The mean scores for respondents on the HIV Knowledge Questionnaire (10.5 out of 18, 58.3%) and STD Knowledge Questionnaire (9.5 out of 27, 35.2%) were both low. Respondents also reported high rates of sexual risk behaviors, with 73% reporting never using a condom and 64% never being tested for HIV. This report provides a portrait of STI and HIV risk among a vulnerable population in Mexico City and the need for urgent interventions to prevent the spread of STIs and HIV. The associated projection mapping intervention will seek to increase HIV and STI knowledge and reduce risk in this hard-to-reach population.

  12. Successful treatment of bilateral visual loss caused by HIV-associated optic neuritis

    Directory of Open Access Journals (Sweden)

    Claire Cullen

    2011-12-01

    Full Text Available Optic neuritis is not an uncommon diagnosis in HIV-infected patients, but it is rarely idiopathic. We report a case of a young HIV-infected woman who developed optic neuritis as her presenting manifestation of HIV infection. She had initially experienced sudden-onset right-sided painful visual loss; the left eye had become involved within days. Bilateral swollen discs were apparent on fundoscopy. Investigations were performed for meningitis (including bacterial, cryptococcal, tuberculous and syphilitic types, auto-immune diseases, toxoplasma, rubella, cytomegalovirus, viral hepatitis, HTLV-1/2, HIV-1/2 and syphilis. The only positive result was a reactive HIV enzyme-linked immunosorbent assay. The CD4 count was 85 cells/µl. A post-contrast magnetic resonance imaging scan of the brain illustrated enhancement of the optic nerves. Treatment was 3 days of intravenous methylprednisolone 1 g daily, followed by 11 days of oral prednisone 60 mg daily. Highly active antiretroviral therapy was initiated after 2 weeks. Vision improved from day 6 after commencement of steroid therapy, with ongoing recovery at 5 months.

  13. The emotional wellbeing of lay HIV counselling and testing counsellors.

    Science.gov (United States)

    Visser, Maretha; Mabota, Princess

    2015-01-01

    The HIV testing, treatment and care programme of the South African public healthcare system depends on HIV counselling and testing (HCT) that is primarily delivered by lay counsellors. Lay counsellors are expected to educate clients about HIV/AIDS, advocate behaviour change, convey test results and support those infected and affected to cope with the emotional and social challenges associated with HIV/AIDS. This research focuses on the emotional wellbeing of lay HCT counsellors because this influences the quality of services they provide. A mixed methods approach was used. The emotional wellbeing, level of burnout, depression and coping style of 50 lay HCT counsellors working at the City of Tshwane clinics were assessed. Additionally, five focus group discussions were conducted. The results showed that HCT counsellors reported average emotional wellbeing, high levels of emotional exhaustion and depression. They had a sense of personal accomplishment and positive coping skills. The results revealed that they may have difficulty dealing with clients' emotional distress without adequate training and supervision. This creates a dilemma for service delivery. In the light of the important role they play in service delivery, the role of the lay HCT counsellor needs to be reconsidered. HCT should develop as a profession with specific training and supervision to develop their emotional competencies to conduct effective counselling sessions.

  14. HIV-related stigma, social norms, and HIV testing in Soweto and Vulindlela, South Africa: National Institutes of Mental Health Project Accept (HPTN 043).

    Science.gov (United States)

    Young, Sean D; Hlavka, Zdenek; Modiba, Precious; Gray, Glenda; Van Rooyen, Heidi; Richter, Linda; Szekeres, Greg; Coates, Thomas

    2010-12-15

    HIV testing is necessary to curb the increasing epidemic. However, HIV-related stigma and perceptions of low likelihood of societal HIV testing may reduce testing rates. This study aimed to explore this association in South Africa, where HIV rates are extraordinarily high. Data were taken from the Soweto and Vulindlela, South African sites of Project Accept, a multinational HIV prevention trial. Self-reported HIV testing, stigma, and social norms items were used to study the relationship between HIV testing, stigma, and perceptions about societal testing rates. The stigma items were broken into 3 factors: negative attitudes, negative perceptions about people living with HIV, and perceptions of fair treatment for people living with HIV (equity). Results from a univariate logistic regression suggest that history of HIV testing was associated with decreased negative attitudes about people living with HIV/AIDS, increased perceptions that people living with HIV/AIDS experience discrimination, and increased perceptions that people with HIV should be treated equitably. Results from a multivariate logistic regression confirm these effects and suggest that these differences vary according to sex and age. Compared with people who had never tested for HIV, those who had previously tested were more likely to believe that the majority of people have tested for HIV. Data suggest that interventions designed to increase HIV testing in South Africa should address stigma and perceptions of societal testing.

  15. Low HIV-testing rates and awareness of HIV infection among high-risk heterosexual STI clinic attendees in The Netherlands

    NARCIS (Netherlands)

    van der Bij, Akke K.; Dukers, Nicole H. T. M.; Coutinho, Roel A.; Fennema, Han S. A.

    2008-01-01

    OBJECTIVES: Since 1999, HIV testing is routinely offered to all attendees of the sexually transmitted infections (STI) outpatient clinic in Amsterdam, the Netherlands. This study evaluates whether this more active HIV-testing policy increased uptake of HIV testing and awareness of an HIV-positive

  16. High HIV Prevalence, Suboptimal HIV Testing, and Low Knowledge of HIV-Positive Serostatus Among Injection Drug Users in St. Petersburg, Russia

    Science.gov (United States)

    Toussova, Olga V.; Verevochkin, Sergei V.; Barbour, Russell; Heimer, Robert; Kozlov, Andrei P.

    2011-01-01

    The purpose of this analysis was to estimate human immunodeficiency virus (HIV) prevalence and testing patterns among injection drug users (IDUs) in St. Petersburg, Russia. HIV prevalence among 387 IDUs in the sample was 50%. Correlates of HIV-positive serostatus included unemployment, recent unsafe injections, and history/current sexually transmitted infection. Seventy-six percent had been HIV tested, but only 22% of those who did not report HIV-positive serostatus had been tested in the past 12 months and received their test result. Correlates of this measure included recent doctor visit and having been in prison or jail among men. Among the 193 HIV-infected participants, 36% were aware of their HIV-positive serostatus. HIV prevalence is high and continuing to increase in this population. Adequate coverage of HIV testing has not been achieved, resulting in poor knowledge of positive serostatus. Efforts are needed to better understand motivating and deterring factors for HIV testing in this setting. PMID:18843531

  17. Toward a Reconceptualization of Communication Cues to Action in the Health Belief Model: HIV Test Counseling.

    Science.gov (United States)

    Mattson, Marifran

    1999-01-01

    Examines the persuasive communication of HIV test counselors as cues to action in clients' decisions to practice safer sex. Indicates hypothesized relationships inherent in the Health Belief Model were not supported for the pre-HIV test survey, but the post-HIV test survey reported compliance with safer-sex recommendations. Finds use of certain…

  18. Repeat HIV testing during pregnancy and delivery: missed opportunities in a rural district hospital in Zambia

    NARCIS (Netherlands)

    Heemelaar, S.; Habets, N.; Makukula, Z.; van Roosmalen, J.; van den Akker, T.

    2015-01-01

    Objective: To assess coverage of repeat HIV testing among women who delivered in a Zambian hospital. HIV testing of pregnant women and repeat testing every 3 months during pregnancy and breastfeeding is the recommended policy in areas of high HIV prevalence. Methods: A prospective implementation

  19. A clinical audit of provider-initiated HIV counselling and testing in a ...

    African Journals Online (AJOL)

    Background. Early initiation of antiretroviral therapy reduces transmission of HIV and prolongs life. Expansion of HIV testing is therefore pivotal in overcoming the HIV pandemic. Provider-initiated counselling and testing (PICT) at first clinical contact is one way of increasing the number of individuals tested. Our impression is ...

  20. Rapid enzymatic test for phenotypic HIV protease drug resistance

    OpenAIRE

    Hoffmann, D.; Assfalg-Machleidt, Irmgard; Nitschko, H; Helm, K. von der; Koszinowski, U.; Machleidt, Werner

    2003-01-01

    A phenotypic resistance test based on recombinant expression of the active HIV protease in E. coli from patient blood samples was developed. The protease is purified in a rapid onestep procedure as active enzyme and tested for inhibition by five selected synthetic inhibitors (amprenavir, indinavir, nelfinavir, ritonavir, and saquinavir) used presently for chemotherapy of HIVinfected patients. The HPLC system used in a previous approach was replaced by a continuous fluorogenic assay suitable f...

  1. Stage of HIV presentation at initial clinic visit following a community-based HIV testing campaign in rural Kenya.

    Science.gov (United States)

    Haskew, John; Turner, Kenrick; Rø, Gunnar; Ho, Andrew; Kimanga, Davies; Sharif, Shahnaaz

    2015-01-21

    The Kenyan Ministry of Health and partners implemented a community-based integrated prevention campaign (IPC) in Western Kenya in 2008. The aim of this study was to determine whether the IPC, compared to Voluntary Counselling and Testing (VCT) services, was able to identify HIV positive individuals earlier in the clinical course of HIV infection following testing. A total of 1,752 adults aged over 15 years who tested HIV positive through VCT services or the IPC, and subsequently registered at initial clinic visit between September 2008 and September 2010, were considered in the analysis. Multivariable logistic regression models were developed to assess the association of CD4 count and WHO clinical stage of HIV infection at first clinic appointment with age group, gender, marital status and HIV testing source. Male gender and marital status were independently associated with late HIV presentation (WHO clinical stage 3 or 4 or CD4 count ≤ 350 cells/μl) at initial clinic visit. Patients testing HIV positive during the IPC had significantly higher mean CD4 count at initial clinic visit compared to individuals who tested HIV positive via VCT services. Patients testing HIV positive during the IPC had more than two times higher odds of presenting early with CD4 count greater than 350 cells/μl (adjusted OR 2.15, 95% CI 1.28 - 3.61, p = 0.004) and presenting early with WHO clinical stage 1 or 2 of HIV infection (adjusted OR 2.39, 95% CI 1.24 - 4.60, p = 0.01) at initial clinic visit compared to individuals who tested HIV positive via VCT services. The community-based integrated prevention campaign identified HIV positive individuals earlier in the course of HIV infection, compared to Voluntary Counselling and Testing services. Community-based campaigns, such as the IPC, may be able to assist countries to achieve earlier testing and initiation of ART in the course of HIV infection. Improving referral mechanisms and strengthening linkages between HIV testing and treatment

  2. Correlates of HIV testing among African American and Latino church congregants: the role of HIV stigmatizing attitudes and discussions about HIV.

    Science.gov (United States)

    Bogart, Laura M; Derose, Kathryn Pitkin; Kanouse, David E; Griffin, Beth Ann; Grifin, Beth Ann; Haas, Ann C; Williams, Malcolm V

    2015-02-01

    Faith-based organizations can be key settings in which to reach African Americans and Latinos for HIV prevention, but little is known regarding factors that predict congregants' HIV testing behaviors. We examined the extent to which sociodemographic factors, HIV-related cues to action (e.g., knowing someone who is HIV-positive), and the social climate surrounding HIV (stigma toward a hypothetical HIV-positive congregant, HIV-related discussions at church about abstinence, condoms, and testing) were associated with willingness to be tested in church and with ever having been tested among 1211 African American and Latino congregants. Multivariate analyses indicated that congregants were more open to church-based testing if they were younger and had discussed condoms at church. They were less open if they expressed stigmatizing attitudes toward a hypothetical congregant. Foreign-born Latinos with low English proficiency were more willing to be tested at church than were African Americans. Congregants were more likely to have ever been tested if they were younger, African American, female, or married; if they knew someone who was HIV-positive; and if they had discussed testing and condoms at church. They were less likely if they had discussed abstinence. Open dialogue around HIV may activate congregants to be more receptive to church-based prevention.

  3. Increased adolescent HIV testing with a hybrid mobile strategy in Uganda and Kenya.

    Science.gov (United States)

    Kadede, Kevin; Ruel, Theodore; Kabami, Jane; Ssemmondo, Emmanuel; Sang, Norton; Kwarisiima, Dalsone; Bukusi, Elizabeth; Cohen, Craig R; Liegler, Teri; Clark, Tamara D; Charlebois, Edwin D; Petersen, Maya L; Kamya, Moses R; Havlir, Diane V; Chamie, Gabriel

    2016-09-10

    We sought to increase adolescent HIV testing across rural communities in east Africa and identify predictors of undiagnosed HIV. Hybrid mobile testing. We enumerated 116 326 adolescents (10-24 years) in 32 communities of Uganda and Kenya ( NCT01864603): 98 694 (85%) reported stable (≥6 months of prior year) residence. In each community we performed hybrid testing: 2-week multidisease community health campaign that included HIV testing, followed by home-based testing of community health campaign nonparticipants. We measured adolescent HIV testing coverage and prevalence, and determined predictors of newly diagnosed HIV among HIV-infected adolescents using multivariable logistic regression. A total of 86 421 (88%) stable adolescents tested for HIV; coverage was 86, 90, and 88% in early (10-14), mid (15-17), and late (18-24) adolescents, respectively. Self-reported prior testing was 9, 26, and 55% in early, mid, and late adolescents tested, respectively. HIV prevalence among adolescents tested was 1.6 and 0.6% in Ugandan women and men, and 7.1 and 1.5% in Kenyan women and men, respectively. Prevalence increased in mid-adolescence for women and late adolescence for men. Among HIV-infected adolescents, 58% reported newly diagnosed HIV. In multivariate analysis of HIV-infected adolescents, predictors of newly diagnosed HIV included male sex [odds ratio (OR) = 1.97 (95% confidence interval (CI): 1.42-2.73)], Ugandan residence [OR = 2.63 (95% CI: 2.08-3.31)], and single status [OR = 1.62 (95% CI: 1.23-2.14) vs. married)]. The SEARCH hybrid strategy tested 88% of stable adolescents for HIV, a substantial increase over the 28% reporting prior testing. The majority (57%) of HIV-infected adolescents were new diagnoses. Mobile HIV testing for adults should be leveraged to reach adolescents for HIV treatment and prevention.

  4. Testing of visual field with virtual reality goggles in manual and visual grasp modes.

    Science.gov (United States)

    Wroblewski, Dariusz; Francis, Brian A; Sadun, Alfredo; Vakili, Ghazal; Chopra, Vikas

    2014-01-01

    Automated perimetry is used for the assessment of visual function in a variety of ophthalmic and neurologic diseases. We report development and clinical testing of a compact, head-mounted, and eye-tracking perimeter (VirtualEye) that provides a more comfortable test environment than the standard instrumentation. VirtualEye performs the equivalent of a full threshold 24-2 visual field in two modes: (1) manual, with patient response registered with a mouse click, and (2) visual grasp, where the eye tracker senses change in gaze direction as evidence of target acquisition. 59 patients successfully completed the test in manual mode and 40 in visual grasp mode, with 59 undergoing the standard Humphrey field analyzer (HFA) testing. Large visual field defects were reliably detected by VirtualEye. Point-by-point comparison between the results obtained with the different modalities indicates: (1) minimal systematic differences between measurements taken in visual grasp and manual modes, (2) the average standard deviation of the difference distributions of about 5 dB, and (3) a systematic shift (of 4-6 dB) to lower sensitivities for VirtualEye device, observed mostly in high dB range. The usability survey suggested patients' acceptance of the head-mounted device. The study appears to validate the concepts of a head-mounted perimeter and the visual grasp mode.

  5. Testing of Visual Field with Virtual Reality Goggles in Manual and Visual Grasp Modes

    Directory of Open Access Journals (Sweden)

    Dariusz Wroblewski

    2014-01-01

    Full Text Available Automated perimetry is used for the assessment of visual function in a variety of ophthalmic and neurologic diseases. We report development and clinical testing of a compact, head-mounted, and eye-tracking perimeter (VirtualEye that provides a more comfortable test environment than the standard instrumentation. VirtualEye performs the equivalent of a full threshold 24-2 visual field in two modes: (1 manual, with patient response registered with a mouse click, and (2 visual grasp, where the eye tracker senses change in gaze direction as evidence of target acquisition. 59 patients successfully completed the test in manual mode and 40 in visual grasp mode, with 59 undergoing the standard Humphrey field analyzer (HFA testing. Large visual field defects were reliably detected by VirtualEye. Point-by-point comparison between the results obtained with the different modalities indicates: (1 minimal systematic differences between measurements taken in visual grasp and manual modes, (2 the average standard deviation of the difference distributions of about 5 dB, and (3 a systematic shift (of 4–6 dB to lower sensitivities for VirtualEye device, observed mostly in high dB range. The usability survey suggested patients’ acceptance of the head-mounted device. The study appears to validate the concepts of a head-mounted perimeter and the visual grasp mode.

  6. Ocular dominance and visual function testing.

    Science.gov (United States)

    Lopes-Ferreira, D; Neves, H; Queiros, A; Faria-Ribeiro, M; Peixoto-de-Matos, S C; González-Méijome, J M

    2013-01-01

    To show the distribution of ocular dominance as measured with sensory and eye sighting methods and its potential relationship with high and low contrast LogMAR visual acuity in presbyopic subjects. Forty-four presbyopes (48.5 ± 3.5 years) participated in this study. Ocular dominance was determined by eye sighting (hole-in-card) and sensorial (+1.50 D lens induced blur) methods. According to the dominance detected with each method (RE: right eye or LE: left eye), patients were classified in dominance type 1 (RE/RE), type 2 (RE/LE), type 3 (LE/RE) and type 4 (LE/LE). Baseline refractive error (MSE) was RE:-0.36 ± 1.67 D and LE:-0.35 ± 1.85 D (P = 0.930). RE was the dominant eye in 61.4% and 70.5% of times as obtained from sensorial and sighting methods, respectively. Most frequent dominance was of type 1 (52.3%), in this case the RE showed statistically significant better distance low contrast LogMAR VA (0.04 LogMAR units) compared to the LE (P eye sighting and sensorial methods to define ocular dominance agreed in more than half of cases. Amount of MSE was not significantly different between dominant and non-dominant eye. But in case of right dominance, the RE presented better distance low contrast VA compared to the LE.

  7. Impact of HIV testing and counseling (HTC) knowledge on HIV prevention practices among traditional birth attendants in Nigeria.

    Science.gov (United States)

    Osuji, Alice; Pharr, Jennifer R; Nwokoro, Uche; Ike, Anulika; Ali, Christiana; Ejiro, Ogheneaga; Osuyali, John; Obiefune, Michael; Fiscella, Kevin; Ezeanolue, Echezona E

    2015-02-10

    Nigeria is second in the world for the number of people with HIV and has a high rate of mother-to-child transmission (MTCT). Over 60% of births in Nigeria occur outside of health care facilities, and because of this, Traditional Birth Attendants (TBAs) play a significant role in maternal and child health. It is important that TBAs be knowledgeable about HIV prevention. The purpose of this study was to determine the impact of HIV testing and counseling (HTC) knowledge on the HIV prevention practices among TBAs in Nigeria. Five hundred TBAs were surveyed. Chi-square and logistic regression were used to assess differences in HIV prevention practices between TBAs with and without HTC knowledge. TBAs with HTC knowledge are significantly more likely to engage in HIV prevention practices than TBAs without HTC. Prevention practices included: wearing gloves during delivery (p HTC training increases HIV prevention practices and can be a key to improve maternal and child health.

  8. Indeterminate rapid HIV-1 test results among antenatal and postnatal mothers

    OpenAIRE

    Matemo, D; Kinuthia, J.; John, F.; Chung, M.; Farquhar, C; John-Stewart, G.; Kiarie, J.

    2009-01-01

    The sensitivity and specificity of rapid HIV-1 tests may be altered during pregnancy and postpartum. We conducted a study to determine the prevalence and correlates of false-positive Abbott Determine™ and false-negative Uni-Gold™ rapid HIV-1 test results among antenatal and postnatal mothers attending a primary care clinic in Nairobi, Kenya. Mothers were tested for HIV-1 using Abbott Determine™ and non-reactive results were considered HIV-1 antibody negative. Reactive samples by Determine wer...

  9. Uptake of HIV testing and counseling, risk perception and linkage to HIV care among Thai university students

    Directory of Open Access Journals (Sweden)

    Thana Khawcharoenporn

    2016-07-01

    Full Text Available Abstract Background HIV testing and counseling (HTC with linkage to care after known infection are key components for HIV transmission prevention. This study was conducted to assess HTC uptake, HIV risk perception and linkage to care among Thai university students. Methods An outreach HTC program was conducted in a large public university in Thailand from January 2013 to December 2014. The program consisted of brief HIV knowledge assessment, free HTC, HIV risk assessment and education provided by the healthcare personnel. Students were categorized into low, moderate and high-risk groups according to the pre-defined HIV risk characteristics. Results One-thousand-eight-hundred-one students participated in the program, 494 (27 % underwent HTC. Independent characteristics associated with no HTC uptake included female sex (P < 0.001, lower HIV knowledge score (P < 0.001, younger age (P < 0.001 and students from non-health science faculties (P = 0.02. Among the 494 students undergoing HTC, 141 (29 % were categorized into moderate or high-risk group, of whom 45/141 (32 % had false perception of low HIV risk. Being heterosexual was independently associated with false perception of low HIV risk (P = 0.04. The rate of new HIV infection diagnosis was 4/494 (0.8 %. Of these 4 HIV-infected students, 3 (75 % were men who have sex with men and only 2 of the 4 students (50 % showed up for HIV continuity care. Conclusions An outreach HIV prevention program with HTC was feasible and beneficial in detecting HIV risk and infection among the university students. However, interventions to improve HTC uptake, HIV risk perception and linkage to care are needed.

  10. An Evaluation of Introduction of Rapid HIV Testing in a Perinatal Program.

    Science.gov (United States)

    Saunders, Sarah; Tulloch, Karen; Maan, Evelyn J; van Schalkwyk, Julianne; Money, Deborah M

    2017-08-01

    This study was conducted to evaluate the roll-out of rapid HIV testing as part of an emergency Prevention of Perinatal HIV Transmission Program. Specifically, HIV prevalence in this population, the reason(s) for performing the rapid HIV test, and compliance with recommendations for antiretroviral prophylaxis were assessed. Since November 2011, all women presenting to a tertiary labour and delivery unit with unknown HIV status or with ongoing risk of HIV infection since their last HIV test were offered rapid HIV testing. Through retrospective chart review, demographic data, HIV risk and prior testing history, and antiretroviral prophylaxis, data were collected and descriptive statistics were performed. One hundred fourteen rapid HIV tests were conducted and there were two preliminary reactive rapid results (one true positive, one false positive). None of the infants was HIV infected. Sixty-three percent of women had multiple risk factors for HIV acquisition, most commonly intravenous drug use (54%). Forty-four percent of women were within the 4-week seroconversion window at the time of delivery; 25% of these women and 52% of their infants received prophylactic drug therapy. Rapid HIV testing identified a high-risk cohort and enabled aggressive management of a newly diagnosed HIV-positive pregnancy, successfully preventing perinatal HIV transmission. Risk factors for HIV acquisition were ongoing within the seroconversion window for over half of the women, impacting the utility of the test in eliminating unnecessary antiretroviral prophylaxis in this population because prophylaxis is recommended despite a negative rapid HIV test in these cases. Copyright © 2017 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.

  11. Ocular Dominance and Visual Function Testing

    Directory of Open Access Journals (Sweden)

    D. Lopes-Ferreira

    2013-01-01

    Full Text Available Purpose. To show the distribution of ocular dominance as measured with sensory and eye sighting methods and its potential relationship with high and low contrast LogMAR visual acuity in presbyopic subjects. Method. Forty-four presbyopes (48.5 ± 3.5 years participated in this study. Ocular dominance was determined by eye sighting (hole-in-card and sensorial (+1.50 D lens induced blur methods. According to the dominance detected with each method (RE: right eye or LE: left eye, patients were classified in dominance type 1 (RE/RE, type 2 (RE/LE, type 3 (LE/RE and type 4 (LE/LE. Results. Baseline refractive error (MSE was RE:−0.36 ± 1.67 D and LE:−0.35 ± 1.85 D (P=0.930. RE was the dominant eye in 61.4% and 70.5% of times as obtained from sensorial and sighting methods, respectively. Most frequent dominance was of type 1 (52.3%, in this case the RE showed statistically significant better distance low contrast LogMAR VA (0.04 LogMAR units compared to the LE (P<0.05. Conclusions. The dominance was more frequent in RE in this sample. The eye sighting and sensorial methods to define ocular dominance agreed in more than half of cases. Amount of MSE was not significantly different between dominant and non-dominant eye. But in case of right dominance, the RE presented better distance low contrast VA compared to the LE.

  12. Rapid HIV testing for individuals on probation/parole: outcomes of an intervention trial.

    Science.gov (United States)

    Gordon, Michael S; Kinlock, Timothy W; McKenzie, Michelle; Wilson, Monique E; Rich, Josiah D

    2013-07-01

    Many probationers and parolees do not receive HIV testing despite being at increased risk for obtaining and transmitting HIV. A two-group randomized controlled trial was conducted between April, 2011 and May, 2012 at probation/parole offices in Baltimore, Maryland and Providence/Pawtucket, Rhode Island. Male and female probationers/parolees were interviewed (n = 1,263) and then offered HIV testing based on random assignment to one of two conditions: (1) On-site rapid HIV testing conducted at the probation/parole office; or (2) Referral for rapid HIV testing off site at a community HIV testing clinic. Outcomes were: (1) undergoing HIV testing; and (2) receipt of HIV testing results. Participants were significantly more likely to be tested on-site at a probation/parole office versus off-site at a HIV testing clinic (p < 0.001). There was no difference between the two groups in terms of receiving HIV testing results. Findings indicate that probationers/parolees are willing to be tested on-site and, independent of testing location, are equally willing to receive their results. Implications for expanding rapid HIV testing to more criminal justice related locations and populations are discussed.

  13. Comparing Cost-Effectiveness of HIV Testing Strategies: Targeted and Routine Testing in Washington, DC.

    Directory of Open Access Journals (Sweden)

    Amanda D Castel

    Full Text Available Routine HIV testing is an essential approach to identifying undiagnosed infections, linking people to care and treatment, and preventing new infections. In Washington, DC, where HIV prevalence is 2.4%, a combination of routine and targeted testing approaches has been implemented since 2006.We sought to evaluate the cost effectiveness of the District of Columbia (DC Department of Health's routine and targeted HIV testing implementation strategies. We collected HIV testing data from 3 types of DC Department of Health-funded testing sites (clinics, hospitals, and community-based organizations; collected testing and labor costs; and calculated effectiveness measures including cost per new diagnosis and cost per averted transmission.Compared to routine testing, targeted testing resulted in higher positivity rates (1.33% vs. 0.44%. Routine testing averted 34.30 transmissions per year compared to targeted testing at 17.78. The cost per new diagnosis was lower for targeted testing ($2,467 vs. $7,753 per new diagnosis as was the cost per transmission averted ($33,160 vs. $104,205. When stratified by testing site, both testing approaches were most cost effective in averting new transmissions when conducted by community based organizations ($25,037 routine; $33,123 targeted compared to hospitals or clinics.While routine testing identified more newly diagnosed infections and averted more infections than targeted testing, targeted testing is more cost effective per diagnosis and per transmission averted overall. Given the high HIV prevalence in DC, the DC Department of Health's implementation strategy should continue to encourage routine testing implementation with emphasis on a combined testing strategy among community-based organizations.

  14. Rapid HIV Testing and Counselling in

    African Journals Online (AJOL)

    Conseil et le test rapide du VIH pendant le travail dans un milieu du Nigéria du nord Entre avril et aôut. 2004 toutes les femmes en travail à]UTH ont subi le test pour le VIH et ont reçu du conseil avec l'opportunité de refuser le test. Les femmes séro-positives reçu la monothérapie de névirapine standard shéma prophylaxie.

  15. Visual matching test-taking strategies used by deaf readers.

    Science.gov (United States)

    LaSasso, C

    1985-03-01

    Earlier investigations of deaf students' test-taking strategies have described visual matching strategies consisting generally of locating a word in the question, locating the same word in the text, and selecting a response in visual proximity to that word. Studies to date have utilized multiple-choice measures. The present investigation sought to confirm and extend earlier findings by (a) determining whether visual matching test-taking strategies are used by deaf students in testing situations requiring them to generate responses; (b) describing these strategies, if found; (c) determining whether visual matching is related to overall test performance of deaf readers; and (d) determining whether there are differences between the strategies used by deaf and hearing readers with comparable SAT-HI reading comprehension test performance. The results of this investigation indicate extensive use of visual matching test-taking strategies by deaf subjects but not by hearing subjects. The extent of strategy use was not related to deaf subjects' overall performance on the lookback test. Nine variations of strategy were identified and described. Implications are drawn for teachers, researchers, and other practitioners working with deaf children.

  16. Offering self-administered oral HIV testing to truck drivers in Kenya to increase testing: a randomized controlled trial.

    Science.gov (United States)

    Kelvin, Elizabeth A; George, Gavin; Mwai, Eva; Nyaga, Eston; Mantell, Joanne E; Romo, Matthew L; Odhiambo, Jacob O; Starbuck, Lila; Govender, Kaymarlin

    2018-01-01

    We conducted a randomized controlled trial among 305 truck drivers from two North Star Alliance roadside wellness clinics in Kenya to see if offering HIV testing choices would increase HIV testing uptake. Participants were randomized to be offered (1) a provider-administered rapid blood (finger-prick) HIV test (i.e., standard of care [SOC]) or (2) a Choice between SOC or a self-administered oral rapid HIV test with provider supervision in the clinic. Participants in the Choice arm who refused HIV testing in the clinic were offered a test kit for home use with phone-based posttest counseling. We compared HIV test uptake using the Mantel Haenszel odds ratio (OR) adjusting for clinic. Those in the Choice arm had higher odds of HIV test uptake than those in the SOC arm (OR = 1.5), but the difference was not statistically significant (p = 0.189). When adding the option to take an HIV test kit for home use, the Choice arm had significantly greater odds of testing uptake (OR = 2.8, p = 0.002). Of those in the Choice arm who tested, 26.9% selected the SOC test, 64.6% chose supervised self-testing in the clinic, and 8.5% took a test kit for home use. Participants varied in the HIV test they selected when given choices. Importantly, when participants who refused HIV testing in the clinic were offered a test kit for home use, an additional 8.5% tested. Offering truck drivers a variety of HIV testing choices may increase HIV testing uptake in this key population.

  17. Factors associated with refusal of rapid HIV testing in an emergency department.

    Science.gov (United States)

    Pisculli, Mary L; Reichmann, William M; Losina, Elena; Donnell-Fink, Laurel A; Arbelaez, Christian; Katz, Jeffrey N; Walensky, Rochelle P

    2011-05-01

    HIV screening studies in the emergency department (ED) have demonstrated rates of HIV test refusal ranging from 40-67%. This study aimed to determine the factors associated with refusal to undergo routine rapid HIV testing in an academic ED in Boston. HIV counselors offered routine testing to 1,959 patients; almost one-third of patients (29%) refused. Data from a self-administered survey were used to determine independent correlates of HIV testing refusal. In multivariate analysis, women and patients with annual household incomes of $50,000 or more were more likely to refuse testing, as were those who reported not engaging in HIV risk behaviors, those previously HIV tested and those who did not perceive a need for testing. Enrollment during morning hours was also associated with an increased risk of refusal. Increased educational efforts to convey the rationale and benefits of universal screening may improve testing uptake among these groups.

  18. HIV testing and counselling for migrant populations living in high-income countries: a systematic review.

    Science.gov (United States)

    Alvarez-del Arco, Debora; Monge, Susana; Azcoaga, Amaya; Rio, Isabel; Hernando, Victoria; Gonzalez, Cristina; Alejos, Belen; Caro, Ana Maria; Perez-Cachafeiro, Santiago; Ramirez-Rubio, Oriana; Bolumar, Francisco; Noori, Teymur; Del Amo, Julia

    2013-12-01

    The barriers to HIV testing and counselling that migrants encounter can jeopardize proactive HIV testing that relies on the fact that HIV testing must be linked to care. We analyse available evidence on HIV testing and counselling strategies targeting migrants and ethnic minorities in high-income countries. Systematic literature review of the five main databases of articles in English from Europe, North America and Australia between 2005 and 2009. Of 1034 abstracts, 37 articles were selected. Migrants, mainly from HIV-endemic countries, are at risk of HIV infection and its consequences. The HIV prevalence among migrants is higher than the general population's, and migrants have higher frequency of delayed HIV diagnosis. For migrants from countries with low HIV prevalence and for ethnic minorities, socio-economic vulnerability puts them at risk of acquiring HIV. Migrants have specific legal and administrative impediments to accessing HIV testing-in some countries, undocumented migrants are not entitled to health care-as well as cultural and linguistic barriers, racism and xenophobia. Migrants and ethnic minorities fear stigma from their communities, yet community acceptance is key for well-being. Migrants and ethnic minorities should be offered HIV testing, but the barriers highlighted in this review may deter programs from achieving the final goal, which is linking migrants and ethnic minorities to HIV clinical care under the public health perspective.

  19. Low HIV-testing rates and awareness of HIV infection among high-risk heterosexual STI clinic attendees in The Netherlands.

    Science.gov (United States)

    Van der Bij, Akke K; Dukers, Nicole H T M; Coutinho, Roel A; Fennema, Han S A

    2008-08-01

    Since 1999, HIV testing is routinely offered to all attendees of the sexually transmitted infections (STI) outpatient clinic in Amsterdam, the Netherlands. This study evaluates whether this more active HIV-testing policy increased uptake of HIV testing and awareness of an HIV-positive serostatus among heterosexual attendees. In addition to routine data collected at each STI consultation, data from half-yearly HIV surveys were used from 1994 to 2004. During each survey period, 1000 consecutive attendees are enrolled voluntary and anonymously for HIV testing and are interviewed on previous HIV testing and outcome. Trends in and predictors for uptake of HIV testing as offered during routine STI consultation were analysed by logistic regression. Trends in awareness of an HIV-positive serostatus as obtained from the anonymous HIV surveys were likewise analysed. The percentage of heterosexual attendees opting for an HIV test during consultation increased from 13% in 1996 to 56% in 2004. However, the proportion of individuals aware of their HIV infection did not change over time and only a minority (19%) of the 108 attendees found HIV-positive in the anonymous surveys were aware of their HIV infection. Persons being or visiting a commercial sex worker, having a non-Dutch ethnicity, lacking health insurance and having an STI diagnosed were less likely to opt for an HIV test. Although heterosexual attendees increased their uptake of HIV testing during STI consultation over time, uptake of testing by attendees at risk for HIV infection, such as those infected with an STI, remained low. As a result, the percentage of persons aware of their HIV infection remained low, posing a risk for their individual health and for ongoing HIV transmission. Current testing strategies, therefore, misses the group that most needs testing. Based on these results, 'opt-out' HIV testing is now the standard procedure at the Amsterdam STI clinic.

  20. Consequences of Missed Opportunities for HIV Testing during Pregnancy and Delayed Diagnosis for Mexican Women, Children and Male Partners

    OpenAIRE

    Kendall, Tamil

    2014-01-01

    Introduction: HIV testing during pregnancy permits prevention of vertical (mother-to-child) transmission and provides an opportunity for women living with HIV to access treatment for their own health. In 2001, Mexico’s National HIV Action Plan committed to universal offer of HIV testing to pregnant women, but in 2011, only 45.6% of women who attended antenatal care (ANC) were tested for HIV. The study objective was to document the consequences of missed opportunities for HIV testing and couns...

  1. The evaluation of a rapid in situ HIV confirmation test in a programme with a high failure rate of the WHO HIV two-test diagnostic algorithm.

    Science.gov (United States)

    Klarkowski, Derryck B; Wazome, Joseph M; Lokuge, Kamalini M; Shanks, Leslie; Mills, Clair F; O'Brien, Daniel P

    2009-01-01

    Concerns about false-positive HIV results led to a review of testing procedures used in a Médecins Sans Frontières (MSF) HIV programme in Bukavu, eastern Democratic Republic of Congo. In addition to the WHO HIV rapid diagnostic test algorithm (RDT) (two positive RDTs alone for HIV diagnosis) used in voluntary counselling and testing (VCT) sites we evaluated in situ a practical field-based confirmation test against western blot WB. In addition, we aimed to determine the false-positive rate of the WHO two-test algorithm compared with our adapted protocol including confirmation testing, and whether weakly reactive compared with strongly reactive rapid test results were more likely to be false positives. 2864 clients presenting to MSF VCT centres in Bukavu during January to May 2006 were tested using Determine HIV-1/2 and UniGold HIV rapid tests in parallel by nurse counsellors. Plasma samples on 229 clients confirmed as double RDT positive by laboratory retesting were further tested using both WB and the Orgenics Immunocomb Combfirm HIV confirmation test (OIC-HIV). Of these, 24 samples were negative or indeterminate by WB representing a false-positive rate of the WHO two-test algorithm of 10.5% (95%CI 6.6-15.2). 17 of the 229 samples were weakly positive on rapid testing and all were negative or indeterminate by WB. The false-positive rate fell to 3.3% (95%CI 1.3-6.7) when only strong-positive rapid test results were considered. Agreement between OIC-HIV and WB was 99.1% (95%CI 96.9-99.9%) with no false OIC-HIV positives if stringent criteria for positive OIC-HIV diagnoses were used. The WHO HIV two-test diagnostic algorithm produced an unacceptably high level of false-positive diagnoses in our setting, especially if results were weakly positive. The most probable causes of the false-positive results were serological cross-reactivity or non-specific immune reactivity. Our findings show that the OIC-HIV confirmation test is practical and effective in field contexts

  2. The evaluation of a rapid in situ HIV confirmation test in a programme with a high failure rate of the WHO HIV two-test diagnostic algorithm.

    Directory of Open Access Journals (Sweden)

    Derryck B Klarkowski

    Full Text Available BACKGROUND: Concerns about false-positive HIV results led to a review of testing procedures used in a Médecins Sans Frontières (MSF HIV programme in Bukavu, eastern Democratic Republic of Congo. In addition to the WHO HIV rapid diagnostic test algorithm (RDT (two positive RDTs alone for HIV diagnosis used in voluntary counselling and testing (VCT sites we evaluated in situ a practical field-based confirmation test against western blot WB. In addition, we aimed to determine the false-positive rate of the WHO two-test algorithm compared with our adapted protocol including confirmation testing, and whether weakly reactive compared with strongly reactive rapid test results were more likely to be false positives. METHODOLOGY/PRINCIPAL FINDINGS: 2864 clients presenting to MSF VCT centres in Bukavu during January to May 2006 were tested using Determine HIV-1/2 and UniGold HIV rapid tests in parallel by nurse counsellors. Plasma samples on 229 clients confirmed as double RDT positive by laboratory retesting were further tested using both WB and the Orgenics Immunocomb Combfirm HIV confirmation test (OIC-HIV. Of these, 24 samples were negative or indeterminate by WB representing a false-positive rate of the WHO two-test algorithm of 10.5% (95%CI 6.6-15.2. 17 of the 229 samples were weakly positive on rapid testing and all were negative or indeterminate by WB. The false-positive rate fell to 3.3% (95%CI 1.3-6.7 when only strong-positive rapid test results were considered. Agreement between OIC-HIV and WB was 99.1% (95%CI 96.9-99.9% with no false OIC-HIV positives if stringent criteria for positive OIC-HIV diagnoses were used. CONCLUSIONS: The WHO HIV two-test diagnostic algorithm produced an unacceptably high level of false-positive diagnoses in our setting, especially if results were weakly positive. The most probable causes of the false-positive results were serological cross-reactivity or non-specific immune reactivity. Our findings show that the OIC-HIV

  3. Assessment of the utilization of pre-marital HIV testing services and ...

    African Journals Online (AJOL)

    Background: Pre-marital HIV testing contributes to the prevention of HIV infection by diminishing heterosexual transmission between partners and indirectly also protects any potential child from contracting the virus. Objectives: To assess the utilization and determinants of pre-marital HIV testing in civil marriages taking ...

  4. Incentives for HIV testing at the workplace in the auto motive industry ...

    African Journals Online (AJOL)

    2017-06-12

    Jun 12, 2017 ... Creative Commons licence CC-BY-NC 4.0. Comprehensive HIV and AIDS workplace programmes made use of substantial lottery incentives in HIV counselling and testing drives to promote HIV testing at four companies in the automotive industry in the Nelson Mandela Bay Municipality. The main aim was ...

  5. Availability and accessibility of HIV counseling and testing services for pregnant women in Hanoi, Vietnam

    NARCIS (Netherlands)

    Nguyen, T.A.; Oosterhoff, P.; Hardon, A.; Ngoc, Y.P.; Tran, H.N.; Coutinho, R.A.; Wright, P.

    2009-01-01

    In Hanoi, Vietnam, HIV counseling and testing is available but apparently still many HIV-positive women were either not detected or were identified too late for optimal PMTCT intervention. The study looked at how easily pregnant women could find out about and use HIV counseling and testing and

  6. Acceptability of counselling and testing for HIV infection in women in ...

    African Journals Online (AJOL)

    Background: Many patients are referred to labour ward as emergencies, and therefore do not benefit from the antenatal HIV counselling and testing and treatment offered to registered patients. Objective: To assess the acceptability and suitability of offering HIV counselling and testing to women of unknown HIV status ...

  7. Prospects of elimination of HIV with test-and-treat strategy

    NARCIS (Netherlands)

    Kretzschmar, Mirjam E.; Schim van der Loeff, Maarten F.; Birrell, Paul J.; de Angelis, Daniela; Coutinho, Roel A.

    2013-01-01

    Recently, there has been much debate about the prospects of eliminating HIV from high endemic countries by a test-and-treat strategy. This strategy entails regular HIV testing in the entire population and starting antiretroviral treatment immediately in all who are found to be HIV infected. We

  8. Correlation between knowledge of HIV, attitudes and perceptions of HIV and a willingness to test for HIV at a regional hospital in KwaZulu-Natal, South Africa

    Directory of Open Access Journals (Sweden)

    Emeka E. Orisakwe

    2012-02-01

    Full Text Available Background: With millions of South Africans infected with human immunodeficiency virus (HIV and less than 10% of the population aware of their HIV status, HIV counselling and testing (HCT is the first step in any attempt to reduce the number of new infections. For those who test negative, HCT personalises the risks and reinforces preventative messages whilst for those who are positive, it is the gateway to accessing counselling and care. The Health Belief Model postulates that knowledge and attitude influence behaviour. The aim of this study was to determine whether knowledge of HIV and the attitude of patients referred for HCT correlated with a willingness to test for HIV.Methods: One hundred and seventy two patients referred for HCT were randomly selected over a three month period. Data were collected by a research assistant using the modified standardised World Health Organization (WHO–Global AIDS Project (GAP questionnaire.Results: Ninety per cent of the participants demonstrated sound knowledge of HIV, acquired immune deficiency syndrome (AIDS and HCT. Despite the 90% of the participants with sound knowledge only 71.5% of the participants tested for HIV. There was no statistically significant difference in knowledge between those who tested and those who did not test for HIV. Twenty five per cent of those who refused to test stated that they had already made up their mind not to test for HIV before the counselling session.Conclusions: Despite excellent knowledge of HIV, a significant number of patients referred for HCT do not test for HIV.

  9. Correlation between knowledge of HIV, attitudes and perceptions of HIV and a willingness to test for HIV at a regional hospital in KwaZulu-Natal, South Africa

    Directory of Open Access Journals (Sweden)

    Emeka E. Orisakwe

    2012-07-01

    Full Text Available Background: With millions of South Africans infected with human immunodeficiency virus (HIV and less than 10% of the population aware of their HIV status, HIV counselling and testing (HCT is the first step in any attempt to reduce the number of new infections. For thosewho test negative, HCT personalises the risks and reinforces preventative messages whilst for those who are positive, it is the gateway to accessing counselling and care. The Health BeliefModel postulates that knowledge and attitude influence behaviour. The aim of this study was to determine whether knowledge of HIV and the attitude of patients referred for HCT correlated with a willingness to test for HIV. Methods: One hundred and seventy two patients referred for HCT were randomly selectedover a three month period. Data were collected by a research assistant using the modified standardised World Health Organization (WHO–Global AIDS Project (GAP questionnaire.Results: Ninety per cent of the participants demonstrated sound knowledge of HIV, acquired immune deficiency syndrome (AIDS and HCT. Despite the 90% of the participants with sound knowledge only 71.5% of the participants tested for HIV. There was no statistically significant difference in knowledge between those who tested and those who did not test for HIV. Twenty five per cent of those who refused to test stated that they had already made up their mind not to test for HIV before the counselling session.Conclusions: Despite excellent knowledge of HIV, a significant number of patients referred for HCT do not test for HIV.

  10. Immunofluorescence tests for HIV antibody and their value as confirmatory tests.

    Science.gov (United States)

    van der Groen, G; Vercauteren, G; Piot, P

    1987-08-01

    The enzyme-linked immunosorbent assay (ELISA) is currently being used as a sensitive screening test for HIV antibody. The immunoblot assay (IBA) and indirect immunofluorescence (IF) techniques are two recommended confirmation tests for EIA-positive sera. An indirect IF test has been developed by various laboratories using acetone fixed mixtures of uninfected and HIV-infected cells, which facilitated the reading, since nonspecific reactions were easily differentiated from specific staining. Similar results have been obtained with H9-, CEM-, and HUT78-HIV-infected and uninfected cells. Anti-nuclear antibodies and auto-antibodies resulting in false-positive EIA results, could easily be differentiated by the IF test. Aspecific fluorescence can be removed by absorption of the specimens with non-infected cells. However, IF is not suitable for the screening of large series of specimens. IF is especially well suited for quantitative analysis of serum antibody levels. Whereas serum antibody titers rise initially after infection, they decrease as AIDS develops. Heat inactivation of sera did not affect reactivity in IF, in contrast to a high rate of false-positive results obtained with heat inactivated sera in some ELISAs. A well characterized serum from an AIDS patient can be used to perform IF in order to monitor HIV infection of susceptible cells. It has been claimed that titers of neutralizing antibodies significantly correlate with the levels of IF anti-HIV antibodies. An overall correlation of 99% between IF and IBA was reported by different laboratories, when HIV ELISA-reactive European and North American sera were tested. The concordance with IBA was 97% when HIV ELISA-reactive African sera were tested.(ABSTRACT TRUNCATED AT 250 WORDS)

  11. Using Prosopagnosia to Test and Modify Visual Recognition Theory.

    Science.gov (United States)

    O'Brien, Alexander M

    2018-02-01

    Biederman's contemporary theory of basic visual object recognition (Recognition-by-Components) is based on structural descriptions of objects and presumes 36 visual primitives (geons) people can discriminate, but there has been no empirical test of the actual use of these 36 geons to visually distinguish objects. In this study, we tested for the actual use of these geons in basic visual discrimination by comparing object discrimination performance patterns (when distinguishing varied stimuli) of an acquired prosopagnosia patient (LB) and healthy control participants. LB's prosopagnosia left her heavily reliant on structural descriptions or categorical object differences in visual discrimination tasks versus the control participants' additional ability to use face recognition or coordinate systems (Coordinate Relations Hypothesis). Thus, when LB performed comparably to control participants with a given stimulus, her restricted reliance on basic or categorical discriminations meant that the stimuli must be distinguishable on the basis of a geon feature. By varying stimuli in eight separate experiments and presenting all 36 geons, we discerned that LB coded only 12 (vs. 36) distinct visual primitives (geons), apparently reflective of human visual systems generally.

  12. Efficacy of Structured Organizational Change Intervention on HIV Testing in Correctional Facilities.

    Science.gov (United States)

    Belenko, Steven; Visher, Christy; Pearson, Frank; Swan, Holly; Pich, Michele; O'Connell, Daniel; Dembo, Richard; Frisman, Linda; Hamilton, Leah; Willett, Jennifer

    2017-06-01

    This article presents findings from a multisite cluster randomized trial of a structured organizational change intervention for improving HIV testing services in jails and prisons. Matched pairs of prison and jail facilities were randomized to experimental and control conditions; all facilities received baseline training about best practices in HIV testing and other HIV services and selected an area of HIV services on which to focus improvement efforts. The experimental facilities formed local change teams and were provided external coaching based on the Network for the Improvement of Addiction Treatment (NIATx) process improvement model. Difference-indifference analyses indicate a significant relative increase in HIV testing in the experimental compared to the control condition. Meta-analyses across the matched pairs indicated a small to medium effect of increased testing overall. The results indicate that the local change team model can achieve significant increases in HIV testing in correctional facilities. Implications for HIV testing policies and challenges for expanding testing are discussed.

  13. HIV testing and counselling in Estonian prisons, 2012 to 2013: aims, processes and impacts.

    Science.gov (United States)

    Kivimets, K; Uuskula, A

    2014-11-27

    We present data from an observational cohort study on human immunodeficiency virus (HIV) prevention and control measures in prisons in Estonia to assess the potential for HIV transmission in this setting. HIV testing and retesting data from the Estonian prison health department were used to estimate HIV prevalence and incidence in prison. Since 2002, voluntary HIV counselling and testing has routinely been offered to all prisoners and has been part of the new prisoners health check. At the end of 2012, there were 3,289 prisoners in Estonia, including 170 women: 28.5% were drug users and 15.6% were infected with HIV. Of the HIV-positive inmates, 8.3% were newly diagnosed on prison entry. In 2012, 4,387 HIV tests (including retests) were performed in Estonian prisons. Among 1,756 initially HIV-negative prisoners who were in prison for more than one year and therefore tested for HIV twice within 12 months (at entry and annual testing), one new HIV infection was detected, an incidence of 0.067 per 100 person-years (95% confidence interval (CI): 0.025–5.572). This analysis indicates low risk of HIV transmission in Estonian prisons. Implementation of HIV management interventions could impact positively on the health of prisoners and the communities to which they return.

  14. HIV testing and counselling for migrant populations living in high-income countries: a systematic review

    Science.gov (United States)

    Monge, Susana; Azcoaga, Amaya; Rio, Isabel; Hernando, Victoria; Gonzalez, Cristina; Alejos, Belen; Caro, Ana Maria; Perez-Cachafeiro, Santiago; Ramirez-Rubio, Oriana; Bolumar, Francisco; Noori, Teymur; Del Amo, Julia

    2013-01-01

    Background: The barriers to HIV testing and counselling that migrants encounter can jeopardize proactive HIV testing that relies on the fact that HIV testing must be linked to care. We analyse available evidence on HIV testing and counselling strategies targeting migrants and ethnic minorities in high-income countries. Methods: Systematic literature review of the five main databases of articles in English from Europe, North America and Australia between 2005 and 2009. Results: Of 1034 abstracts, 37 articles were selected. Migrants, mainly from HIV-endemic countries, are at risk of HIV infection and its consequences. The HIV prevalence among migrants is higher than the general population’s, and migrants have higher frequency of delayed HIV diagnosis. For migrants from countries with low HIV prevalence and for ethnic minorities, socio-economic vulnerability puts them at risk of acquiring HIV. Migrants have specific legal and administrative impediments to accessing HIV testing—in some countries, undocumented migrants are not entitled to health care—as well as cultural and linguistic barriers, racism and xenophobia. Migrants and ethnic minorities fear stigma from their communities, yet community acceptance is key for well-being. Conclusions: Migrants and ethnic minorities should be offered HIV testing, but the barriers highlighted in this review may deter programs from achieving the final goal, which is linking migrants and ethnic minorities to HIV clinical care under the public health perspective. PMID:23002238

  15. Functional MRI of the visual cortex and visual testing in patients with previous optic neuritis

    DEFF Research Database (Denmark)

    Langkilde, Annika Reynberg; Frederiksen, J.L.; Rostrup, Egill

    2002-01-01

    of the activated area and the signal change following ON, and compared the results with results of neuroophthalmological testing. We studied nine patients with previous acute ON and 10 healthy persons served as controls using fMRI with visual stimulation. In addition to a reduced activated volume, patients showed...... to both the results of the contrast sensitivity test and to the Snellen visual acuity. Our results indicate that fMRI is a useful method for the study of ON, even in cases where the visual acuity is severely impaired. The reduction in activated volume could be explained as a reduced neuronal input......The volume of cortical activation as detected by functional magnetic resonance imaging (fMRI) in the visual cortex has previously been shown to be reduced following optic neuritis (ON). In order to understand the cause of this change, we studied the cortical activation, both the size...

  16. CDC Vital Signs–HIV Testing

    Centers for Disease Control (CDC) Podcasts

    2017-11-28

    This podcast is based on the December 2017 CDC Vital Signs report. In the U.S., about 15 percent of people who have HIV don't know they have it. Learn about the importance of testing, early diagnosis, and treatment.  Created: 11/28/2017 by Centers for Disease Control and Prevention (CDC).   Date Released: 11/28/2017.

  17. Visual comparison testing of automotive paint simulation

    Science.gov (United States)

    Meyer, Gary; Fan, Hua-Tzu; Seubert, Christopher; Evey, Curtis; Meseth, Jan; Schnackenberg, Ryan

    2015-03-01

    An experiment was performed to determine whether typical industrial automotive color paint comparisons made using real physical samples could also be carried out using a digital simulation displayed on a calibrated color television monitor. A special light booth, designed to facilitate evaluation of the car paint color with reflectance angle, was employed in both the real and virtual color comparisons. Paint samples were measured using a multi-angle spectrophotometer and were simulated using a commercially available software package. Subjects performed the test quicker using the computer graphic simulation, and results indicate that there is only a small difference between the decisions made using the light booth and the computer monitor. This outcome demonstrates the potential of employing simulations to replace some of the time consuming work with real physical samples that still characterizes material appearance work in industry.

  18. Are partners of HIV-infected people being tested for HIV? A mixed-methods research from Gujarat, India.

    Science.gov (United States)

    Selvaraj, K; Kumar, A M V; Chawla, S; Shringarpure, K S; Thekkur, P; Palanivel, C; Verma, P B; Shah, A N; Pandya, K N; Roy, G; Singh, Z; Rewari, B B; Dongre, A R

    2017-03-21

    Setting: Four selected antiretroviral therapy (ART) centres of Gujarat State, India, which accounts for 8% of the human immunodeficiency virus (HIV) burden in India. Objectives: 1) To assess the proportion of people living with HIV (PLHIV) whose partners were not tested for HIV; 2) to assess sociodemographic and clinical characteristics of index cases associated with partner testing; and 3) to understand perceived facilitators and barriers to partner testing and make suggestions on how to improve testing from the perspective of the health-care provider. Design: A mixed-method design with a quantitative phase that involved reviewing the programme records of married PLHIV enrolled during 2011-2015, followed by a qualitative phase of key informant interviews. Results: Of 3884 married PLHIV, 1279 (33%) did not have their partners tested for HIV. Factors including index cases being male, illiterate, aged >25 years, belonging to key populations, substance use and being in advanced clinical stages were more likely to be associated with partner non-testing. Non-disclosure of HIV status (due to fear of marital discord) and lack of awareness and risk perception were the key barriers to testing. Conclusion: One third of PLHIV did not have their partners tested for HIV. Several factors were identified as being associated with the non-testing of partners, and solutions were explored that need to be implemented urgently if we are to achieve the 90-90-90 targets and end HIV.

  19. Self-Reported HIV-Positive Status But Subsequent HIV-Negative Test Result Using Rapid Diagnostic Testing Algorithms Among Seven Sub-Saharan African Military Populations

    Science.gov (United States)

    2017-07-07

    in many sub-Saharan African countries, and extensive laboratory testing has con- firmed HIV RDTs have excellent sensitivity and specificity. However... interpretation of results. We conducted HIV serosur- veys in seven sub-Saharan African military populations and recorded the frequency of per- sonnel...positive results, such as greater adherence to quality assurance guidelines and prevalence-specific HIV testing algorithms as described in the World

  20. Suboptimal HIV Testing Uptake Among Men Who Engage in Commercial Sex Work with Men in Asia.

    Science.gov (United States)

    Jin, Harry; Friedman, Mackey Reuel; Lim, Sin How; Guadamuz, Thomas E; Wei, Chongyi

    2016-12-01

    Men who have sex with men and are sex workers (MSMSW) are disproportionately affected by the growing and emerging HIV epidemic. As sex work and same-sex behavior are heavily stigmatized and often illegal in most Asian countries, HIV research focusing on MSMSW has been limited. The goal of this analysis is to examine HIV testing practices and identify correlates of HIV testing among MSMSW in Asia. The Asia Internet MSM Sex Survey, an online cross-sectional survey of 10,861 men who have sex with men (MSM), was conducted in 2010. Data on sociodemographic characteristics, HIV testing behaviors, and sexual behaviors were collected. Five hundred and seventy-four HIV-negative/unknown respondents reported receiving payment for sex with men at least once in the past 6 months and were included in this analysis. Multivariable logistic regression was conducted to identify independent correlates of HIV testing in the past year. About half (48.6%) of the participants had been tested for HIV at least once within the past year, and 30.5% had never been tested. We also found that MSMSW participants who engaged in risky behaviors were less likely to be tested. While one might expect a high HIV testing rate among MSMSW due to the risks associated with engaging in sex work, we found that HIV testing uptake is suboptimal among MSMSW in Asia. These results suggest that targeted HIV prevention and testing promotion among MSMSW are needed.

  1. Comparing automated visual GUI testing tools: an industrial case study

    NARCIS (Netherlands)

    Garousi, V.; Afzal, Wasif; Caglar, Adem; Berk Isik, Ihsan; Baydan, Berker; Caylak, Seckin; Zeki Boyraz, Ahmet; Yolacan, Burak; Herkiloglu, Kadir

    2017-01-01

    Visual GUI testing (VGT) is a tool-driven technique, which uses image recognition for interaction and assertion of the behaviour of system under test. Motivated by a real industrial need, in the context of a large Turkish software and systems company providing solutions in the areas of defense and

  2. Internalized homophobia and reduced HIV testing among men who have sex with men in China.

    Science.gov (United States)

    Pyun, Thomas; Santos, Glenn-Milo; Arreola, Sonya; Do, Tri; Hebert, Pato; Beck, Jack; Makofane, Keletso; Wilson, Patrick A; Ayala, George

    2014-03-01

    Although previous research has examined barriers and facilitators of HIV testing among men who have sex with men (MSM) in China, few studies have focused on social factors, including homophobia and internalized homophobia. This study utilized data from a global online survey to determine correlates of HIV testing as part of a subanalysis focused on Chinese MSM. Controlling for age, HIV knowledge, number of sexual partners, and other covariates, ever having tested for HIV was significantly correlated with lower internalized homophobia. This study suggests that stigma associated with sexual orientation may serve as a barrier to participation in HIV testing and other health-promoting behaviors.

  3. DEPIVIH 2: Use of three HIV testing methods in French primary care settings - ELISA laboratory screening versus two rapid point-of-care HIV tests.

    Science.gov (United States)

    Papadima, D; Gauthier, R; Prévoteau du Clary, F; Bouée, S; Conort, G; Livrozet, J-M; Taulera, O; Wajsbrot, A; Majerholc, C; Peter, J-M; Aubert, J-P

    2017-12-18

    The primary endpoint was to evaluate the use of HIV testing methods by French primary care providers: Elisa laboratory screening, instant result HIV diagnostic test and rapid result HIV diagnostic test. The secondary endpoints were the population screening rate of unknown HIV status consulting during the study period, reasons for screening and for choosing the specific screening method, the investigators' satisfaction with the rapid diagnostic test (RDT) and problems encountered. National prospective interventional study with French family physicians (FP) from December 2013 to December 2014. FPs enrolled all consenting adults consulting for an HIV screening test during a 6-month period: the choice was an Elisa laboratory test or one of the two RDTs. During the study period, 43 FPs included 981 patients. HIV screening was performed for the first time for 31.6% of patients; 767 (78.2%) Elisa laboratory test prescriptions and 214 (21.8%) RDTs were performed, leading to a screening rate of 1.3%. For 120 (15.7%) of the Elisa laboratory tests, the result was not reported and six RDTs were not valid. Nine patients were diagnosed as HIV-infected (0.9%): five with Elisa laboratory test and four with RDT. Almost 90% of FPs were willing to keep on using RDTs in their daily practice. In general practice, RDTs may be an important additional tool to traditional HIV screening. They could account for one in five tests prescribed in this context. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  4. HIV resistance to antiretroviral drugs: Mechanisms, genotypic and phenotypic resistance testing in clinical practice

    OpenAIRE

    Blaise, Pierre; Clevenbergh, P.; Vaira, Dolorès; Moutschen, Michel; Dellamonica, P

    2002-01-01

    HIV resistance to antiretroviral agents is a major contributory cause of treatment failure. The dynamics of HIV replication, together with patient-, physician-, and drug-related factors, lead to emergence of HIV resistant strains in most of the patients. Phenotypic assays look for an increase in the antiretroviral drug (ARV) concentration that inhibits 50% of the growth of the tested HIV strain (IC50), comparatively with a reference strain cultivated in parallel. Genotypic tests detect resist...

  5. Correlates of HIV testing and receipt of test results in addiction health services in Los Angeles County

    OpenAIRE

    Frimpong, Jemima A.; Guerrero, Erick G; Kong, Yinfei; Tsai, Gary

    2015-01-01

    Background HIV testing and receipt of HIV test results among individuals with substance use disorders is less than optimal. We examined rates and correlates of HIV testing and receipt of test results in one of the largest public addiction health services systems in the United States. Methods The study included 139,516 adult clients in treatment between 2006 and 2011. We used logistic regression models to examine associations between predisposing, enabling, and need factors and two dependent v...

  6. Estimating the impact of universal antiretroviral therapy for HIV serodiscordant couples through home HIV testing: insights from mathematical models

    Directory of Open Access Journals (Sweden)

    Sarah T Roberts

    2016-05-01

    Full Text Available Introduction: Antiretroviral therapy (ART prevents HIV transmission within HIV serodiscordant couples (SDCs, but slow implementation and low uptake has limited its impact on population-level HIV incidence. Home HIV testing and counselling (HTC campaigns could increase ART uptake among SDCs by incorporating couples’ testing and ART referral. We estimated the reduction in adult HIV incidence achieved by incorporating universal ART for SDCs into home HTC campaigns in KwaZulu-Natal (KZN, South Africa, and southwestern (SW Uganda. Methods: We constructed dynamic, stochastic, agent-based network models for each region. We compared adult HIV incidence after 10 years under three scenarios: (1 “Current Practice,” (2 “Home HTC” with linkage to ART for eligible persons (CD4 <350 and (3 “ART for SDCs” regardless of CD4, delivered alongside home HTC. Results: ART for SDCs reduced HIV incidence by 38% versus Home HTC: from 1.12 (95% CI: 0.98–1.26 to 0.68 (0.54–0.82 cases per 100 person-years (py in KZN, and from 0.56 (0.50–0.62 to 0.35 (0.30–0.39 cases per 100 py in SW Uganda. A quarter of incident HIV infections were averted over 10 years, and the proportion of virally suppressed HIV-positive persons increased approximately 15%. Conclusions: Using home HTC to identify SDCs and deliver universal ART could avert substantially more new HIV infections than home HTC alone, with a smaller number needed to treat to prevent new HIV infections. Scale-up of home HTC will not diminish the effectiveness of targeting SDCs for treatment. Increasing rates of couples’ testing, disclosure, and linkage to care is an efficient way to increase the impact of home HTC interventions on HIV incidence.

  7. False-positive HIV DNA PCR testing of infants: implications in a changing epidemic.

    Science.gov (United States)

    Feucht, Ute Dagmar; Forsyth, Brian; Kruger, Mariana

    2012-02-23

    To examine false-positive HIV DNA polymerase chain reaction (PCR) test results in children, and the potential implications for the paediatric HIV epidemic in sub-Saharan Africa. A review was done of records over a 6-year period of children less than 18 months old at an HIV treatment site in South Africa, to evaluate those with an initial 'false'-positive HIV DNA PCR result, but later proven to be HIV-uninfected with HIV DNA PCR and/or quantitative HIV RNA PCR tests. We calculated the influence of changing HIV transmission rates on predictive values (PV) of HIV DNA PCR tests in a hypothetical population of all HIV-exposed infants over a 1-year period. (Positive PV: proportion of individuals with a positive test with disease; negative PV: proportion of individuals with negative test and no disease). Of 718 children, 40 with an initial positive HIV DNA PCR test were subsequently proven to be HIV-uninfected, resulting in a positive PV of 94.4%. Most (75%) uninfected children had PMTCT interventions and were asymptomatic or mildly symptomatic (77.5%). Calculations using a test specificity of 99.4%, as reported previously, show a decrease in positive PV using a single-test strategy from 98.6% at 30% HIV transmission rate, to 94.8% at 10% transmission, to 62.5% at 1% transmission. Reduction in test specificity further decreases positive PV at low transmission rates. Decreasing mother-to-child HIV transmission rates reduce the positive predictive value of a single HIV DNA PCR test result, necessitating adaptations to diagnostic algorithms to avoid misdiagnosis and inappropriate treatment, especially with early initiation of antiretroviral therapy in asymptomatic infants.

  8. Expanding HIV testing efforts in concentrated epidemic settings: a population-based survey from rural Vietnam.

    Directory of Open Access Journals (Sweden)

    Anastasia Pharris

    Full Text Available BACKGROUND: To improve HIV prevention and care programs, it is important to understand the uptake of HIV testing and to identify population segments in need of increased HIV testing. This is particularly crucial in countries with concentrated HIV epidemics, where HIV prevalence continues to rise in the general population. This study analyzes determinants of HIV testing in a rural Vietnamese population in order to identify potential access barriers and areas for promoting HIV testing services. METHODS: A population-based cross-sectional survey of 1874 randomly sampled adults was linked to pregnancy, migration and economic cohort data from a demographic surveillance site (DSS. Multivariate logistic regression analysis was used to determine which factors were associated with having tested for HIV. RESULTS: The age-adjusted prevalence of ever-testing for HIV was 7.6%; however 79% of those who reported feeling at-risk of contracting HIV had never tested. In multivariate analysis, younger age (aOR 1.85, 95% CI 1.14-3.01, higher economic status (aOR 3.4, 95% CI 2.21-5.22, and semi-urban residence (aOR 2.37, 95% CI 1.53-3.66 were associated with having been tested for HIV. HIV testing rates did not differ between women of reproductive age who had recently been pregnant and those who had not. CONCLUSIONS: We found low testing uptake (6% among pregnant women despite an existing prevention of mother-to-child HIV testing policy, and lower-than-expected testing among persons who felt that they were at-risk of HIV. Poverty and residence in a more geographically remote location were associated with less HIV testing. In addition to current HIV testing strategies focusing on high-risk groups, we recommend targeting HIV testing in concentrated HIV epidemic settings to focus on a scaled-up provision of antenatal testing. Additional recommendations include removing financial and geographic access barriers to client-initiated testing, and encouraging provider

  9. Remaining Gap in HIV Testing Uptake Among Female Sex Workers in Iran.

    Science.gov (United States)

    Shokoohi, Mostafa; Noori, Atefeh; Karamouzian, Mohammad; Sharifi, Hamid; Khajehkazemi, Razieh; Fahimfar, Noushin; Hosseini-Hooshyar, Samira; Kazerooni, Parvin Afsar; Mirzazadeh, Ali

    2017-08-01

    We estimated the prevalence of recent HIV testing (i.e., having an HIV test during the last 12 months and knew the results) among 1295 HIV-negative Iranian female sex workers (FSW) in 2015. Overall, 70.4% (95% confidence intervals: 59.6, 79.3) of the participants reported a recent HIV testing. Concerns about their HIV status (83.2%) was reported as the most common reason for HIV testing. Incarceration history, having >5 paying partners, having >1 non-paying partner, receiving harm reduction services, utilizing healthcare services, and knowing an HIV testing site were significantly associated with recent HIV testing. In contrast, outreach participants, having one non-paying sexual partner, and self-reported inconsistent condom use reduced the likelihood of recent HIV testing. HIV testing uptake showed a ~2.5 times increase among FSW since 2010. While these findings are promising and show improvement over a short period, HIV testing programs should be expanded particularly through mobile and outreach efforts.

  10. Individual- and contextual-level factors associated with client-initiated HIV testing

    Directory of Open Access Journals (Sweden)

    Claudia Renata dos Santos Barros

    Full Text Available ABSTRACT: Background: Knowing the reasons for seeking HIV testing is central for HIV prevention. Despite the availability of free HIV counseling and testing in Brazil, coverage remains lacking. Methods: Survey of 4,760 respondents from urban areas was analyzed. Individual-level variables included sociodemographic characteristics; sexual and reproductive health; HIV/AIDS treatment knowledge and beliefs; being personally acquainted with a person with HIV/AIDS; and holding discriminatory ideas about people living with HIV. Contextual-level variables included the Human Development Index (HDI of the municipality; prevalence of HIV/AIDS; and availability of local HIV counseling and testing (CT services. The dependent variable was client-initiated testing. Multilevel Poisson regression models with random intercepts were used to assess associated factors. Results: Common individual-level variables among men and women included being personally acquainted with a person with HIV/AIDS and age; whereas discordant variables included those related to sexual and reproductive health and experiencing sexual violence. Among contextual-level factors, availability of CT services was variable associated with client-initiated testing among women only. The contextual-level variable “HDI of the municipality” was associated with client-initiated testing among women. Conclusion: Thus, marked gender differences in HIV testing were found, with a lack of HIV testing among married women and heterosexual men, groups that do not spontaneously seek testing.

  11. Performance of the Liaison XL Murex HIV Ab/Ag test on clinical samples representing current epidemic HIV variants.

    Science.gov (United States)

    Lemee, Véronique; Leoz, Marie; Etienne, Manuel; De Oliveira, Fabienne; Plantier, Jean-Christophe

    2014-09-01

    Screening for HIV infection has improved since the first immunoassays. Today, diagnosis of HIV infection can be performed with fourth-generation tests that track both the patient's antibodies and HIV antigen. The objective of this study was to evaluate the clinical sensitivity and specificity of the new DiaSorin Liaison XL Murex HIV Ab/Ag assay compared to another fourth-generation assay, the Abbott Architect HIV Ag/Ab Combo kit. This work was performed on a large panel of 900 samples, including negative samples (n = 493) and HIV-positive (n = 407) representatives of HIV-1 group M subtypes and circulating recombinant forms (CRFs), HIV-1 group O, and HIV-2 variants. The results highlight the high specificity (98.9%) and sensitivity (100%) of this new fourth-generation assay, which are consistent with its use for the screening and diagnosis of HIV infections with the current circulating strains. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

  12. Premarital HIV testing in Malaysia: a qualitative exploratory study on the views of major stakeholders involved in HIV prevention.

    Science.gov (United States)

    Barmania, Sima; Aljunid, Syed Mohamed

    2017-05-10

    HIV screening has existed in numerous methods as an important part of HIV prevention efforts over the years. Premarital HIV testing for couples who wish to marry has been implemented in a number of regions, which often operate in a mandatory rather than voluntary basis and is considered a contentious issue, with viewpoints held in favour and against. One such region is Malaysia which has a policy of mandatory premarital HIV testing of prospective Muslim married couples. The purpose of this study is to understand stakeholders' views on premarital HIV testing given the Malaysian Islamic context. 35 in-depth face to face semi-structured interviews were undertaken with key stakeholder groups involved in HIV prevention policy in Malaysia, namely, officials from the Ministry of Health, religious leaders and people living with HIV. Participants were recruited from the Klang Valley area, from July to December 2013, using purposive sampling techniques. Inclusion criteria necessitated that participants were over the age of 18 and provided full consent. Interviews were audiotaped, followed a standardised topic guide, transcribed verbatim and analysed using a framework analysis. Participants identified pre-marital HIV testing as an effective HIV prevention policy implemented in Malaysia and was viewed, for the most part, as a positive initiative across all stakeholders. Religious leaders were supportive of testing as it provides a protective mechanism, in line with the teachings of the Shariah, while Ministry of Health officials considered it a normal part of their HIV prevention screening initiatives. However, there were concerns surrounding issues such as confidentiality, counselling and discrimination surrounding the test described by the PLHIV group. The findings of this study show that among the participants interviewed was strong support for mandatory premarital HIV testing, which could possibly expose the vulnerability to HIV, reluctance to test and other areas in the

  13. Testing and testing positive: childhood adversities and later life HIV status among Kenyan women and their partners.

    Science.gov (United States)

    Goodman, Michael L; Raimer-Goodman, Lauren; Chen, Catherine X; Grouls, Astrid; Gitari, Stanley; Keiser, Philip H

    2017-12-01

    Adverse childhood experiences are a critical feature of lifelong health. No research assesses whether childhood adversities predict HIV-testing behaviors, and little research analyzes childhood adversities and later life HIV status in sub-Saharan Africa. We use regression models with cross-sectional data from a representative sample (n = 1974) to analyze whether adverse childhood experiences, separately or as cumulative exposures, predict reports of later life HIV testing and testing HIV+ among semi-rural Kenyan women and their partners. No significant correlation was observed between thirteen cumulative childhood adversities and reporting prior HIV testing for respondent or partner. Separately, childhood sexual abuse and emotional neglect predicted lower odds of reporting having previously been tested for HIV. Witnessing household violence during one's childhood predicted significantly higher odds of reporting HIV+. Sexual abuse predicted higher odds of reporting a partner tested HIV+. Preventing sexual abuse and household violence may improve HIV testing and test outcomes among Kenyan women. More research is required to understand pathways between adverse childhood experiences and partner selection within Kenya and sub-Saharan Africa, and data presented here suggest understanding pathways may help improve HIV outcomes.

  14. Three-Dimensional Visualizations in Teaching Genomics and Bioinformatics: Mutations in HIV Envelope Proteins and Their Consequences for Vaccine Design

    Directory of Open Access Journals (Sweden)

    Kathy Takayama

    2009-11-01

    Full Text Available This project addresses the need to provide a visual context to teach the practical applications of genome sequencing and bioinformatics. Present-day research relies on indirect visualization techniques (e.g., fluorescence-labeling of DNA in sequencing reactions and sophisticated computer analysis. Such methods are impractical and prohibitively expensive for laboratory classes. More importantly, there is a need for curriculum resources that visually demonstrate the application of genome sequence information rather than the DNA sequencing methodology itself. This project is a computer-based lesson plan that engages students in collaborative, problem-based learning. The specific example focuses on approaches to Human Immunodeficiency Virus-1 (HIV-1 vaccine design based on HIV-1 genome sequences using a case study. Students performed comparative alignments of variant HIV-1 sequences available from a public database. Students then examined the consequences of HIV-1 mutations by applying the alignments to three-dimensional images of the HIV-1 envelope protein structure, thus visualizing the implications for applications such as vaccine design. The lesson enhances problem solving through the application of one type of information (genomic or protein sequence into concrete visual conceptualizations. Assessment of student comprehension and problem-solving ability revealed marked improvement after the computer tutorial. Furthermore, contextual presentation of these concepts within a case study resulted in student responses that demonstrated higher levels of cognitive ability than was expected by the instructor.

  15. Self-testing as strategy to increase the uptake of HIV testing in South ...

    African Journals Online (AJOL)

    African Journal of AIDS Research ... for HIV above testing in a medical facility were the need for privacy and confidentiality; the need to keep testing as well as the results secret; fear of discrimination and stigma; distrust in the health care system to keep results confidential; and an aversion to face-to-face counselling.

  16. HIV testing experiences and their implications for patient engagement with HIV care and treatment on the eve of 'test and treat': findings from a multicountry qualitative study.

    Science.gov (United States)

    Wringe, Alison; Moshabela, Mosa; Nyamukapa, Constance; Bukenya, Dominic; Ondenge, Ken; Ddaaki, William; Wamoyi, Joyce; Seeley, Janet; Church, Kathryn; Zaba, Basia; Hosegood, Victoria; Bonnington, Oliver; Skovdal, Morten; Renju, Jenny

    2017-07-01

    In view of expanding 'test and treat' initiatives, we sought to elicit how the experience of HIV testing influenced subsequent engagement in HIV care among people diagnosed with HIV. As part of a multisite qualitative study, we conducted in-depth interviews in Uganda, South Africa, Tanzania, Kenya, Malawi and Zimbabwe with 5-10 health workers and 28-59 people living with HIV, per country. Topic guides covered patient and provider experiences of HIV testing and treatment services. Themes were derived through deductive and inductive coding. Various practices and techniques were employed by health workers to increase HIV testing uptake in line with national policies, some of which affected patients' subsequent engagement with HIV services. Provider-initiated testing was generally appreciated, but rarely considered voluntary, with instances of coercion and testing without consent, which could lead to disengagement from care.Conflicting rationalities for HIV testing between health workers and their clients caused tensions that undermined engagement in HIV care among people living with HIV. Although many health workers helped clients to accept their diagnosis and engage in care, some delivered static, morally charged messages regarding sexual behaviours and expectations of clinic use which discouraged future care seeking. Repeat testing was commonly reported, reflecting patients' doubts over the accuracy of prior results and beliefs that antiretroviral therapy may cure HIV. Repeat testing provided an opportunity to develop familiarity with clinical procedures, address concerns about HIV services and build trust with health workers. The principles of consent and confidentiality that should underlie HIV testing and counselling practices may be modified or omitted by health workers to achieve perceived public health benefits and policy expectations. While such actions can increase HIV testing rates, they may also jeopardise efforts to connect people diagnosed with HIV to

  17. Equity in HIV testing: evidence from a cross-sectional study in ten Southern African countries

    Directory of Open Access Journals (Sweden)

    Mitchell Steven

    2010-09-01

    Full Text Available Abstract Background HIV testing with counseling is an integral component of most national HIV and AIDS prevention strategies in southern Africa. Equity in testing implies that people at higher risk for HIV such as women; those who do not use condoms consistently; those with multiple partners; those who have suffered gender based violence; and those who are unable to implement prevention choices (the choice-disabled are tested and can have access to treatment. Methods We conducted a household survey of 24,069 people in nationally stratified random samples of communities in Botswana, Lesotho, Malawi, Mozambique, Namibia, South Africa, Swaziland, Tanzania, Zambia, and Zimbabwe. We asked about testing for HIV in the last 12 months, intention to test, and about HIV risk behaviour, socioeconomic indicators, access to information, and attitudes related to stigma. Results Across the ten countries, seven out of every ten people said they planned to have an HIV test but the actual proportion tested in the last 12 months varied from 24% in Mozambique to 64% in Botswana. Generally, people at higher risk of HIV were not more likely to have been tested in the last year than those at lower risk, although women were more likely than men to have been tested in six of the ten countries. In Swaziland, those who experienced partner violence were more likely to test, but in Botswana those who were choice-disabled for condom use were less likely to be tested. The two most consistent factors associated with HIV testing across the countries were having heard about HIV/AIDS from a clinic or health centre, and having talked to someone about HIV and AIDS. Conclusions HIV testing programmes need to encourage people at higher risk of HIV to get tested, particularly those who do not interact regularly with the health system. Service providers need to recognise that some people are not able to implement HIV preventive actions and may not feel empowered to get themselves

  18. Condom negotiation, HIV testing, and HIV risks among women from alcohol serving venues in Cape Town, South Africa.

    Science.gov (United States)

    Pitpitan, Eileen V; Kalichman, Seth C; Cain, Demetria; Eaton, Lisa A; Carey, Kate B; Carey, Michael P; Harel, Ofer; Simbayi, Leickness C; Mehlomakhulu, Vuyelwa; Mwaba, Kelvin

    2012-01-01

    Women in South Africa are at particularly high-risk for HIV infection and are dependent on their male partners' use of condoms for sexual risk reduction. However, many women are afraid to discuss condoms with male partners, placing them at higher risk of HIV infection. To examine the association between fear of condom negotiation with HIV testing and transmission risk behaviors, including alcohol use and sexual risks among South African women. Women (N = 1333) residing in a primarily Xhosa-speaking African township in Cape Town and attending informal alcohol-serving venues (shebeens) completed anonymous surveys. Logistic regression was used to test the hypothesis that fear of condom negotiation would be associated with increased risk for HIV. Compared to women who did not fear condom negotiation, those who did were significantly less likely to have been tested for HIV, were more likely to have experienced relationship abuse, and to report more alcohol use and more unprotected sex. For women in South Africa, fear of condom negotiation is related to higher risk of HIV. HIV prevention efforts, including targeted HIV counseling and testing, must directly address gender issues.

  19. Condom negotiation, HIV testing, and HIV risks among women from alcohol serving venues in Cape Town, South Africa.

    Directory of Open Access Journals (Sweden)

    Eileen V Pitpitan

    Full Text Available Women in South Africa are at particularly high-risk for HIV infection and are dependent on their male partners' use of condoms for sexual risk reduction. However, many women are afraid to discuss condoms with male partners, placing them at higher risk of HIV infection.To examine the association between fear of condom negotiation with HIV testing and transmission risk behaviors, including alcohol use and sexual risks among South African women.Women (N = 1333 residing in a primarily Xhosa-speaking African township in Cape Town and attending informal alcohol-serving venues (shebeens completed anonymous surveys. Logistic regression was used to test the hypothesis that fear of condom negotiation would be associated with increased risk for HIV.Compared to women who did not fear condom negotiation, those who did were significantly less likely to have been tested for HIV, were more likely to have experienced relationship abuse, and to report more alcohol use and more unprotected sex.For women in South Africa, fear of condom negotiation is related to higher risk of HIV. HIV prevention efforts, including targeted HIV counseling and testing, must directly address gender issues.

  20. HIV Testing and HIV/AIDS Treatment Services in Rural Counties in 10 Southern States: Service Provider Perspectives

    Science.gov (United States)

    Sutton, Madeline; Anthony, Monique-Nicole; Vila, Christie; McLellan-Lemal, Eleanor; Weidle, Paul J.

    2010-01-01

    Context: Forty percent of AIDS cases are reported in the southern United States, the region with the largest proportion of HIV/AIDS cases from rural areas. Data are limited regarding provider perspectives of the accessibility and availability of HIV testing and treatment services in southern rural counties. Purpose: We surveyed providers in the…

  1. HIV-1 tropism testing in subjects achieving undetectable HIV-1 RNA: diagnostic accuracy, viral evolution and compartmentalization.

    Science.gov (United States)

    Pou, Christian; Codoñer, Francisco M; Thielen, Alexander; Bellido, Rocío; Pérez-Álvarez, Susana; Cabrera, Cecilia; Dalmau, Judith; Curriu, Marta; Lie, Yolanda; Noguera-Julian, Marc; Puig, Jordi; Martínez-Picado, Javier; Blanco, Julià; Coakley, Eoin; Däumer, Martin; Clotet, Bonaventura; Paredes, Roger

    2013-01-01

    Technically, HIV-1 tropism can be evaluated in plasma or peripheral blood mononuclear cells (PBMCs). However, only tropism testing of plasma HIV-1 has been validated as a tool to predict virological response to CCR5 antagonists in clinical trials. The preferable tropism testing strategy in subjects with undetectable HIV-1 viremia, in whom plasma tropism testing is not feasible, remains uncertain. We designed a proof-of-concept study including 30 chronically HIV-1-infected individuals who achieved HIV-1 RNA evolution in PBMCs during viremia suppression and only found evolution of R5 viruses in one subject. No de novo CXCR4-using HIV-1 production was observed over time. Finally, Slatkin-Maddison tests suggested that plasma and cell-associated V3 forms were sometimes compartmentalized. The absence of tropism shifts during viremia suppression suggests that, when available, testing of stored plasma samples is generally safe and informative, provided that HIV-1 suppression is maintained. Tropism testing in PBMCs may not necessarily produce equivalent biological results to plasma, because the structure of viral populations and the diagnostic performance of tropism assays may sometimes vary between compartments. Thereby, proviral DNA tropism testing should be specifically validated in clinical trials before it can be applied to routine clinical decision-making.

  2. HIV/AIDS: the labour market implications of compulsory testing.

    Science.gov (United States)

    Taylor, O W

    2013-01-01

    It is intended in this brief paper to outline the policy direction that ought to be followed regarding the phenomenon of HIV/AIDS and the workplace. In essence, this is a viewpoint instructed by data and research and not anecdotal evidence. This is not primary research as it utilizes secondary material from existing literature as well as data from government sources. The method is a strict narrative regarding the data and frequencies and there there are no sophisticated statistical packages used for data analysis. On examining the data, it is clear that young women are disproportionately represented in the HIV and unemployment data. It is therefore likely that if testing for the purposes of employment is allowed to continue, it will create a disincentive to seek employment and thus will help to drive the infection underground.

  3. [Development of a rapid test kit for antibody to HIV by nano immunomagnetic lateral flow method].

    Science.gov (United States)

    Yang, Fa-qing; Lee, Tony; Wang, Chao-nan; Sun, Shu-ye; Li, Shan-shan; Tian, Hui

    2010-06-01

    To develop a rapid test kit for antibody to HIV by nano immunomagnetic lateral flow method. A rapid test kit was developed by conjugation of the HIV antigen gp41 and gp36 to 200nm super paramagnetic particles by carbodiimide (EDC) and coating of the HIV antigen gp41 and gp36 to nitrocellulose membrane. Then the kit was evaluated with serials of experiments. The kit was qualified with examination of national reference panel of anti-HIV antibody for colloidal gold diagnostic kit. The sensitivity was 100% by tested with 20 HIV antibody positive sera, the specificity was 98.5% by tested with 600 HIV antibody negative sera, respectively. The stability of the kit was over 12 month by storage at room temperature. A diagnostic kit for antibody to HIV was developed with the advantages of convenience, rapid test, good stability and point of care.

  4. Assessment of Oral Fluid HIV Test Performance in an HIV Pre-Exposure Prophylaxis Trial in Bangkok, Thailand.

    Science.gov (United States)

    Suntharasamai, Pravan; Martin, Michael; Choopanya, Kachit; Vanichseni, Suphak; Sangkum, Udomsak; Tararut, Pairote; Leelawiwat, Wanna; Anekvorapong, Rapeepan; Mock, Philip A; Cherdtrakulkiat, Thitima; Leethochawalit, Manoj; Chiamwongpaet, Sithisat; Gvetadze, Roman J; McNicholl, Janet M; Paxton, Lynn A; Kittimunkong, Somyot; Curlin, Marcel E

    2015-01-01

    Rapid easy-to-use HIV tests offer opportunities to increase HIV testing among populations at risk of infection. We used the OraQuick Rapid HIV-1/2 antibody test (OraQuick) in the Bangkok Tenofovir Study, an HIV pre-exposure prophylaxis trial among people who inject drugs. The Bangkok Tenofovir Study was a randomized, double-blind, placebo-controlled trial. We tested participants' oral fluid for HIV using OraQuick monthly and blood using a nucleic-acid amplification test (NAAT) every 3 months. We used Kaplan-Meier methods to estimate the duration from a positive HIV NAAT until the mid-point between the last non-reactive and first reactive oral fluid test and proportional hazards to examine factors associated with the time until the test was reactive. We screened 3678 people for HIV using OraQuick. Among 447 with reactive results, 436 (97.5%) were confirmed HIV-infected, 10 (2.2%) HIV-uninfected, and one (0.2%) had indeterminate results. Two participants with non-reactive OraQuick results were, in fact, HIV-infected at screening yielding 99.5% sensitivity, 99.7% specificity, a 97.8% positive predictive value, and a 99.9% negative predictive value. Participants receiving tenofovir took longer to develop a reactive OraQuick (191.8 days) than participants receiving placebo (16.8 days) (p = 0.02) and participants infected with HIV CRF01_AE developed a reactive OraQuick earlier than participants infected with other subtypes (p = 0.04). The oral fluid HIV test performed well at screening, suggesting it can be used when rapid results and non-invasive tools are preferred. However, participants receiving tenofovir took longer to develop a reactive oral fluid test result than those receiving placebo. Thus, among people using pre-exposure prophylaxis, a blood-based HIV test may be an appropriate choice. ClinicalTrials.gov NCT00119106.

  5. HIV and Childhood Sexual Violence: Implications for Sexual Risk Behaviors and HIV Testing in Tanzania.

    Science.gov (United States)

    Chiang, Laura F; Chen, Jieru; Gladden, Matthew R; Mercy, James A; Kwesigabo, Gideon; Mrisho, Fatma; Dahlberg, Linda L; Nyunt, Myo Zin; Brookmeyer, Kate A; Vagi, Kevin

    2015-10-01

    Prior research has established an association between sexual violence and HIV. Exposure to sexual violence during childhood can profoundly impact brain architecture and stress regulatory response. As a result, individuals who have experienced such trauma may engage in sexual risk-taking behavior and could benefit from targeted interventions. In 2009, nationally representative data were collected on violence against children in Tanzania from 13-24 year old respondents (n=3,739). Analyses show that females aged 19-24 (n=579) who experienced childhood sexual violence, were more likely to report no/infrequent condom use in the past 12 months (AOR=3.0, CI [1.5, 6.1], p=0.0017) and multiple sex partners in the past 12 months (AOR=2.3, CI [1.0, 5.1], p=0.0491), but no more likely to know where to get HIV testing or to have ever been tested. Victims of childhood sexual violence could benefit from targeted interventions to mitigate impacts of violence and prevent HIV.

  6. Social Media Monitoring of Discrimination and HIV Testing in Brazil, 2014-2015.

    Science.gov (United States)

    Nielsen, René Clausen; Luengo-Oroz, Miguel; Mello, Maeve B; Paz, Josi; Pantin, Colin; Erkkola, Taavi

    2017-07-01

    Big data can be used to assess perceptions about public health issues. This study assessed social media data from Twitter to inform communication campaigns to promote HIV testing and reduce discrimination related to HIV/AIDS or towards key populations to the HIV epidemic, and its potential utility to evaluate such campaigns through HIV testing uptake. Tweets from Brazil were collected from January 2014 to March 2015 and filtered by four categories of keywords including discrimination, HIV prevention, HIV testing, and HIV campaigns. In total over 100,000 geo-located tweets were extracted and analyzed. A dynamic online dashboard updated daily allowed mapping trends, anomalies and influencers, and enabled its use for feedback to campaigns, including correcting misconceptions. These results encourage the use of social networking data for improved messaging in campaigns. Clinical HIV test data was collected monthly from the city of Curitiba and compared to the number of tweets mapped to the city showing a moderate positive correlation (r = 0.39). Results are limited due to the availability of the HIV testing data. The potential of social media as a proxy for HIV testing uptake needs further validation, which can only be done with higher frequency and higher spatial granularity of service delivery data, enabling comparisons with the social media data. Such timely information could empower early response immediate media messaging to support programmatic efforts, such as HIV prevention, testing, and treatment scale up.

  7. HIV Transmission

    Science.gov (United States)

    ... Abroad Treatment Basic Statistics Get Tested Find an HIV testing site near you. Enter ZIP code or city Follow HIV/AIDS CDC HIV CDC HIV/AIDS See RSS | ... on HIV Syndicated Content Website Feedback HIV/AIDS HIV Transmission Language: English (US) Español (Spanish) Recommend on ...

  8. Utilities derived from visual analog scale scores in patients with HIV/AIDS.

    Science.gov (United States)

    Mrus, Joseph M; Yi, Michael S; Freedberg, Kenneth A; Wu, Albert W; Zackin, Robert; Gorski, Heather; Tsevat, Joel

    2003-01-01

    Visual analog scale (VAS) scores are used as global quality-of-life indicators and, unlike true utilities (which assess the desirability of health states v. an external metric), are often collected in HIV-related clinical trials. The purpose of this study was to derive and evaluate transformations relating aggregate VAS scores to utilities for current health in patients with HIV/AIDS. HIV-specific transformations were developed using linear and nonlinear regression to attain models that best fit mean VAS and standard gamble (SG) utility values directly derived from 299 patients with HIV/AIDS participating in a multicenter study of health values. The authors evaluated the transformations using VAS and SG utility values derived directly from patients in other HIV/AIDS studies. Derived transformations were also compared with published transformations. A simple linear transformation was derived (u = 0.44v + 0.49), as was the exponent for a curvilinear model (u = 1 - [1 - v]1.6), where u = the sample mean utility and v the sample mean VAS score. The curvilinear transformation predicted values within 0.10 of the actual SG utility in 5 of 8 estimates and within 0.05 in 3 of 8 estimates (absolute error ranged from -0.01 to +0.21). The linear transformation performed somewhat better, predicting within 0.10 of the actual SG value in 6 of 8 cases and within 0.05 in 5 of 8 estimates (absolute error ranged from -0.05 to +0.13). An alternative linear model (u = v + 0.018) derived from the literature performed similarly to our linear model (7 of 8 predictions within 0.10, 1 of 8 estimates within 0.05, and absolute error ranging from -0.15 to +0.10), whereas an alternative published curvilinear model (u = 1 - [1 - v]2.3) performed the least well (2 of 8 estimates within 0.10 of the actual values and no estimates within 0.05). Predicted utilities are a reasonable alternative for use in HIV/AIDS decision analyses and cost-effectiveness analyses. Linear transformations performed

  9. Lay Counsellor-Based Risk Reduction Intervention with HIV Positive Diagnosed Patients at Public HIV Counselling and Testing Sites in Mpumalanga, South Africa

    Science.gov (United States)

    Peltzer, Karl; Tabane, Cily; Matseke, Gladys; Simbayi, Leickness

    2010-01-01

    Objective: To evaluate the feasibility, fidelity, and effect of a human immunodeficiency virus (HIV) risk reduction intervention delivered to HIV-infected patients by lay counsellors during routine HIV counselling and testing (HCT) public service in Mpumalanga, South Africa. Methods: A total of 488 HIV-infected patients, aged 18 years and older,…

  10. Social problems of indeterminate and false positive hiv test results among clients attending a nigerian hiv treatment clinic.

    Science.gov (United States)

    Olowookere, S A; Adewole, I F

    2011-06-01

    Increased availability of Human Immunodeficiency Virus (HIV) screening test and more public enlightenment have resulted in more people coming forward to access counseling and testing at the HIV counseling and testing centers in Nigeria. Some of the clients however obtained indeterminate and false positive results leading to emotional disturbance and occasionally, dilemma to the attending physician. This article/case series looked at some of these situations and discussed how they were attended to.

  11. VSTOL ground effects testing with flow visualization and image enhancement

    Science.gov (United States)

    Kegelman, Jerome T.; Johns, Albert L.

    1991-01-01

    A remotely controlled high-energy fiber-optic light delivery technique is employed to examine the implementation of a laser-light-sheet flow-visualization system. During testing, video data are enhanced in real time using digital image processing techniques. A summary of test results for an advanced VSTOL configuration in ground effect, and techniques for the generation of 3D reconstructions for the flowfield are outlined. The system performed well during all phases of the test and proved to be an extremely useful asset to the overall test program. The most useful application of the flow visualization system was the interactive real-time flow field analysis made during the actual testing.

  12. 75 FR 51273 - Expanded Human Immunodeficiency Virus (HIV) Testing for Disproportionately Affected Populations

    Science.gov (United States)

    2010-08-19

    ... Announcement CDC-RFA-PS10-10138, ``Expanded Human Immunodeficiency Virus (HIV) Testing for Disproportionately... Assistance Number: 93.523 The Affordable Care Act: Human Immunodeficiency Virus (HIV) Prevention and Public... Number 93.523 The Affordable Care Act: Human Immunodeficiency Virus (HIV) Prevention and Public Health...

  13. HIV/AIDS Contamination Risk, Savings and the Welfare Effects of Diagnostic Testing

    NARCIS (Netherlands)

    Lammers, J.; Meijdam, A.C.; Verbon, H.A.A.

    2007-01-01

    This paper models the effect of a HIV/AIDS epidemic on saving behavior and studies the welfare effects of testing for HIV. The model specifies a utility function that includes both regular consumption, and medical expenditures. Medical expenditures generate more utility if individuals are HIV

  14. False-positive HIV test results in infancy and management of uninfected children receiving antiretroviral therapy.

    Science.gov (United States)

    Sutcliffe, Catherine G; Moss, William J; Thuma, Philip E

    2015-06-01

    This report summarizes 2 children misdiagnosed with HIV infection in a clinic in rural Zambia and discusses the implications of false-positive HIV DNA tests in HIV-exposed infants, including the potential magnitude of the problem. Recommendations are needed to address the management of children receiving antiretroviral therapy who are suspected of being uninfected.

  15. Collaborative update of a rule-based expert system for HIV-1 genotypic resistance test interpretation

    NARCIS (Netherlands)

    Paredes, Roger; Tzou, Philip L.; van Zyl, Gert; Barrow, Geoff; Camacho, Ricardo; Carmona, Sergio; Grant, Philip M.; Gupta, Ravindra K.; Hamers, Raph L.; Harrigan, P. Richard; Jordan, Michael R.; Kantor, Rami; Katzenstein, David A.; Kuritzkes, Daniel R.; Maldarelli, Frank; Otelea, Dan; Wallis, Carole L.; Schapiro, Jonathan M.; Shafer, Robert W.

    2017-01-01

    HIV-1 genotypic resistance test (GRT) interpretation systems (IS) require updates as new studies on HIV-1 drug resistance are published and as treatment guidelines evolve. An expert panel was created to provide recommendations for the update of the Stanford HIV Drug Resistance Database (HIVDB)

  16. Urinary dipstick proteinuria testing: does automated strip analysis offer an advantage over visual testing?

    Science.gov (United States)

    De Silva, Dane A; Halstead, Anne C; Côté, Anne-Marie; Sabr, Yasser; von Dadelszen, Peter; Magee, Laura A

    2014-07-01

    To compare the diagnostic test properties of automated and visually read urine dipstick screening for detection of a random protein:creatinine ratio (PrCr) ≥ 30 mg/mmol. Urine samples were collected prospectively from 160 women attending high-risk maternity clinics at a tertiary care facility. Samples were divided into two aliquots; one aliquot was tested using two different urine test strips, one read visually and one by an automated reader. A second aliquot of the same urine was analyzed for urinary protein and creatinine. Performance of visual and automated dipstick results (proteinuria ≥ 1+) were compared for detection of PrCr ≥ 30 mg/mmol using non-dilute urine samples (urinary creatinine ≥ 3 mmol/L). Both urine test strips showed low sensitivity (visual 56.0% and automated 53.8%). Positive likelihood ratios were 15.0 for visual dipstick testing (95% CI 5.9 to 37.9) and 24.6 for automated (95% CI 7.6 to 79.6). Negative likelihood ratios were 0.46 for visual dipstick testing (95% CI 0.29 to 0.71) and 0.47 for automated (95% CI 0.31 to 0.72). Automated dipstick testing was not superior to visual testing for detection of proteinuria in pregnant women in a primarily outpatient setting. Sensitivity may depend on the test strips and/or analyzer used.

  17. HIV testing of patients diagnosed with tuberculosis increased in Denmark during the period from 2007 to 2009

    DEFF Research Database (Denmark)

    Perch, M; Andersen, PH; Kok-Jensen, A

    2013-01-01

    We examined the trends of HIV testing among patients notified with TB in Denmark during a 3-year period from 2007 to 2009. We were able to obtain HIV testing status for 96%. There was a significant increase of patients examined for HIV infection during the 3-year period. HIV prevalence among HIV-......-tested TB patients in Denmark is much higher than in the average population. It seems there is an increasing awareness in Denmark towards testing TB cases for HIV co-infection.......We examined the trends of HIV testing among patients notified with TB in Denmark during a 3-year period from 2007 to 2009. We were able to obtain HIV testing status for 96%. There was a significant increase of patients examined for HIV infection during the 3-year period. HIV prevalence among HIV...

  18. Practicing provider-initiated HIV testing in high prevalence settings: consent concerns and missed preventive opportunities

    OpenAIRE

    Shayo Elizabeth H; Blystad Astrid; Njeru Mercy K; Nyamongo Isaac K; Fylkesnes Knut

    2011-01-01

    Abstract Background Counselling is considered a prerequisite for the proper handling of testing and for ensuring effective HIV preventive efforts. HIV testing services have recently been scaled up substantially with a particular focus on provider-initiated models. Increasing HIV test rates have been attributed to the rapid scale-up of the provider-initiated testing model, but there is limited documentation of experiences with this new service model. The aim of this study was to determine the ...

  19. Opt-out of voluntary HIV testing: a Singapore hospital's experience.

    Directory of Open Access Journals (Sweden)

    Arlene C Chua

    Full Text Available INTRODUCTION: Since 2008, the Singapore Ministry of Health (MOH has expanded HIV testing by increasing anonymous HIV test sites, as well as issuing a directive to hospitals to offer routine voluntary opt out inpatient HIV testing. We reviewed this program implemented at the end of 2008 at Tan Tock Seng Hospital (TTSH, the second largest acute care general hospital in Singapore. METHODS AND FINDINGS: From January 2009 to December 2010, all inpatients aged greater or equal than 21 years were screened for HIV unless they declined or were not eligible for screening. We reviewed the implementation of the Opt Out testing policy. There were a total of 93,211 admissions; 41,543 patients were included based on HIV screening program eligibility criteria. Among those included, 79% (n = 32,675 opted out of HIV screening. The overall acceptance rate was 21%. Majority of eligible patients who were tested (63% were men. The mean age of tested patients was 52 years. The opt out rate was significantly higher among females (OR: 1.5, 95%CI: 1.4-1.6, aged >60 years (OR: 2.3, 95%CI: 2.2-2.4 and Chinese ethnicity (OR: 1.7, 95%CI:1.6-1.8. The false positive rate of the HIV screening test is 0.56%. The proportion of patients with HIV infection among those who underwent HIV screening is 0.18%. All 16 confirmed HIV patients were linked to care. CONCLUSION: The default opt-in rate of inpatient HIV testing was low at Tan Tock Seng Hospital, Singapore. Efforts to address individual HIV risk perception and campaigns against HIV stigma are needed to encourage more individuals to be tested for HIV.

  20. Surprising results: HIV testing and changes in contraceptive practices among young women in Malawi

    Science.gov (United States)

    Sennott, Christie; Yeatman, Sara

    2015-01-01

    This study uses eight waves of data from the population-based Tsogolo la Thanzi study (2009–2011) in rural Malawi to examine changes in young women’s contraceptive practices, including the use of condoms, non-barrier contraceptive methods, and abstinence, following positive and negative HIV tests. The analysis factors in women’s prior perceptions of their HIV status that may already be shaping their behaviour and separates surprise HIV test results from those that merely confirm what was already believed. Fixed effects logistic regression models show that HIV testing frequently affects the contraceptive practices of young Malawian women, particularly when the test yields an unexpected result. Specifically, women who are surprised to test HIV positive increase their condom use and are more likely to use condoms consistently. Following an HIV negative test (whether a surprise or expected), women increase their use of condoms and decrease their use of non-barrier contraceptives; the latter may be due to an increase in abstinence following a surprise negative result. Changes in condom use following HIV testing are robust to the inclusion of potential explanatory mechanisms including fertility preferences, relationship status, and the perception that a partner is HIV positive. The results demonstrate that both positive and negative tests can influence women’s sexual and reproductive behaviours, and emphasise the importance of conceptualizing of HIV testing as offering new information only insofar as results deviate from prior perceptions of HIV status. PMID:26160156

  1. Field accuracy of fourth-generation rapid diagnostic tests for acute HIV-1: a systematic review

    OpenAIRE

    Lewis, Joseph M; MacPherson, Peter; Adams, Emily R.; Ochodo, Eleanor; Sands, Anita; Taegtmeyer, Miriam

    2015-01-01

    Introduction: Fourth-generation HIV-1 rapid diagnostic tests (RDTs) detect HIV-1 p24 antigen to screen for acute HIV-1. However, diagnostic accuracy during clinical use may be suboptimal. Methods: Clinical sensitivity and specificity of fourth-generation RDTs for acute HIV-1 were collated from field evaluation studies in adults identified by a systematic literature search. Results: Four studies with 17?381 participants from Australia, Swaziland, the United Kingdom and Malawi were identified. ...

  2. Routine HIV testing among hospitalized patients in Argentina. is it time for a policy change?

    Directory of Open Access Journals (Sweden)

    María Eugenia Socías

    Full Text Available INTRODUCTION: The Argentinean AIDS Program estimates that 110,000 persons are living with HIV/AIDS in Argentina. Of those, approximately 40% are unaware of their status, and 30% are diagnosed in advanced stages of immunosuppression. Though studies show that universal HIV screening is cost-effective in settings with HIV prevalence greater than 0.1%, in Argentina, with the exception of antenatal care, HIV testing is always client-initiated. OBJECTIVE: We performed a pilot study to assess the acceptability of a universal HIV screening program among inpatients of an urban public hospital in Buenos Aires. METHODS: Over a six-month period, all eligible adult patients admitted to the internal medicine ward were offered HIV testing. Demographics, uptake rates, reasons for refusal and new HIV diagnoses were analyzed. RESULTS: Of the 350 admissions during this period, 249 were eligible and subsequently enrolled. The enrolled population was relatively old compared to the general population, was balanced on gender, and did not report traditional high risk factors for HIV infection. Only 88 (39% reported prior HIV testing. One hundred and ninety (76% patients accepted HIV testing. In multivariable analysis only younger age (OR 1.02; 95%CI 1.003-1.05 was independently associated with test uptake. Three new HIV diagnoses were made (undiagnosed HIV prevalence: 1.58%; none belonged to a most-at-risk population. CONCLUSIONS: Our findings suggest that universal HIV screening in this setting is acceptable and potentially effective in identifying undiagnosed HIV-infected individuals. If confirmed in a larger study, our findings may inform changes in the Argentinean HIV testing policy.

  3. Routine HIV testing among hospitalized patients in Argentina. is it time for a policy change?

    Science.gov (United States)

    Socías, María Eugenia; Hermida, Laura; Singman, Mariana; Kulgis, Gisela; Díaz Armas, Andrés; Cando, Osvaldo; Sued, Omar; Pérez, Héctor; Hermes, Ricardo; Presas, José Luis; Cahn, Pedro

    2013-01-01

    The Argentinean AIDS Program estimates that 110,000 persons are living with HIV/AIDS in Argentina. Of those, approximately 40% are unaware of their status, and 30% are diagnosed in advanced stages of immunosuppression. Though studies show that universal HIV screening is cost-effective in settings with HIV prevalence greater than 0.1%, in Argentina, with the exception of antenatal care, HIV testing is always client-initiated. We performed a pilot study to assess the acceptability of a universal HIV screening program among inpatients of an urban public hospital in Buenos Aires. Over a six-month period, all eligible adult patients admitted to the internal medicine ward were offered HIV testing. Demographics, uptake rates, reasons for refusal and new HIV diagnoses were analyzed. Of the 350 admissions during this period, 249 were eligible and subsequently enrolled. The enrolled population was relatively old compared to the general population, was balanced on gender, and did not report traditional high risk factors for HIV infection. Only 88 (39%) reported prior HIV testing. One hundred and ninety (76%) patients accepted HIV testing. In multivariable analysis only younger age (OR 1.02; 95%CI 1.003-1.05) was independently associated with test uptake. Three new HIV diagnoses were made (undiagnosed HIV prevalence: 1.58%); none belonged to a most-at-risk population. Our findings suggest that universal HIV screening in this setting is acceptable and potentially effective in identifying undiagnosed HIV-infected individuals. If confirmed in a larger study, our findings may inform changes in the Argentinean HIV testing policy.

  4. The Importance of School Staff Referrals and Follow-Up in Connecting High School Students to HIV and STD Testing

    Science.gov (United States)

    Rasberry, Catherine N.; Liddon, Nicole; Adkins, Susan Hocevar; Lesesne, Catherine A.; Hebert, Andrew; Kroupa, Elizabeth; Rose, India D.; Morris, Elana

    2017-01-01

    This study examined predictors of having received HIV and sexually transmitted disease (STD) testing and having been referred by school staff for HIV/STD testing. In 2014, students in seven high schools completed paper-and-pencil questionnaires assessing demographic characteristics, sexual behavior, referrals for HIV/STD testing, and HIV/STD…

  5. Attitudes, perceptions and behaviours towards HIV testing among African-American and East African immigrant women in Washington, DC: implications for targeted HIV testing promotion and communication strategies.

    Science.gov (United States)

    De Jesus, Maria; Carrete, Claudia; Maine, Cathleen; Nalls, Patricia

    2015-12-01

    The objective of the study was to examine and compare the HIV testing attitudes, perceptions and behaviours between African-American and East African immigrant women in the Washington, DC metropolitan area. Adopting an inductive, qualitative methodological approach, we conducted a total of 40 in-depth, semistructured interviews between October 2012 and March 2013. Qualitative thematic analysis was used to analyse the data. Overall, African-American women held more favourable views towards HIV testing than East African immigrant women. Very few East African immigrant women sought HIV testing intentionally. The majority of East African participants were tested inadvertently, while others tested for immigration-related or employment-related purposes. There were many barriers that impede women from seeking an HIV test including negative assumptions (eg, "Getting an HIV test implies that I am HIV positive"), negative emotions (eg, "Fear of being diagnosed with HIV and what this will mean for me") and potential negative reactions from partner or others (eg, "Getting an HIV test can signal distrust, disrespect, or infidelity"). There were nuances in how each group articulated some of these barriers and East African women expressed unique concerns that originated from experiences in their home countries. The study shed light into the complexity of factors that constrain women from presenting themselves voluntarily for an HIV test and highlighted the nuances between African-American and East African perceptions. Implications of findings for effective targeted HIV screening promotion and communication strategies among these groups of women are discussed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  6. Barriers to workplace HIV testing in South Africa: a systematic review of the literature.

    Science.gov (United States)

    Weihs, Martin; Meyer-Weitz, Anna

    2016-01-01

    Low workplace HIV testing uptake makes effective management of HIV and AIDS difficult for South African organisations. Identifying barriers to workplace HIV testing is therefore crucial to inform urgently needed interventions aimed at increasing workplace HIV testing. This study reviewed literature on workplace HIV testing barriers in South Africa. Pubmed, ScienceDirect, PsycInfo and SA Publications were systematically researched. Studies needed to include measures to assess perceived or real barriers to participate in HIV Counselling and Testing (HCT) at the workplace or discuss perceived or real barriers of HIV testing at the workplace based on collected data, provide qualitative or quantitative evidence related to the research topic and needed to refer to workplaces in South Africa. Barriers were defined as any factor on economic, social, personal, environmental or organisational level preventing employees from participating in workplace HIV testing. Four peer-reviewed studies were included, two with quantitative and two with qualitative study designs. The overarching barriers across the studies were fear of compromised confidentiality, being stigmatised or discriminated in the event of testing HIV positive or being observed participating in HIV testing, and a low personal risk perception. Furthermore, it appeared that an awareness of an HIV-positive status hindered HIV testing at the workplace. Further research evidence of South African workplace barriers to HIV testing will enhance related interventions. This systematic review only found very little and contextualised evidence about workplace HCT barriers in South Africa, making it difficult to generalise, and not really sufficient to inform new interventions aimed at increasing workplace HCT uptake.

  7. Correlates of HIV/STD testing and willingness to test among rural-to-urban migrants in China.

    Science.gov (United States)

    Wang, Bo; Li, Xiaoming; Stanton, Bonita; McGuire, James

    2010-08-01

    This study investigates socio-demographic, behavioral, psychological, and structural factors associated with self-reported HIV/STD testing and willingness to test among 1,938 Chinese migrants. Overall, 6% and 14% of participants had ever been tested for HIV and STD, respectively. The results of multivariate analyses indicate that working at entertainment sectors, engaging in commercial sex, and utilization of health care were positively associated with both HIV and STD testing. Younger age, selling blood, perceived peer sexual risk involvement, and satisfaction with life were associated with HIV testing only. Female gender, early sexual debut, multiple sexual partners, and perceived vulnerability to HIV/STD were associated with STD testing only. Male gender, having premarital sex, perceived higher severity of and vulnerability to HIV/STD, and utilization of health care were associated with willingness to be tested for both HIV and STD. Interventions designed to raise the perception of vulnerability to HIV/STD and to improve access to and utilization of health care may be effective in encouraging more HIV testing in this vulnerable population.

  8. Discovering Visual Scanning Patterns in a Computerized Cancellation Test

    Science.gov (United States)

    Huang, Ho-Chuan; Wang, Tsui-Ying

    2013-01-01

    The purpose of this study was to develop an attention sequential mining mechanism for investigating the sequential patterns of children's visual scanning process in a computerized cancellation test. Participants had to locate and cancel the target amongst other non-targets in a structured form, and a random form with Chinese stimuli. Twenty-three…

  9. Testing a Conceptual Change Model Framework for Visual Data

    Science.gov (United States)

    Finson, Kevin D.; Pedersen, Jon E.

    2015-01-01

    An emergent data analysis technique was employed to test the veracity of a conceptual framework constructed around visual data use and instruction in science classrooms. The framework incorporated all five key components Vosniadou (2007a, 2007b) described as existing in a learner's schema: framework theory, presuppositions, conceptual domains,…

  10. [The advance of detection technology of HIV self-testing].

    Science.gov (United States)

    Yan, L; Xiao, P P; Yan, H J; Huan, X P; Fu, G F; Li, J J; Yang, H T

    2017-11-06

    At present, China's AIDS testing increased rapidly, but there are still many people living with HIV do not recognize their status, thus postponing the antiviral treatment time. HIV self-testing (HST) is an effective method to expand the testing, not only simple operation, easy to get a result, effectively protect the detection privacy, expand the selection of testers, suit to the entire population, but also the premise and basis of other AIDS comprehensive prevention measures, all over the world are promoting it. Because the HST has controversies in the window period, price and before and after controversial, and our country is in the initial stage of HST, so it is not to develop related policies, but more and more countries are in accordance with their own situations are modified or developed to allow to use rapid detection of AIDS policy to regulate the field. This paper analyzed and summarized the advantage and influence factors of HST promotion, HST believes that in the long term, the advantages outweigh the disadvantages, we need to formulate relevant policies, and improve the sensitivity of the kit, shorten the window period of time, production and promotion of operation standard of video, specification and testing the operating practices, preventing and reporting the possible social harm, investigation and understanding of the needs of the people of the crowd, to maximize the advantages of HST, find more infection, so as to curb the epidemic of AIDS.

  11. Evaluation of accuracy of OraQuick ® rapid test in detecting HIV ...

    African Journals Online (AJOL)

    Objective: The accuracy of OraQuick® rapid test in detecting HIV 1 & 2 antibodies in saliva is evaluated against the blood EIA benchmark tests with confirmatory testing, against which OraQuick® accuracy is determined. Method: Paired samples of saliva and blood from 281 Nigerians were tested for HIV antibodies, and ...

  12. Predictors of HIV self-testing among health workers at Nyeri ...

    African Journals Online (AJOL)

    Background: HIV self-testing is recognised as a possible option of expanding access to HIV testing and counselling (HTC). There is high demand for self testing among health workers. However, in many health facilities in Kenya, the rate of unregulated self-testing and factors influencing the practice remain unknown.

  13. Rapid HIV testing experience at Veterans Affairs North Texas Health Care System's Homeless Stand Downs.

    Science.gov (United States)

    Hooshyar, Dina; Surís, Alina M; Czarnogorski, Maggie; Lepage, James P; Bedimo, Roger; North, Carol S

    2014-01-01

    In the USA, 21% of the estimated 1.1 million people living with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) are unaware they are HIV-infected. In 2011, Veterans Health Administration (VHA)'s Office of Public Health in conjunction with VHA's Health Care for Homeless Veterans Program funded grants to support rapid HIV testing at homeless outreach events because homeless populations are more likely to obtain emergent rather than preventive care and have a higher HIV seroprevalence as compared to the general population. Because of a Veterans Affairs North Texas Health Care System (VANTHCS)'s laboratory testing requirement, VANTHCS partnered with community agencies to offer rapid HIV testing for the first time at VANTHCS' 2011 Homeless Stand Downs in Dallas, Fort Worth, and Texoma, Texas. Homeless Stand Downs are outreach events that connect Veterans with services. Veterans who declined testing were asked their reasons for declining. Comparisons by Homeless Stand Down site used Pearson χ², substituting Fisher's Exact tests for expected cell sizes Veterans attending the Homeless Stand Downs, 261 Veterans reported reasons for declining HIV testing, and 133 Veterans were tested, where 92% of the tested Veterans obtained their test results at the events - all tested negative. Veterans' reported reasons for declining HIV testing included previous negative result (n=168), no time to test (n=49), no risk factors (n=36), testing is not a priority (n=11), uninterested in knowing serostatus (n=6), and HIV-infected (n=3). Only "no time to test" differed significantly by Homeless Stand Down site. Nonresponse rate was 54%. Offering rapid HIV testing at Homeless Stand Downs is a promising testing venue since 15% of Veterans attending VANTHCS' Homeless Stand Downs were tested for HIV, and majority obtained their HIV test results at point-of-care while further research is needed to determine how to improve these rates.

  14. Functional MRI of the visual cortex and visual testing in patients with previous optic neuritis

    DEFF Research Database (Denmark)

    Langkilde, Annika Reynberg; Frederiksen, J.L.; Rostrup, Egill

    2002-01-01

    The volume of cortical activation as detected by functional magnetic resonance imaging (fMRI) in the visual cortex has previously been shown to be reduced following optic neuritis (ON). In order to understand the cause of this change, we studied the cortical activation, both the size of the activ......The volume of cortical activation as detected by functional magnetic resonance imaging (fMRI) in the visual cortex has previously been shown to be reduced following optic neuritis (ON). In order to understand the cause of this change, we studied the cortical activation, both the size...... of the activated area and the signal change following ON, and compared the results with results of neuroophthalmological testing. We studied nine patients with previous acute ON and 10 healthy persons served as controls using fMRI with visual stimulation. In addition to a reduced activated volume, patients showed...... to both the results of the contrast sensitivity test and to the Snellen visual acuity. Our results indicate that fMRI is a useful method for the study of ON, even in cases where the visual acuity is severely impaired. The reduction in activated volume could be explained as a reduced neuronal input...

  15. Modified matching Ronchi test to visualize lens aberrations

    Energy Technology Data Exchange (ETDEWEB)

    Hassani, Kh; Ziafi, H Hooshmand, E-mail: hassanikh@ut.ac.ir [Optics Research Lab 3, Department of Physics, University of Tehran, PO Box 14395/547, Tehran (Iran, Islamic Republic of)

    2011-09-15

    We introduce a modification to the matching Ronchi test to visualize lens aberrations with simple and inexpensive equipment available in educational optics labs. This method can help instructors and students to observe and estimate lens aberrations in real time. It is also a semi-quantitative tool for primary tests in research labs. In this work by comparing a single lens with a doublet, we can clearly demonstrate the superior quality of the doublet over the single lens, and estimate their conic constants.

  16. Early HIV infection among persons referred for malaria parasite testing in Nigeria.

    Science.gov (United States)

    Olusola, Babatunde A; Olaleye, David O; Odaibo, Georgina N

    2018-02-01

    Persons in the early stages of HIV infection are the major drivers of new infections. These individuals may also develop renal dysfunctions at this time. Nigeria, as other African countries, has one of the highest prevalence of newly diagnosed HIV infections. Despite this, limited information exists on early HIV detection in the continent. This may be related to difficulties in providing early HIV diagnosis and treatment. Patients referred for malaria testing may provide a unique opportunity for early HIV detection. In this study, a method for identifying early HIV-infected individuals was assessed. HIV-1 subtype and renal function biomarkers were also analyzed in these persons. To identify early HIV infection, over a period of 18 months blood samples were collected from persons referred by clinicians for malaria parasite tests in Nigeria. A total of 671 samples were collected and analyzed for HIV antigen/antibody and subtypes. 101 of these samples were categorized into one of four groups: early HIV, chronic HIV, malaria infection and control groups for renal function analysis. 29% of HIV infected individuals were at the early stages of infection. The predominant subtype detected was CRF02_AG (57.14%). The early HIV group had the highest mean serum creatinine (95 µmol/L) and urea (5.7 mmol/L) values across all groups with the difference significant at P HIV infection. Our results show the feasibility of screening persons referred for malaria tests for early HIV. This can be used to control new HIV infections in sub-Saharan Africa.

  17. [The capacities of current test systems to verify early HIV infection].

    Science.gov (United States)

    Baranova, E N; Sharipova, I N; Denisova, N M; Susekina, M E; Puzyrev, V F; Sarkisian, K A; Vorob'eva, M S; Burkov, A N; Ulanova, T I

    2009-01-01

    The purpose of the present investigation was to comparatively evaluate the performance characteristics of the test systems designed to verify the positive results of screening survey for HIV infection, such as the solid-phase immunoassay DS-EIA-HIV-AB/AG-SPECTR (Diagnosticheskiye Sistemy (Diagnostic Systems) Research-and-Production Association, Nizhni Novgorod) and tests based on immune blotting (IB). The investigation examined 15 seroconversion panels produced by ZeptoMetrix (USA) and BBI (USA). The use of the DS-EIA-HIV-AB/AG-SPECTR test system determined 88 of the 167 seroconversion panels as HIV positive. The IB-based tests revealed only 45 of the 167 samples as positive. Consequently, the application of the DS-EIA-HIV-AB/AG-SPECTR test system is more effective than the IB-based tests in early HIV infection.

  18. [Viral load test conducive to excluding negative subjects from suspects in HIV antibody detections].

    Science.gov (United States)

    Hei, Fa-Xin; Zhang, Qi-Yun; Sun, Wei-Dong; Zhang, Qin; Ye, Jing-Rong; Liu, Hai-Lin; Lu, Hong-Yan

    2008-01-01

    To study whether plasma viral load testing is helpful to exclude ones free from Human immunodeficiency virus (HIV) infections from suspects in HIV antibody detections. 19 Specimens, which showed disconcordant results of the two HIV EIA testing (S/CO test, were selected. Viral load of the specimens were detected. A six-month follow up survey in detecting HIV antibody was conducted in these subjects. None of these 19 cases was observed to be positive HIV viral loads and there was no any progress in WB bands development during the follow-up period. The possibility of HIV infection could be excluded. When the specimens react with very low intensity in both EIA and WB, negative viral load result is conducive to exclude negative subjects from suspects in HIV antibody detections.

  19. Investigating Recent Testing among MSM: Results from Community-Based HIV Rapid Testing Attendees in France

    Directory of Open Access Journals (Sweden)

    Nicolas Lorente

    2013-01-01

    Full Text Available Background. We aimed to identify factors associated with recent HIV testing in MSM who attended two experimental community-based and nonmedicalized voluntary counselling and testing programmes (CB-VCT targeting MSM in France. Methods. This analysis was based on data collected in 2009–2011 through a self-administered pretesting questionnaire. An index measuring the level of participants’ sexual orientation disclosure was built: the higher the index, the greater the disclosure. Factors associated with recent HIV testing (last test ≤ 1 year were identified using a multivariate logistic regression model adjusted for the CB-VCT programme of enrolment. Results. 716 MSM provided data on testing history. Overall, 49% were recently tested for HIV and 51% were not. Recently tested MSM had a higher homosexuality disclosure index (adjusted OR [95% confidence interval]: aOR = 1.2 [1.1–1.4], reported more inconsistent condom use during anal sex with men (aOR = 1.6 [1.2–2.1], and were less likely to have sex under the influence of club drugs (aOR = 0.6 [0.4–1.0]. Conclusion. New testing strategies should focus on those who live their homosexuality relatively secretly and those who use club drugs before sex. Governments should develop policies which encourage improved social acceptance of homosexuality as concealment of sexual orientation represents a major barrier to testing.

  20. Situational analysis of communication of HIV and AIDS information to persons with visual impairment: a case of Kang?onga Production Centre in Ndola, Zambia

    OpenAIRE

    Chintende, Grace Nsangwe; Sitali, Doreen; Michelo, Charles; Mweemba, Oliver

    2017-01-01

    Background Despite the increases in health promotion and educational programs on HIV and AIDS, lack of information and communication on HIV and AIDS for the visually impaired persons continues. The underlying factors that create the information and communication gaps have not been fully explored in Zambia. It is therefore important that, this situational analysis on HIV and AIDS information dissemination to persons with visual impairments at Kang?onga Production Centre in Ndola was conducted....

  1. HIV testing preferences among long distance truck drivers in Kenya: a discrete choice experiment.

    Science.gov (United States)

    Strauss, Michael; George, Gavin; Lansdell, Emma; Mantell, Joanne E; Govender, Kaymarlin; Romo, Matthew; Odhiambo, Jacob; Mwai, Eva; Nyaga, Eston N; Kelvin, Elizabeth A

    2018-01-01

    Providing HIV testing services to truck drivers in Africa is crucial but has proven challenging. The introduction of HIV self-testing promises to provide expanded service delivery options for clients, potentially increasing demand for services and expanding coverage - especially important for high-risk and difficult-to-reach populations. This study examines the preferences regarding HIV testing service delivery models, among long distance truck drivers to identify testing services that would appeal to this population. Using a discrete choice experiment, this study examines the drivers of choice regarding HIV counselling and testing among 305 truck drivers recruited from two roadside wellness clinics along major trucking routes in Kenya. Participants made trade-offs between characteristics of HIV testing service delivery models by making hypothetical choices in a series of paired HIV testing scenarios. Conditional logit models were used to identify the HIV testing characteristics driving the selection of preferred scenarios, as well as determine whether preferences interact with individual characteristics - especially HIV testing history. Participants preferred free, provider-administered HIV testing at a roadside clinic, using a finger-prick test, with in-person counselling, undertaken in the shortest possible time. The strongest driver of choice was the cost of the test. Those who had never tested previously preferred oral testing and telephonic counselling, while those who were not regular testers favoured clinic based - over self-testing. The results of this study indicate that for the majority of participants - most of whom had tested before - the existing services offered at roadside clinics were the preferred service delivery model. The introduction of oral self-testing increases the options available to truck drivers and may even improve testing uptake for some, especially among those who have never tested before. However, these findings suggest the impact

  2. Leveraging rapid community-based hiv testing campaigns for non-communicable diseases in rural uganda

    OpenAIRE

    Gabriel Chamie; Dalsone Kwarisiima; Clark, Tamara D; Jane Kabami; Vivek Jain; Elvin Geng; Petersen, Maya L; Harsha Thirumurthy; Moses R Kamya; Havlir, Diane V.; Charlebois, Edwin D.

    2012-01-01

    Background The high burden of undiagnosed HIV in sub-Saharan Africa limits treatment and prevention efforts. Community-based HIV testing campaigns can address this challenge and provide an untapped opportunity to identify non-communicable diseases (NCDs). We tested the feasibility and diagnostic yield of integrating NCD and communicable diseases into a rapid HIV testing and referral campaign for all residents of a rural Ugandan parish. Methods A five-day, multi-disease campaign, offering diag...

  3. Expanding HIV testing and linkage to care in southwestern Uganda with community health extension workers.

    Science.gov (United States)

    Asiimwe, Stephen; Ross, Jennifer M; Arinaitwe, Anthony; Tumusiime, Obed; Turyamureeba, Bosco; Roberts, D Allen; O'Malley, Gabrielle; Barnabas, Ruanne V

    2017-07-21

    Achieving the UNAIDS goals of 90-90-90 will require more than doubling the number of people accessing HIV care in Uganda. Community-based programmes for entry into HIV care are effective strategies to expand access to HIV care, but few programmes have been evaluated with a particular focus on scale-up. Integrated Community Based Initiatives, a Uganda-based non-governmental organization, designed and implemented a programme of community-based HIV counselling and testing and facilitated linkage to care utilizing community health extension workers (CHEWs) in rural Sheema District, Uganda. CHEWs performed programme activities during 1 October 2015 through 31 March 2016. Outcomes for this evaluation were (1) the number of people tested for HIV, and (2) the proportion of those testing positive who were seen at an ART clinic within three months of their positive test, and (3) the cost of the programme per person newly diagnosed with HIV. Microcosting methods were used to calculate the programme costs. Program scalability factors were evaluated using a published framework. Sixty-two CHEWs attended a five-day training that introduced the biology of HIV, the conduct of confidential HIV testing, HIV prevention messages, and linkage, referral, and reporting requirements. CHEWs received a $30 monthly stipend and a field testing kit that included a bicycle, field bag, umbrella, gumboots, reporting booklet, pens, and HIV testing materials. Trained CHEWs tested 43,696 persons for HIV infection during the six-month programme period. Nine-hundred seventy-four participants (2.2%) were identified as HIV positive, and 623 participants (64%) were linked to HIV care. An estimated 69% of adult residents received testing as part of this campaign. The programme cost $3.02 per person test, $135.70 per positive person identified, and $212.15 per HIV-positive person linked to care. Lay community health extension workers (CHEWs) can be rapidly trained to scale-up home-based HIV testing and

  4. Performance of rapid HIV testing using Determine HIV-1/2 for the diagnosis of HIV infection during pregnancy in Tijuana, Baja California, Mexico.

    Science.gov (United States)

    Viani, R M; Hubbard, P; Ruiz-Calderon, J; Araneta, M R G; Lopez, G; Chacón-Cruz, E; Spector, S A

    2007-02-01

    The aim of this study was to evaluate the performance of the rapid antibody test Determine HIV-1/2, in pregnant women at Tijuana General Hospital. Pregnant women seeking prenatal care or admitted in labour had blood drawn for a rapid HIV test (Determine HIV-1/2), enzyme immunoassay (EIA) and Western blot. Between March and November 2003, 1068 women in labour and 1529 women in prenatal care were enrolled. The sensitivity, specificity, positive and negative predictive values were 100%, 99.8%, 77% and 100%, respectively. For women in labour, the mean time between blood collection and rapid test results was 92 minutes (range: 20-205 minutes) compared with 41 hours (range 24-120 hours) for HIV EIA (P = 0.012). All HIV-exposed infants received oral zidovudine. These findings indicate that the rapid test Determine HIV-1/2 has a high sensitivity and specificity in pregnant women. Rapid HIV testing greatly diminishes the time to diagnosis and enables prompt intervention with antiretrovirals at delivery.

  5. Preferences for rapid point-of-care HIV testing in Nova Scotia, Canada.

    Science.gov (United States)

    Lewis, Nathaniel M; Gahagan, Jacqueline C; Stein, Carlye

    2013-05-01

    Rapid point-of-care (POC) testing for HIV has been shown to increase the uptake of testing, rates of clients receiving test results, numbers of individuals aware of their status and timely access to care for those who test positive. In addition, several studies have shown that rapid POC testing for HIV is highly acceptable to clients in a variety of clinical and community-based health care settings. Most acceptability studies conducted in North America, however, have been conducted in large, urban environments where concentrations of HIV testing sites and testing innovations are greatest. Using a survey of client preferences at a sexual health clinic in Halifax, Nova Scotia, we suggest that HIV test seekers living in a region outside of Canada's major urban HIV epicentres find rapid POC testing highly acceptable. We compare the results of the Halifax survey with existing acceptability studies of rapid POC HIV testing in North America and suggest ways in which it might be of particular benefit to testing clients and potential clients in Nova Scotia and other regions of Canada that currently have few opportunities for anonymous or rapid testing. Overall, we found that rapid POC HIV testing was highly desirable at this study site and may serve to overcome many of the challenges associated with HIV prevention and testing outside of well-resourced metropolitan environments.

  6. Using Participatory System Dynamics Modeling to Examine the Local HIV Test and Treatment Care Continuum in Order to Reduce Community Viral Load.

    Science.gov (United States)

    Weeks, Margaret R; Li, Jianghong; Lounsbury, David; Green, Helena Danielle; Abbott, Maryann; Berman, Marcie; Rohena, Lucy; Gonzalez, Rosely; Lang, Shawn; Mosher, Heather

    2017-12-01

    Achieving community-level goals to eliminate the HIV epidemic requires coordinated efforts through community consortia with a common purpose to examine and critique their own HIV testing and treatment (T&T) care system and build effective tools to guide their efforts to improve it. Participatory system dynamics (SD) modeling offers conceptual, methodological, and analytical tools to engage diverse stakeholders in systems conceptualization and visual mapping of dynamics that undermine community-level health outcomes and identify those that can be leveraged for systems improvement. We recruited and engaged a 25-member multi-stakeholder Task Force, whose members provide or utilize HIV-related services, to participate in SD modeling to examine and address problems of their local HIV T&T service system. Findings from the iterative model building sessions indicated Task Force members' increasingly complex understanding of the local HIV care system and demonstrated their improved capacity to visualize and critique multiple models of the HIV T&T service system and identify areas of potential leverage. Findings also showed members' enhanced communication and consensus in seeking deeper systems understanding and options for solutions. We discuss implications of using these visual SD models for subsequent simulation modeling of the T&T system and for other community applications to improve system effectiveness. © Society for Community Research and Action 2017.

  7. Visual reproduction test in normal elderly: Influence of schooling and visual task complexity

    Directory of Open Access Journals (Sweden)

    Paulo Roberto de Brito-Marques

    Full Text Available ABSTRACT Tests of visual reproduction are used to assess visual memory. However, when the test is based on geometrical elements results could be influenced by schooling. Objective: To evaluate the influence of different schooling levels on performance of a visual reproduction task. Methods: A sample of 253 individuals (66 male and 187 female, aged 60 to 92 years were evaluated on a visual reproduction task comprising three geometric pictures of increasing complexity. Each individual was shown a picture for 8 to10 seconds and a drawing of it was then immediately elicited. Four groups were defined according to the following schooling levels: illiterate, 1 to 4 years, 5 to 8 years and over 8 years. Individual performance was measured by summing the items correctly reproduced for the three pictures. Results: A significant difference for age was found between the illiterate and other three schooling groups. The reproduction of picture one was better reproduced than pictures 2 and 3 for all schooling levels (p<0.001. Pictures 2 and 3 did not differ among the schooling levels. Picture reproduction among the schooling levels showed that the group with over 8 years of schooling performed better on pictures 1 and 2 (p<0.001 but not on picture 3. Conclusion: Individuals aged 60 years or older, with 8 years' schooling or less, showed a reduced capacity to reproduce geometric pictures of a high degree of complexity. Clinical evaluations that use geometrical tests could be misinterpreted when not controlled for schooling level.

  8. Effects of rapid versus standard HIV voluntary counselling and testing on receipt rate of HIV test results: a meta-analysis.

    Science.gov (United States)

    Wang, Yuan; Guo, Jian; Lu, Wenli

    2015-03-01

    Rapid HIV voluntary counselling and testing (RVCT) is an alternative method of standard HIV voluntary counselling and testing (SVCT). Less is known about whether RVCT improves the receipt rate of HIV test results among clients who seek HIV counselling and testing. We aimed to evaluate effectiveness of RVCT on result receipt rate. We conducted a comprehensive search of databases containing Medline, EBSCO, Web of science, and Cochrane library to identify studies published up to August 2012. Reviewers extracted information independently. Risk of bias was evaluated with Cochrane Collaboration's tool for assessing study quality. Five randomised controlled trials were included and analysed for the result receipt rate using a random-effects model. The pooled receipt rate of HIV test results in the RVCT was significantly higher than in the SVCT (RR = 1.74, 95% CI = 1.47-2.07). Our results suggest RVCT as a favourable method to increase the receipt of HIV test results. Only two included studies assessed the modification of risk behaviour after HIV-CT in a different manner; also, the sample size was small in the current meta-analysis. In future research, it is necessary to confirm the effect of RVCT on disinhibition of post-test risk behaviour. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  9. What are the reasons for poor uptake of HIV testing among patients with TB in an Eastern India District?

    Directory of Open Access Journals (Sweden)

    Bipra Bishnu

    Full Text Available BACKGROUND: National policy in India recommends HIV testing of all patients with TB. In West Bengal state, only 28% of patients with TB were tested for HIV between April-June, 2010. We conducted a cross-sectional survey to understand patient, provider and health system related factors associated with low uptake of HIV testing among patients with TB. METHODS: We reviewed TB and HIV program records to assess the HIV testing status of patients registered for anti-TB treatment from July-September 2010 in South-24-Parganas district, West Bengal, assessed availability of HIV testing kits and interviewed a random sample of patients with TB and providers. RESULTS: Among 1633 patients with TB with unknown HIV status at the time of diagnosis, 435 (26% were tested for HIV within the intensive phase of TB treatment. Patients diagnosed with and treated for TB at facilities with co-located HIV testing services were more likely to get tested for HIV than at facilities without [RR = 1.27, (95% CI 1.20-3.35]. Among 169 patients interviewed, 67 reported they were referred for HIV testing, among whom 47 were tested. During interviews, providers attributed the low proportion of patients with TB being referred and tested for HIV to inadequate knowledge among providers about the national policy, belief that patients will not test for HIV even if they are referred, shortage of HIV testing kits, and inadequate supervision by both programs. DISCUSSION: In West Bengal, poor uptake of HIV testing among patients with TB was associated with absence of HIV testing services at sites providing TB care services and to poor referral practices among providers. Comprehensive strategies to change providers' beliefs and practices, decentralization of HIV testing to all TB care centers, and improved HIV test kit supply chain management may increase the proportion of patients with TB who are tested for HIV.

  10. What are the reasons for poor uptake of HIV testing among patients with TB in an Eastern India District?

    Science.gov (United States)

    Bishnu, Bipra; Bhaduri, Sudipto; Kumar, Ajay M V; Click, Eleanor S; Chadha, Vineet Kumar; Satyanarayana, Srinath; Nair, Sreenivas Achutan; Gupta, Devesh; Ahmed, Quazi T; Sarkar, Silajit; Paul, Durba; Dewan, Puneet

    2013-01-01

    National policy in India recommends HIV testing of all patients with TB. In West Bengal state, only 28% of patients with TB were tested for HIV between April-June, 2010. We conducted a cross-sectional survey to understand patient, provider and health system related factors associated with low uptake of HIV testing among patients with TB. We reviewed TB and HIV program records to assess the HIV testing status of patients registered for anti-TB treatment from July-September 2010 in South-24-Parganas district, West Bengal, assessed availability of HIV testing kits and interviewed a random sample of patients with TB and providers. Among 1633 patients with TB with unknown HIV status at the time of diagnosis, 435 (26%) were tested for HIV within the intensive phase of TB treatment. Patients diagnosed with and treated for TB at facilities with co-located HIV testing services were more likely to get tested for HIV than at facilities without [RR = 1.27, (95% CI 1.20-3.35)]. Among 169 patients interviewed, 67 reported they were referred for HIV testing, among whom 47 were tested. During interviews, providers attributed the low proportion of patients with TB being referred and tested for HIV to inadequate knowledge among providers about the national policy, belief that patients will not test for HIV even if they are referred, shortage of HIV testing kits, and inadequate supervision by both programs. In West Bengal, poor uptake of HIV testing among patients with TB was associated with absence of HIV testing services at sites providing TB care services and to poor referral practices among providers. Comprehensive strategies to change providers' beliefs and practices, decentralization of HIV testing to all TB care centers, and improved HIV test kit supply chain management may increase the proportion of patients with TB who are tested for HIV.

  11. The cost-effectiveness of repeat HIV testing during pregnancy in a resource-limited setting.

    Science.gov (United States)

    Kim, Lena H; Cohan, Deborah L; Sparks, Teresa N; Pilliod, Rachel A; Arinaitwe, Emmanuel; Caughey, Aaron B

    2013-06-01

    To estimate the cost-effectiveness of HIV screening strategies for the prevention of perinatal transmission in Uganda, a resource-limited country with high HIV prevalence and incidence. We designed a decision analytic model from a health care system perspective to assess the vertical transmission rates and cost-effectiveness of 4 different HIV screening strategies in pregnancy: (1) rapid HIV antibody (Ab) test at initial visit (current standard of care), (2) strategy 1 + HIV RNA at initial visit (adds detection of acute HIV), (3) strategy 1 + repeat HIV Ab at delivery (adds detection of incident HIV), and (4) strategy 3 + HIV RNA at delivery (adds detection of acute HIV at delivery). Model estimates were derived from the literature and local sources, and life years saved were discounted at a rate of 3% per year. Based on World Health Organization guidelines, we defined our cost-effectiveness threshold as ≤3 times the gross domestic product per capita, which for Uganda was US$3300 in 2008. Using base case estimates of 10% HIV prevalence among women entering prenatal care and 3% incidence during pregnancy, strategy 3 was incrementally the cost-effective option that led to the greatest total life years. Repeat rapid HIV Ab testing at the time of labor is a cost-effective strategy even in a resource-limited setting such as Uganda.

  12. 75 FR 22814 - Guidance for Industry: Nucleic Acid Testing (NAT) for Human Immunodeficiency Virus Type 1 (HIV-1...

    Science.gov (United States)

    2010-04-30

    ... Immunodeficiency Virus Type 1 (HIV-1) Nucleic Acid Test (NAT) and Hepatitis C Virus (HCV) NAT, on testing... test results, HIV-1 p24 antigen test results, and anti-HCV test results that were provided in the FDA... (Anti-HCV),'' August 5, 1993; ``Recommendations for Donor Screening with a Licensed Test for HIV-1...

  13. Diagnostic Performance of Visual Screening Tests in the Elderly

    Science.gov (United States)

    Lança, Carla Costa; Carolino, Elisabete

    2011-09-01

    This study aimed to determine and evaluate the diagnostic accuracy of visual screening tests for detecting vision loss in elderly. This study is defined as study of diagnostic performance. The diagnostic accuracy of 5 visual tests -near convergence point, near accommodation point, stereopsis, contrast sensibility and amsler grid—was evaluated by means of the ROC method (receiver operating characteristics curves), sensitivity, specificity, positive and negative likelihood ratios (LR+/LR-). Visual acuity was used as the reference standard. A sample of 44 elderly aged 76.7 years (±9.32), who were institutionalized, was collected. The curves of contrast sensitivity and stereopsis are the most accurate (area under the curves were 0.814-p = 0.001, C.I.95%[0.653;0.975]— and 0.713-p = 0.027, C.I.95%[0,540;0,887], respectively). The scores with the best diagnostic validity for the stereopsis test were 0.605 (sensitivity 0.87, specificity 0.54; LR+ 1.89, LR-0.24) and 0.610 (sensitivity 0.81, specificity 0.54; LR+ 1.75, LR-0.36). The scores with higher diagnostic validity for the contrast sensibility test were 0.530 (sensitivity 0.94, specificity 0.69; LR+ 3.04, LR-0.09). The contrast sensitivity and stereopsis test's proved to be clinically useful in detecting vision loss in the elderly.

  14. Associations of HIV testing and late diagnosis at a Japanese university hospital.

    Science.gov (United States)

    Horino, Tetsuya; Sato, Fumiya; Kato, Tetsuro; Hosaka, Yumiko; Shimizu, Akihiro; Kawano, Shinji; Hoshina, Tokio; Nakaharai, Kazuhiko; Nakazawa, Yasushi; Yoshikawa, Koji; Yoshida, Masaki; Hori, Seiji

    2016-02-01

    This study was conducted to clarify the rate of late diagnosis of HIV infection and to identify relationships between the reasons for HIV testing and a late diagnosis. This retrospective cohort study was conducted among HIV-positive patients at the Jikei University Hospital between 2001 and 2014. Patient characteristics from medical records, including age, sex, sexuality, the reason for HIV testing and the number of CD4-positive lymphocytes at HIV diagnosis, were assessed. A total of 459 patients (men, n=437; 95.2%) were included in this study and the median age at HIV diagnosis was 36 years (range, 18-71 years). Late (CD4 cell count HIV diagnosis was voluntary testing (38.6%, 177/459 patients), followed by AIDS-defining illness (18.3%, 84/459 patients). Multivariate analysis revealed a significant association of voluntary HIV testing with non-late and non-very-late diagnoses and there was a high proportion of AIDS-defining illness in the late and very late diagnosis groups compared with other groups. Men who have sex with men was a relative factor for non-late diagnosis, whereas nonspecific abnormal blood test results, such as hypergammaglobulinemia and thrombocytopenia, were risk factors for very late diagnosis. Voluntary HIV testing should be encouraged and physicians should screen all patients who have symptoms or signs and particularly hypergammaglobulinemia and thrombocytopenia, that may nonspecifically indicate HIV infection.

  15. National South African HIV prevalence estimates robust despite substantial test non-participation

    Directory of Open Access Journals (Sweden)

    Guy Harling

    2017-07-01

    Full Text Available Background. South African (SA national HIV seroprevalence estimates are of crucial policy relevance in the country, and for the worldwide HIV response. However, the most recent nationally representative HIV test survey in 2012 had 22% test non-participation, leaving the potential for substantial bias in current seroprevalence estimates, even after controlling for selection on observed factors. Objective. To re-estimate national HIV prevalence in SA, controlling for bias due to selection on both observed and unobserved factors in the 2012 SA National HIV Prevalence, Incidence and Behaviour Survey. Methods. We jointly estimated regression models for consent to test and HIV status in a Heckman-type bivariate probit framework. As selection variable, we used assigned interviewer identity, a variable known to predict consent but highly unlikely to be associated with interviewees’ HIV status. From these models, we estimated the HIV status of interviewed participants who did not test. Results. Of 26 710 interviewed participants who were invited to test for HIV, 21.3% of females and 24.3% of males declined. Interviewer identity was strongly correlated with consent to test for HIV; declining a test was weakly associated with HIV serostatus. Our HIV prevalence estimates were not significantly different from those using standard methods to control for bias due to selection on observed factors: 15.1% (95% confidence interval (CI 12.1 - 18.6 v. 14.5% (95% CI 12.8 - 16.3 for 15 - 49-year-old males; 23.3% (95% CI 21.7 - 25.8 v. 23.2% (95% CI 21.3 - 25.1 for 15 - 49-year-old females. Conclusion. The most recent SA HIV prevalence estimates are robust under the strongest available test for selection bias due to missing data. Our findings support the reliability of inferences drawn from such data.

  16. Earlier testing for HIV--how do we prevent late presentation?

    DEFF Research Database (Denmark)

    Yazdanpanah, Yazdan; Lange, Joep; Gerstoft, Jan

    2010-01-01

    HIV testing policies and practices vary widely across Europe. It is clear that there are individuals who might present late for HIV diagnosis and care within all risk groups, and potentially in any healthcare setting. This article explores the need to ensure earlier identification and treatment...... of late-presenting patients by reviewing strategies that might be considered. Such strategies could include routine provider-initiated HIV testing of at-risk groups in settings such as sexually transmitted infection clinics, drug dependency programmes or antenatal care. Healthcare providers might also...... consider routine HIV testing in all healthcare facilities, in settings including emergency and primary care, where local HIV prevalence is above a threshold that should be further evaluated. They should also take advantage of rapid testing technologies and be aware of barriers to HIV testing among specific...

  17. Earlier testing for HIV--how do we prevent late presentation?

    DEFF Research Database (Denmark)

    Yazdanpanah, Yazdan; Lange, Joep; Gerstoft, Jan

    2010-01-01

    consider routine HIV testing in all healthcare facilities, in settings including emergency and primary care, where local HIV prevalence is above a threshold that should be further evaluated. They should also take advantage of rapid testing technologies and be aware of barriers to HIV testing among specific......HIV testing policies and practices vary widely across Europe. It is clear that there are individuals who might present late for HIV diagnosis and care within all risk groups, and potentially in any healthcare setting. This article explores the need to ensure earlier identification and treatment...... of late-presenting patients by reviewing strategies that might be considered. Such strategies could include routine provider-initiated HIV testing of at-risk groups in settings such as sexually transmitted infection clinics, drug dependency programmes or antenatal care. Healthcare providers might also...

  18. Barriers and facilitators to routine HIV testing in VA primary care.

    Science.gov (United States)

    Bokhour, Barbara G; Solomon, Jeffrey L; Knapp, Herschel; Asch, Steven M; Gifford, Allen L

    2009-10-01

    Approximately 21% of the 1.1 million HIV-infected persons in the United States are unaware of their HIV status. The Centers for Disease Control (CDC) recommend routine opt-out HIV testing for all patients aged 13-64. Yet little is known about patient and provider perspectives on routine HIV testing. We sought to understand patient and provider perspectives on the adoption of routine HIV testing within the US Department of Veterans Affairs. We conducted four focus groups with patients and two focus groups with primary care providers to explore perceptions of, communication about, and barriers and facilitators to routine HIV testing in primary care. Convenience sample of patients and primary care providers at two geographically diverse Veterans' Affairs Medical Centers. We conducted grounded thematic analyses of transcribed audio-recordings of focus groups to identify major themes, identifying similarities and differences between patient and provider perspectives. Patients and providers concurred that implementation of routine HIV testing, treating HIV like other chronic diseases, and removing requirements for written informed consent and pre-test counseling were of benefit to patients and to public health. Patients, however, wished to have HIV testing routinely offered by providers so that they could decide whether or not to be tested. Veterans also stated that routinizing testing would help destigmatize HIV. Six steps to communicating about routine testing ("the 6 R's") were identified. Patients and providers appear ready for implementation of routine HIV testing. However, providers should use patient-centered communication strategies to ease patients' concerns about confidentiality and stigma associated with HIV disease.

  19. Parallel rapid HIV testing in pregnant women at Tijuana General Hospital, Baja California, Mexico.

    Science.gov (United States)

    Viani, Rolando M; Araneta, Maria Rosario G; Spector, Stephen A

    2013-03-01

    The objectives of this study were to evaluate the performance of parallel rapid HIV testing and the presence of HIV-associated risk factors in pregnant women with unknown HIV status in Baja California, Mexico. Pregnant women attending the delivery unit or the prenatal clinic at Tijuana General Hospital had blood drawn for parallel rapid HIV testing with Determine™ HIV-1/2 and Uni-Gold™ Recombigen(®) HIV. The parallel rapid HIV test performance was compared to the enzyme immunoassay (EIA) and western blot. From September 2007 to July 2008, 1,383 (94%) of 1,464 women in labor and 1,992 (96%) of 2,075 women in prenatal care were enrolled. The HIV seroprevalence among women screened during labor (19/1,383, 1.37%, 95% CI: 0.85-2.18%) was significantly higher compared to those seeking prenatal care (5/1,992, 0.25%, 95% CI: 0.09-0.62%; ppositive by parallel rapid HIV testing 24 had a positive confirmatory western blot and one (0.03%) was confirmed as false positive. Additionally, two (0.06%) women had parallel rapid HIV discordant testing results; both tested negative by western blot. All women who tested negative by rapid testing had negative results on pooled EIA antibody testing. The overall sensitivity, specificity, and positive and negative predictive values of parallel rapid HIV testing were 100%, 99.9%, 96%, and 100%, respectively. These findings document a very high acceptance rate and an excellent performance of the parallel rapid HIV testing strategy during pregnancy.

  20. Crowdsourcing HIV Test Promotion Videos: A Noninferiority Randomized Controlled Trial in China.

    Science.gov (United States)

    Tang, Weiming; Han, Larry; Best, John; Zhang, Ye; Mollan, Katie; Kim, Julie; Liu, Fengying; Hudgens, Michael; Bayus, Barry; Terris-Prestholt, Fern; Galler, Sam; Yang, Ligang; Peeling, Rosanna; Volberding, Paul; Ma, Baoli; Xu, Huifang; Yang, Bin; Huang, Shujie; Fenton, Kevin; Wei, Chongyi; Tucker, Joseph D

    2016-06-01

    Crowdsourcing, the process of shifting individual tasks to a large group, may enhance human immunodeficiency virus (HIV) testing interventions. We conducted a noninferiority, randomized controlled trial to compare first-time HIV testing rates among men who have sex with men (MSM) and transgender individuals who received a crowdsourced or a health marketing HIV test promotion video. Seven hundred twenty-one MSM and transgender participants (≥16 years old, never before tested for HIV) were recruited through 3 Chinese MSM Web portals and randomly assigned to 1 of 2 videos. The crowdsourced video was developed using an open contest and formal transparent judging while the evidence-based health marketing video was designed by experts. Study objectives were to measure HIV test uptake within 3 weeks of watching either HIV test promotion video and cost per new HIV test and diagnosis. Overall, 624 of 721 (87%) participants from 31 provinces in 217 Chinese cities completed the study. HIV test uptake was similar between the crowdsourced arm (37% [114/307]) and the health marketing arm (35% [111/317]). The estimated difference between the interventions was 2.1% (95% confidence interval, -5.4% to 9.7%). Among those tested, 31% (69/225) reported a new HIV diagnosis. The crowdsourced intervention cost substantially less than the health marketing intervention per first-time HIV test (US$131 vs US$238 per person) and per new HIV diagnosis (US$415 vs US$799 per person). Our nationwide study demonstrates that crowdsourcing may be an effective tool for improving HIV testing messaging campaigns and could increase community engagement in health campaigns. NCT02248558. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  1. Knowledge of HIV/AIDS and predictors of uptake of HIV counseling and testing among undergraduate students of a privately owned university in Nigeria.

    Science.gov (United States)

    Abiodun, Olumide; Sotunsa, John; Ani, Franklin; Jaiyesimi, Ebunoluwa

    2014-09-12

    The spread of HIV/AIDS among the reproductive age group particularly young adults is a major public health concern in Nigeria. Lifestyles of students on university campuses put them at increased risk of contracting the HIV. The aim of this study was to assess the level of HIV/AIDS knowledge and to investigate the factors that were correlated with the uptake of and willingness to take up HIV counseling and testing. A cross-sectional study of 1,250 university students selected by 2-stage random sampling technique using self-administered questionnaire. The participants consisted of 57.7% females and 42.3% males with ages ranging from 15 to 32 years and a mean of 19.13 ± 2.32 years. The awareness of HIV was universal. The knowledge about HIV/AIDS was very high with a mean score of 8.18 ± 1.60 out of 10; and 97.1% of participants having good knowledge of HIV/AIDS. The major source of HIV/AIDS information was the mass media. There was a significant difference in knowledge of HIV/AIDS by gender where male students had better knowledge about HIV/AIDS than females [t (1225) = 3.179, p = 0.002]. While 95% of the participants knew where to get an HIV test done, only 30.4% had tested for HIV within the six months preceding the study. However, 72.2% of them were willing to test for HIV. There was no significant association between demographic characteristics and having tested for HIV in the preceding six months but there was significant association between willingness to have an HIV test and the participants' age groups, sex, marital status and their knowledge of HIV/AIDS. Participants who were aged 21 years and above and had good knowledge about HIV were more willing to take an HIV test. Females were more willing to take an HIV test than males. The participants' knowledge about HIV /AIDS was quite good, the willingness to have HIV test done was high and the knowledge of a place where test can be done was nearly universal yet HIV testing was low. Innovative

  2. Knowledge of HIV and willingness to conduct oral rapid HIV testing among dentists in Xi'an China.

    Directory of Open Access Journals (Sweden)

    Lirong Wang

    Full Text Available China is considered a country of low HIV prevalence (780,000 people living with HIV, however, HIV infections among high-risk populations continue to grow at alarming rates. Voluntary Counseling and Testing services were first implemented in 2003, and oral rapid HIV testing (ORHT began in 2012. Dentists, as oral health experts, would be well placed to conduct ORHT. We assessed willingness of dentists to undertake ORHT in their clinical practice.A cross-sectional, paper-based survey of dentists from the Xi'an region of China was conducted from April to June 2013. Dentists were recruited from Shaanxi Stomatological Association using a stratified sampling methodology. A 40-item survey was used to measure knowledge of HIV, attitudes toward people living with HIV and willingness to conduct ORHT.477 dentists completed the survey with a mean HIV knowledge test score of 13.2/18 (SD 1.9. If made available in the dental setting, 276 (57.9% preferred to use blood to diagnose HIV, only 190 (39.8% preferred saliva or both. Four hundred and thirty-five (91.2% thought that ORHT was needed in dental clinics. Female dentists felt more accepting of ORHT than males (93.8% vs. 87.8%; χ2=5.145; p<0.05. 42.6% of the participants who responded thought that lack of education on ORHT for dentists was the most urgent problem to solve for ORHT, 144 (31.3% thought that lack of support for ORHT from patients was the most urgent problem. There was statistically significant difference among dental hospital, dentistry and department of dentistry (χ2=24.176; p<0.05.The majority of Chinese dentists thought that ORHT was needed in the dental setting. Providing opportunities for dentists and dental students to learn about HIV testing guidelines and practices is needed as well as feasibility and implementation science research.

  3. 'Getting checked and having the test': drug injectors' perceptions of HIV testing - findings from qualitative research conducted in England.

    Science.gov (United States)

    Hughes, Rhidian

    2002-04-01

    If HIV and AIDS policy initiatives are to be successful in tackling the spread of infection it is important to understand more about the ways in which people perceive HIV and AIDS. HIV testing is a policy initiative that will work when people take the test and make appropriate changes to their behaviour as a result. This paper is based on a study that used in-depth interviews and a vignette with drug injectors to explore drug injectors' perceptions of HIV risk outside and inside prison. HIV testing was an integral part of drug injectors' perceptions of risk. Three main themes emerged from the analysis of these data: first, reasons for not taking a test; second, reasons for taking a test; and third, the impact of testing upon subsequent behaviour. The paper ends with a summary and conclusions highlighting implications for future research and policy development. Copyright 2002 S. Karger AG, Basel

  4. AIDS-related stigma, HIV testing, and transmission risk among patrons of informal drinking places in Cape Town, South Africa.

    Science.gov (United States)

    Pitpitan, Eileen V; Kalichman, Seth C; Eaton, Lisa A; Cain, Demetria; Sikkema, Kathleen J; Skinner, Donald; Watt, Melissa H; Pieterse, Desiree

    2012-06-01

    AIDS-related stigma as a barrier to HIV testing has not been examined within the context of high at risk environments such as drinking venues. Of particular importance is whether AIDS-related stigma is associated with HIV transmission risks among people who have never been tested for HIV. We examined: (1) AIDS-related stigma as a barrier to testing, controlling for other potential barriers, and (2) whether stigma is associated with HIV risks among HIV-untested individuals. We surveyed 2,572 individuals attending informal drinking establishments in Cape Town, South Africa to assess HIV testing status, AIDS-related stigma endorsement, and HIV transmission sexual risk behavior. Endorsement of AIDS-related stigma was negatively associated with HIV lifetime testing. In addition, stigma endorsement was associated with higher HIV transmission risks. AIDS-related stigma must be addressed in HIV prevention campaigns across South Africa. Antistigma messages should be integrated with risk reduction counseling and testing.

  5. A Cost-Effectiveness Analysis of a Home-Based HIV Counselling and Testing Intervention versus the Standard (Facility Based) HIV Testing Strategy in Rural South Africa.

    Science.gov (United States)

    Tabana, Hanani; Nkonki, Lungiswa; Hongoro, Charles; Doherty, Tanya; Ekström, Anna Mia; Naik, Reshma; Zembe-Mkabile, Wanga; Jackson, Debra; Thorson, Anna

    2015-01-01

    There is growing evidence concerning the acceptability and feasibility of home-based HIV testing. However, less is known about the cost-effectiveness of the approach yet it is a critical component to guide decisions about scaling up access to HIV testing. This study examined the cost-effectiveness of a home-based HIV testing intervention in rural South Africa. Two alternatives: clinic and home-based HIV counselling and testing were compared. Costs were analysed from a provider's perspective for the period of January to December 2010. The outcome, HIV counselling and testing (HCT) uptake was obtained from the Good Start home-based HIV counselling and testing (HBHCT) cluster randomised control trial undertaken in KwaZulu-Natal province. Cost-effectiveness was estimated for a target population of 22,099 versus 23,864 people for intervention and control communities respectively. Average costs were calculated as the cost per client tested, while cost-effectiveness was calculated as the cost per additional client tested through HBHCT. Based on effectiveness of 37% in the intervention (HBHCT) arm compared to 16% in control arm, home based testing costs US$29 compared to US$38 per person for clinic HCT. The incremental cost effectiveness per client tested using HBHCT was $19. HBHCT was less costly and more effective. Home-based HCT could present a cost-effective alternative for rural 'hard to reach' populations depending on affordability by the health system, and should be considered as part of community outreach programs.

  6. Time Until Emergence of HIV Test Reactivity Following Infection With HIV-1: Implications for Interpreting Test Results and Retesting After Exposure.

    Science.gov (United States)

    Delaney, Kevin P; Hanson, Debra L; Masciotra, Silvina; Ethridge, Steven F; Wesolowski, Laura; Owen, Sherry Michele

    2017-01-01

     Understanding the period of time between an exposure resulting in infection with human immunodeficiency virus (HIV) and when a test can reliably detect the presence of that infection, that is, the test window period, may benefit testing programs and clinicians in counseling patients about when the clinician and the patient can be confident a suspected exposure did not result in HIV infection.  We evaluated the intervals between reactivity of the Aptima HIV-1 RNA test (Aptima) and 20 US Food and Drug Administration-approved HIV immunoassays using 222 longitudinally collected plasma specimens from HIV-1 seroconverters from the United States. Using interval-censored survival and binomial regression approaches a multi-model framework was implemented to estimate the relative emergence of test reactivity, referred to here as an inter-test reactivity interval (ITRI). We then combined ITRI results with simulated data for the eclipse period, the time between exposure and detection of HIV virus by Aptima, to estimate the window period for each test.  The estimated ITRIs were shorter with each new class of HIV tests, ranging from 5.9 to 24.8 days. The 99 th percentiles of the window period probability distribution ranged from 44 days for laboratory screening tests that detect both antigen and antibody to 65 days for the Western blot test.  Our directly comparable estimates of the emergence of reactivity for 20 immunoassays are valuable to testing providers for interpreting negative HIV test results obtained shortly after exposure, and for counseling individuals on when to retest after an exposure. Published by Oxford University Press for the Infectious Diseases Society of America 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  7. Barriers to HIV testing for migrant black Africans in Western Europe

    NARCIS (Netherlands)

    Fakoya, A.; Reynolds, R.; Caswell, G.; Shiripinda, I.

    2008-01-01

    Migrant black Africans are disproportionately affected by HIV in Western Europe; we discuss the barriers to HIV testing for sub-Saharan migrants, with particular emphasis on the UK and the Netherlands. Cultural, social and structural barriers to testing, such as access to testing and care, fear of

  8. 26. willingness to accept hiv testing among caretakers with a child

    African Journals Online (AJOL)

    Esem

    therefore RTC should be implemented in all health facilities ... sharps. 41. 17.1. VCT services available. - protest counselling. 228. 95.4. - HIV testing. 232. 97.1. - post test counselling. 227. 95.0. Home based care. 21. 8.8. ART services. 95. 39.7 ... prevention and treatment of HIV begins with testing which allows one to know ...

  9. Feasibility and Effectiveness of Indicator Condition-Guided Testing for HIV

    DEFF Research Database (Denmark)

    Sullivan, A.K.; Raben, D.; Reekie, J.

    2013-01-01

    % had previously tested HIV negative (median time since last test: 1.58 years); which together with the median CD4 count at diagnosis (400 cell/uL) adds weight to this strategy being effective in diagnosing HIV at an earlier stage. A positive test was more likely for non-white individuals, MSM...

  10. Visual or automated dipstick testing for proteinuria in pregnancy?

    Science.gov (United States)

    Correa, Mauricio E; Côté, Anne-Marie; De Silva, Dane A; Wang, Li; Packianathan, Prianthiny; von Dadelszen, Peter; Magee, Laura A

    2017-01-01

    To compare the Multistix 10SG/visual-read with two automated methods (Multistix 10SG/Clinitek 50 and Chemstrip 10A/Urisys 1100) to detect significant proteinuria among high-risk pregnant women. Prospective cohort study at British Columbia Women's Hospital & Health Centre, Vancouver, Canada. Diagnostic accuracy determined by sensitivity, specificity, positive and negative likelihood ratios (LR+ and LR-). 303 (89.6%) of 338 women had a urine sample tested by all three dipstick methods. 196 samples (64.7%) were collected in the morning (subsequent to their first void) and from outpatients. 107 samples (35.3%) were from inpatients at various times throughout the day. A PrCr ⩾30mg/mmol was present in 46 (15.2%) samples. The sensitivity for proteinuria was higher with Multistix 10SG/Clinitek 50 (65.2%) than with Multistix 10SG/visual-read (41.3%, p90% for all methods studied, although it was highest for Multistix 10SG/visual-read (98.4%) compared with either Multistix 10SG/Clinitek 50 (92.6%, p5), but LR- poor-fair (>0.20). 29 samples were discordant for proteinuria between methods. 28/29 women had negative proteinuria by Multistix 10SG/visual-read, but at least 1+ proteinuria by an automated method; 17/28 were false positives and 11/28 true positives. Automated dipstick methods are more sensitive than visual urinalysis for proteinuria, but test performance is still only poor-fair as a 'rule-out' test for proteinuria. Whether the enhanced sensitivity would be worth the false positives, cost, and personnel training remains to be determined for detection of low-level proteinuria in pregnancy. Copyright © 2017 International Society for the Study of Hypertension in Pregnancy. Published by Elsevier B.V. All rights reserved.

  11. Do employees participate in workplace HIV testing just to win a lottery prize? A quantitative study

    Directory of Open Access Journals (Sweden)

    Martin Weihs

    2016-02-01

    Full Text Available Orientation: To encourage workers to participate in workplace HIV testing, some SouthAfrican automotive companies use lotteries. However, there is a lack of empirical evidence on how lottery incentives may influence employees’ workplace HIV counselling and testing behaviour.Research purpose: Determine whether workers intend to test for HIV only to win a lottery prize.Motivation for the study: The positive and also negative influences of lotteries on workers’ HIV testing behaviour need to be understood to avoid undue coercion in workplace HIV testing participation.Research design, approach and method: Post-test only quasi-experimental studies were conducted the day HIV testing and lotteries were announced to staff in four companies using a cross-sectional, self-administered survey that measured workers’ workplace HIV testing behaviour intentions. Intention to participate in workplace HIV counselling and testing was used as the main outcome of respondents’ behaviour and investigated via the statement: ‘If the company would organise its on-site Wellness Day tomorrow, I would go testing for HIV tomorrow’. In a first setting, two companies’ workers had to test for HIV to be entered in the lottery (n = 198. In the second setting, two other companies’ workers did not have to test to be entered in the lottery (n = 316. Chi-square tests were conducted to measure significant differences between the two conditions distinguishing between permanent and non-permanent staff.Main findings: No significant association was found between behaviour intention in the two settings for permanent workers’ workplace HIV testing intention ( χ2 = 1.145, p = 0.285, phi = -0.097. However, a significant association with a small effect size was found for non-permanent workers ( χ2 = 8.04, p = 0.005, phi = -0.279.Practical/managerial implications: Results show that lotteries to encourage workplace HIV testing are very likely to help workers ‘do the right

  12. New law on HIV testing in Botswana: The implications for healthcare professionals

    Directory of Open Access Journals (Sweden)

    Rofiah O. Sarumi

    2015-04-01

    Full Text Available Background: Botswana is one of the countries with the highest HIV prevalence rates in the world. Innovative HIV testing strategies are required to ensure that those infected or at risk of infection become aware of their HIV status and are able to access treatment, care and support. Despite this public health imperative, HIV testing strategies in Botswana will in future be based around the principles in the new Public Health Act (2013. The present article describes the HIV testing norms in the Act, and sets out the strengths and weaknesses of this approach and its implications for healthcare professionals in Botswana.Objectives: To compare international norms on HIV testing with the provisions governing such testing in the new Botswana Public Health Act and to assess the extent to which the new Act meets international human rights norms on HIV testing.Method: A ‘desktop’ review of international human rights norms and those in the Botswana Public Health Act.Conclusion: HIV testing norms in the new Public Health Act in Botswana violate individual rights and will place healthcare workers in a position where they will have to elect between acting lawfully or ethically. Law reform is required in order to ensure that HIV testing achieves the joint goals of public health and human rights.

  13. Pilot Integration of HIV Screening and Healthcare Settings with Multi- Component Social Network and Partner Testing for HIV Detection.

    Science.gov (United States)

    Rentz, Michael F; Ruffner, Andrew H; Ancona, Rachel M; Hart, Kimberly W; Kues, John R; Barczak, Christopher M; Lindsell, Christopher J; Fichtenbaum, Carl J; Lyons, Michael S

    2017-11-23

    Healthcare settings screen broadly for HIV. Public health settings use social network and partner testing ("Transmission Network Targeting (TNT)") to select high-risk individuals based on their contacts. HIV screening and TNT systems are not integrated, and healthcare settings have not implemented TNT. The study aimed to evaluate pilot implementation of multi-component, multi-venue TNT in conjunction with HIV screening by a healthcare setting. Our urban, academic health center implemented a TNT program in collaboration with the local health department for five months during 2011. High-risk or HIV positive patients of the infectious diseases clinic and emergency department HIV screening program were recruited to access social and partner networks via compensated peer-referral, testing of companions present with them, and partner notification services. Contacts became the next-generation index cases in a snowball recruitment strategy. The pilot TNT program yielded 485 HIV tests for 482 individuals through eight generations of recruitment with five (1.0%; 95% CI = 0.4%, 2.3%) new diagnoses. Of these, 246 (51.0%; 95% CI = 46.6%, 55.5%) reported that they had not been tested for HIV within the last 12 months and 383 (79.5%; 95% CI = 75.7%, 82.9%) had not been tested by the existing ED screening program within the last five years. TNT complements population screening by more directly targeting high-risk individuals and by expanding the population receiving testing. Information from existing healthcare services could be used to seed TNT programs, or TNT could be implemented within healthcare settings. Research evaluating multi-component, multi-venue HIV detection is necessary to maximize complementary approaches while minimizing redundancy. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  14. Positive attitudes to pediatric HIV testing: findings from a nationally representative survey from Zimbabwe.

    Directory of Open Access Journals (Sweden)

    Raluca Buzdugan

    Full Text Available OBJECTIVE: Early HIV testing and diagnosis are paramount for increasing treatment initiation among children, necessary for their survival and improved health. However, uptake of pediatric HIV testing is low in high-prevalence areas. We present data on attitudes towards pediatric testing from a nationally representative survey in Zimbabwe. METHODS: All 18-24 year olds and a proportion of 25-49 year olds living in randomly selected enumeration areas from all ten Zimbabwe provinces were invited to self-complete an anonymous questionnaire on a personal digital assistant, and 16,719 people agreed to participate (75% of eligibles. RESULTS: Most people think children can benefit from HIV testing (91%, 81% of people who looked after children know how to access testing for their children and 92% would feel happier if their children were tested. Notably, 42% fear that, if tested, children may be discriminated against by some community members and 28% fear their children are HIV positive. People who fear discrimination against children who have tested for HIV are more likely than their counterparts to perceive their community as stigmatizing against HIV positive people (43% vs. 29%. They are also less likely to report positive attitudes to HIV themselves (49% vs. 74%. Only 28% think it is possible for children HIV-infected at birth to live into adolescence without treatment. Approximately 70% of people (irrespective of whether they are themselves parents think HIV-infected children in their communities can access testing and treatment. CONCLUSIONS: Pediatric HIV testing is the essential gateway to prevention and care services. Our data indicate positive attitudes to testing children, suggesting a conducive environment for increasing uptake of pediatric testing in Zimbabwe. However, there is a need to better understand the barriers to pediatric testing, such as stigma and discrimination, and address the gaps in knowledge regarding HIV/AIDS in children.

  15. Simple Instrumental and Visual Tests for Nonlaboratory Environmental Control

    Directory of Open Access Journals (Sweden)

    L. P. Eksperiandova

    2016-01-01

    Full Text Available Proposed are simple and available techniques that can be used for rapid and reliable environmental control specifically of natural water by means of instrumental and visual tests in outdoor conditions. Developed are the chemical colorimetric modes for fast detection of socially dangerous trace impurities in water such as Co(II, Pd(II, and Rh(III as well as NO2--ions and Fe(III serving as model impurities. Application of portable digital devices and scanner allows estimating the color coordinates and increasing the accuracy and sensitivity of the tests. The combination of complex formation with preconcentration of colored complexes replaces the sensitive but time-consuming and capricious kinetic method that is usually used for this purpose at the more convenient and reliable colorimetric method. As the test tools, the following ones are worked out: polyurethane foam tablets with sorbed colored complexes, the two-layer paper sandwich packaged in slide adapter and saturated by reagents, and polyethylene terephthalate blister with dried reagents. Fast analysis of polyurethane foam tablets is realized using a pocket digital RGB-colorimeter or portable photometer. Express analysis of two-layer paper sandwich or polyethylene terephthalate blister is realized by visual and instrumental tests. The metrological characteristics of the developed visual and instrumental express analysis techniques are estimated.

  16. A Cross-Sectional Survey of HIV Testing and Prevalence in Twelve Brazilian Correctional Facilities.

    Science.gov (United States)

    Sgarbi, Renata Viebrantz Enne; Carbone, Andrea da Silva Santos; Paião, Dayse Sanchez Guimarães; Lemos, Everton Ferreira; Simionatto, Simone; Puga, Marco Antonio Moreira; Motta-Castro, Ana Rita Coimbra; Pompilio, Mauricio Antonio; Urrego, Juliana; Ko, Albert I; Andrews, Jason R; Croda, Julio

    2015-01-01

    Prior studies have reported higher HIV prevalence among prisoners than the general population in Brazil, but data have been derived from single prisons. The aim of this study was to evaluate HIV testing practices, prevalence and linkage to care among inmates in a network of 12 prisons. We administered a questionnaire to a population-based sample of inmates from 12 prisons in Central-West Brazil and collected sera for HIV and syphilis testing from January to December 2013. We evaluated factors associated with HIV testing and infection using multivariable logistic regression models. Six months after HIV testing, we assessed whether each HIV-infected prisoner was engaged in clinical care and whether they had started antiretroviral therapy. We recruited 3,362 inmates, of whom 2,843 (85%) were men from 8 prisons, and 519 (15%) were women from 4 prisons. Forty-five percent of participants reported never having been tested for HIV previously. In multivariable analysis, the variables associated with previous HIV testing were lack of a stable partner (adjusted odds ratio [AOR]: 1.38; 95% CI: 1.18-1.60), completed more than four years of schooling (AOR 1.40; 95% CI: 1.20-1.64), history of previous incarceration (AOR: 1.68; 95% CI: 1.43-1.98), history of mental illness (AOR 1.52; 95% CI: 1.31-1.78) and previous surgery (AOR 1.31; 95% CI: 1.12-1.52). Fifty-four (1.6%) of all participants tested positive for HIV; this included 44 (1.54%) men and 10 (1.92%) women. Among male inmates, HIV infection was associated with homosexuality (AOR 6.20, 95% CI: 1.73-22.22), self-report of mental illness (AOR 2.18, 95% CI: 1.13-4.18), history of sexually transmitted infections (AOR 3.28, 95% CI: 1.64-6.56), and syphilis sero-positivity (AOR 2.54, 95% CI: 1.20-5.39). Among HIV-infected individuals, 34 (63%) were unaware of their HIV status; only 23 of these 34 (68%) newly diagnosed participants could be reached at six month follow-up, and 21 of 23 (91%) were engaged in HIV care. HIV testing

  17. A Cross-Sectional Survey of HIV Testing and Prevalence in Twelve Brazilian Correctional Facilities.

    Directory of Open Access Journals (Sweden)

    Renata Viebrantz Enne Sgarbi

    Full Text Available Prior studies have reported higher HIV prevalence among prisoners than the general population in Brazil, but data have been derived from single prisons. The aim of this study was to evaluate HIV testing practices, prevalence and linkage to care among inmates in a network of 12 prisons.We administered a questionnaire to a population-based sample of inmates from 12 prisons in Central-West Brazil and collected sera for HIV and syphilis testing from January to December 2013. We evaluated factors associated with HIV testing and infection using multivariable logistic regression models. Six months after HIV testing, we assessed whether each HIV-infected prisoner was engaged in clinical care and whether they had started antiretroviral therapy.We recruited 3,362 inmates, of whom 2,843 (85% were men from 8 prisons, and 519 (15% were women from 4 prisons. Forty-five percent of participants reported never having been tested for HIV previously. In multivariable analysis, the variables associated with previous HIV testing were lack of a stable partner (adjusted odds ratio [AOR]: 1.38; 95% CI: 1.18-1.60, completed more than four years of schooling (AOR 1.40; 95% CI: 1.20-1.64, history of previous incarceration (AOR: 1.68; 95% CI: 1.43-1.98, history of mental illness (AOR 1.52; 95% CI: 1.31-1.78 and previous surgery (AOR 1.31; 95% CI: 1.12-1.52. Fifty-four (1.6% of all participants tested positive for HIV; this included 44 (1.54% men and 10 (1.92% women. Among male inmates, HIV infection was associated with homosexuality (AOR 6.20, 95% CI: 1.73-22.22, self-report of mental illness (AOR 2.18, 95% CI: 1.13-4.18, history of sexually transmitted infections (AOR 3.28, 95% CI: 1.64-6.56, and syphilis sero-positivity (AOR 2.54, 95% CI: 1.20-5.39. Among HIV-infected individuals, 34 (63% were unaware of their HIV status; only 23 of these 34 (68% newly diagnosed participants could be reached at six month follow-up, and 21 of 23 (91% were engaged in HIV care.HIV testing

  18. Incentives for HIV testing at the workplace in the automotive industry in the Nelson Mandela Bay Municipality: Ethical considerations

    OpenAIRE

    Martin Weihs; Anna Meyer-Weitz; Friederike Baasner-Weihs

    2017-01-01

    Comprehensive HIV and AIDS workplace programmes made use of substantial lottery incentives in HIV counselling and testing drives to promote HIV testing at four companies in the automotive industry in the Nelson Mandela Bay Municipality. The main aim was to use lottery incentives to increase uptake for HIV testing. This would help to define company HIV prevalence and ensure timely support, care and treatment of employees. In total, 1 324 employees, making up about 90% of the total staff, were ...

  19. Accuracy in HIV Rapid Testing among Laboratory and Non-laboratory Personnel in Zambia: Observations from the National HIV Proficiency Testing System.

    Directory of Open Access Journals (Sweden)

    Sheila Mwangala

    Full Text Available Despite rapid task-shifting and scale-up of HIV testing services in high HIV prevalence countries, studies evaluating accuracy remain limited. This study aimed to assess overall accuracy level and factors associated with accuracy in HIV rapid testing in Zambia.Accuracy was investigated among rural and urban HIV testing sites participating in two annual national HIV proficiency testing (PT exercises conducted in 2009 (n = 282 sites and 2010 (n = 488 sites. Testers included lay counselors, nurses, laboratory personnel and others. PT panels of five dry tube specimens (DTS were issued to testing sites by the national reference laboratory (NRL. Site accuracy level was assessed by comparison of reported results to the expected results. Non-parametric rank tests and multiple linear regression models were used to assess variation in accuracy between PT cycles and between tester groups, and to examine factors associated with accuracy respectively.Overall accuracy level was 93.1% (95% CI: 91.2-94.9 in 2009 and 96.9% (95% CI: 96.1-97.8 in 2010. Differences in accuracy were seen between the tester groups in 2009 with laboratory personnel being more accurate than non-laboratory personnel, while in 2010 no differences were seen. In both PT exercises, lay counselors and nurses had more difficulties interpreting results, with more occurrences of false-negative, false-positive and indeterminate results. Having received the standard HIV rapid testing training and adherence to the national HIV testing algorithm were positively associated with accuracy.The study showed an improvement in tester group and overall accuracy from the first PT exercise to the next. Average number of incorrect test results per 1000 tests performed was reduced from 69 to 31. Further improvement is needed, however, and the national HIV proficiency testing system seems to be an important tool in this regard, which should be continued and needs to be urgently strengthened.

  20. Integrating tuberculosis and HIV services for people living with HIV: Costs of the Zambian ProTEST Initiative

    Directory of Open Access Journals (Sweden)

    Kayawe Ignatius

    2008-01-01

    Full Text Available Abstract Background In the face of the dual TB/HIV epidemic, the ProTEST Initiative was one of the first to demonstrate the feasibility of providing collaborative TB/HIV care for people living with HIV (PLWH in poor settings. The ProTEST Initiative facilitated collaboration between service providers. Voluntary counselling and testing (VCT acted as the entry point for services including TB screening and preventive therapy, clinical treatment for HIV-related disease, and home-based care (HBC, and a hospice. This paper estimates the costs of the ProTEST Initiative in two sites in urban Zambia, prior to the introduction of anti-retroviral therapy. Methods Annual financial and economic providers costs and output measures were collected in 2000–2001. Estimates are made of total costs for each component and average costs per: person reached by ProTEST; VCT pre-test counselled, tested and completed; isoniazid preventive therapy started and completed; clinic visit; HBC patient; and hospice admission and bednight. Results Annual core ProTEST costs were (in 2007 US dollars $84,213 in Chawama and $31,053 in Matero. The cost of coordination was 4%–5% of total site costs ($1–$6 per person reached. The largest cost component in Chawama was voluntary counselling and testing (56% and the clinic in Matero (50%, where VCT clients had higher HIV-prevalences and more advanced HIV. Average costs were lower for all components in the larger site. The cost per HBC patient was $149, and per hospice bednight was $24. Conclusion This study shows that coordinating an integrated and comprehensive package of services for PLWH is relatively inexpensive. The lessons learnt in this study are still applicable today in the era of ART, as these services must still be provided as part of the continuum of care for people living with HIV.

  1. HIV Testing and Diagnosis Rates in Kiev, Ukraine: April 2013 - March 2014

    Science.gov (United States)

    Simmons, Ruth; Malyuta, Ruslan; Medoeva, Antonia; Kruglov, Yuri; Yurchenko, Alexander; Copas, Andrew; Porter, Kholoud

    2015-01-01

    Objective Data from Ukraine on risk factors for HIV acquisition are limited. We describe the characteristics of individuals testing for HIV in the main testing centres of the Ukrainian capital Kiev, including HIV risk factors, testing rates, and positivity rates. Methods As part of a larger study to estimate HIV incidence within Kiev City, we included questions on possible risk factors for HIV acquisition and testing history to existing systems in 4 infectious disease clinics. Data were provided by the person requesting an HIV test using a handheld electronic tablet. All persons (≥16yrs) presenting for an HIV test April 2013–March 2014 were included. Rates per 100,000 were calculated using region-specific denominators for Kiev. Results During the study period 6370 individuals tested for HIV, equivalent to a testing rate of 293.2 per 100,000. Of these, 467 (7.8%) were HIV-positive, with the highest proportion positive among 31–35 year olds (11.2%), males (9.4%), people who inject drugs (PWID) (17.9%) and men who have sex with men (MSM) (24.1%). Using published population size estimates of MSM, diagnosis rates for MSM ranged from 490.6to 1548.3/100,000. A higher proportion of heterosexual women compared to heterosexual men reported contact with PWID, (16% vs. 4.7%) suggesting a bridging in risk between PWID and their sexual partners. Conclusion Collection of HIV risk factor information in Kiev, essential for the purposes of developing effective HIV prevention and response tools, is feasible. The high percentage of MSM among those testing positive for HIV, may indicate a significant level of undisclosed sex between men in national figures. PMID:26322977

  2. Interventions for Increasing HIV Testing Uptake in Migrants: A Systematic Review of Evidence.

    Science.gov (United States)

    Aung, Eithandee; Blondell, Sarah J; Durham, Jo

    2017-07-14

    Migrants have been identified as being at greater risk for late HIV testing and diagnosis. Late diagnosis is of concern because timely diagnosis and initiation of treatment can both optimise health outcomes and reduce transmission. We reviewed and evaluated interventions that aimed to increase HIV testing uptake in migrant populations. Of 6511 papers retrieved, 10 met the inclusion criteria and were included in the review. Three types of interventions were identified (exposure to HIV prevention messages, HIV education programs, and direct offer of testing). All interventions were based on individual models of behaviour change targeting migrants or GPs. While important, interventions that also address broader health system and structural factors that contribute to late HIV-diagnosis in at-risk members of migrant populations are needed. Integrating PITC into existing primary healthcare settings shows promise of creating an enabling environment within patient-doctor relationships that can encourage HIV testing uptake among migrant populations.

  3. Field-Based Video Pre-Test Counseling, Oral Testing, and Telephonic Post-Test Counseling: Implementation of an HIV Field Testing Package among High-Risk Indian Men

    Science.gov (United States)

    Snyder, Hannah; Yeldandi, Vijay V.; Kumar, G. Prem; Liao, Chuanhong; Lakshmi, Vemu; Gandham, Sabitha R.; Muppudi, Uma; Oruganti, Ganesh; Schneider, John A.

    2012-01-01

    In India, men who have sex with men (MSM) and truck drivers are high-risk groups that often do not access HIV testing due to stigma and high mobility. This study evaluated a field testing package (FTP) that identified HIV positive participants through video pre-test counseling, OraQuick oral fluid HIV testing, and telephonic post-test counseling…

  4. Determinants for HIV testing and counselling in Nairobi urban informal settlements

    Directory of Open Access Journals (Sweden)

    Mgomella George

    2011-08-01

    Full Text Available Abstract Background Counselling and testing is important in HIV prevention and care. Majority of people in sub-Saharan Africa do not know their HIV status and are therefore unable to take steps to prevent infection or take up life prolonging anti-retroviral drugs in time if infected. This study aimed at exploring determinants of HIV testing and counselling in two Nairobi informal settlements. Methods Data are derived from a cross-sectional survey nested in an ongoing demographic surveillance system. A total of 3,162 individuals responded to the interview and out of these, 82% provided a blood sample which was tested using rapid test kits. The outcome of interest in this paper was HIV testing status in the past categorised as "never tested"; "client-initiated testing and counselling (CITC" and provider-initiated testing and counselling (PITC. Multinomial logistic regression was used to identify determinants of HIV testing. Results Approximately 31% of all respondents had ever been tested for HIV through CITC, 22% through PITC and 42% had never been tested but indicated willingness to test. Overall, 62% of females and 38% of males had ever been tested for HIV. Males were less likely to have had CITC (OR = 0.47; p value Conclusion Although the proportion of individuals ever tested in the informal settlements is similar to the national average, it remains low compared to that of Nairobi province especially among men. Key determinants of HIV testing and counselling include; gender, age, education level, HIV status and marital status. These factors need to be considered in efforts aimed at increasing participation in HIV testing.

  5. HIV Testing and Antiretroviral Therapy Initiation at Birth: Views from ...

    African Journals Online (AJOL)

    PMTCT) programme, 14 000 children in South Africa became HIV-infected in 2012. There are many reasons for this gap in PMTCT efforts. Late maternal diagnosis of HIV, late antenatal antiretroviral therapy (ART) initiation, seroconversion in ...

  6. HIV testing policies for migrants and ethnic minorities in EU/EFTA Member States

    Science.gov (United States)

    Monge, Susana; Caro-Murillo, Ana M.; Ramírez-Rubio, Oriana; Azcoaga-Lorenzo, Amaya; Belza, Maria J.; Rivero-Montesdeoca, Yaiza; Noori, Teymur; Del Amo, Julia

    2014-01-01

    Background: In the context of an European Centre for Disease Prevention and Control (ECDC) research project, our objective was to describe current recommendations regarding HIV testing and counselling targeting migrants and ethnic minorities in the European Union/European Economic Area/European Free Trade Association (EU/EEA/EFTA) Member States. Methods: An on-line survey was conducted among 31 EU/EEA/EFTA Member States. The survey inquired on the existence of specific HIV testing and counselling recommendations or policies for migrants and/or ethnic minorities and the year of their publication. Additionally, we performed a review of national recommendations, guidelines or any other policy documents retrieved from an Internet search through the different countries’ competent bodies. Results: Twenty-nine (94%) country representatives responded the survey, and 28 documents from 27 countries were identified. National guidelines on HIV testing are heterogeneous and tailored, according to the epidemiological situation. Twenty-two countries identify migrants and four countries identify ethnic minorities as particularly vulnerable to HIV. Sixteen countries explicitly recommend offering an HIV test to migrants/ethnic minorities. Guidelines especially target people originating from HIV endemic countries, and benefits of HIV early detection are highlighted. HIV testing is not mandatory in any country, but some countries overtly facilitate this practice. Conclusion: Benefits of HIV testing in migrants and ethnic minorities, at both individual and community levels are recognized by many countries. In spite of this, not all countries identify the need to test these groups. PMID:23921295

  7. Factors affecting voluntary HIV counselling and testing among men in Ethiopia: a cross-sectional survey

    OpenAIRE

    Leta Tesfaye H; Sandøy Ingvild F; Fylkesnes Knut

    2012-01-01

    Abstract Background Voluntary HIV counselling and testing (VCT) is one of the key strategies in the HIV/AIDS prevention and control programmes in Ethiopia. However, utilization of this service among adults is very low. The aim of the present study was to investigate factors associated with VCT utilization among adult men since men are less likely than women to be offered and accept routine HIV testing. Methods The study utilized data from the Ethiopian Demographic Health Survey (EDHS) 2005, w...

  8. HIV testing services in Kenya, Tanzania and Zambia: Determinants, experiences and responsiveness

    OpenAIRE

    Njeru, Mercy Karimi

    2011-01-01

    Introduction: HIV/AIDS has been one of the most challenging pandemics in health and development. Sub- Saharan Africa remains the most affected region and it handles over two-thirds of the individuals infected world wide. A large number of interventions have been implemented to control the infection. HIV testing is one of these interventions, and is a key entry point for both prevention and treatment. HIV testing has mainly been offered through the client initiated, voluntar...

  9. Low rates of child testing for HIV persist in a high risk area of East Africa

    Science.gov (United States)

    O’Donnell, Karen; Yao, Jia; Ostermann, Jan; Thielman, Nathan; Reddy, Elisabeth; Whetten, Rachel; Maro, Venance; Itemba, Dafrosa; Pence, Brian; Dow, Dorothy; Whetten, Kathryn

    2015-01-01

    Children in low income countries are the least touched by recent successes in the diagnosis and treatment of HIV/AIDS globally. Early treatment is essential for a child’s longer and higher quality of life; however, by 2011 only a small proportion of HIV-seropositive children in low- and middle-income (LMIC) countries were receiving treatment, in part because of persisting low rates of diagnosis. This study of the prevalence and characteristics of children tested for HIV was embedded in the Coping with HIV/AIDS in Tanzania (CHAT) study in which HIV-seropositive, and HIV-seronegative adults, and adults with unknown HIV status were asked about HIV testing for their children. Data were gathered from November 2009 to August 2010 during the scale up of Prevention of Mother to Child Transmission and Early Infant Diagnosis programs in the region. Reports on 1,776 children indicate that 31.7% of all children were reported to have been tested, including only 42.9% of children with an HIV-seropositive caregiver. In general, children more likely to be HIV tested were a biological child of study participants, younger, of widowed adults, in urban areas, and of HIV-seropositive parents/caregivers. Children belonging to the two indigenous tribes, Chagga and Pare, were more likely to be tested than those from other tribes. Rates of testing among children less than two years old were low, even for the HIV-seropositive caregiver group. The persistence of low testing rates is discussed in terms of the accessibility and acceptability of child testing in resource poor settings. PMID:23875966

  10. Increasing HIV testing among African immigrants in ireland: challenges and opportunities.

    Science.gov (United States)

    Adedimeji, Adebola A; Asibon, Aba; O'Connor, Gerard; Carson, Richard; Cowan, Ethan; McKinley, Philip; Leider, Jason; Mallon, Patrick; Calderon, Yvette

    2015-02-01

    In 2012, immigrants constitute 63% of new cases of heterosexually transmitted HIV among individuals born outside Ireland. Current strategies to encourage testing can be ineffective if immigrants perceive them as culturally insensitive. We obtained qualitative data to explore challenges to voluntary HIV-testing for immigrants in Ireland. Content analysis was undertaken to identify and describe pertinent themes. Widespread beliefs that HIV is primarily a disease of African immigrants were identified as challenges that constrain access to testing and care. The organization and location of testing services, attitude of health workers, and beliefs regarding mandatory HIV-testing for immigrants seeking access to welfare benefits were also identified. Immigrants in Ireland encounter a variety of structural, cultural and personal constraints to HIV testing. Opportunities exist in the Irish Health system to increase testing among immigrants through greater acknowledgement of cultural sensitivities of immigrant groups.

  11. HIV testing during the Canadian immigration medical examination: a national survey of designated medical practitioners.

    Science.gov (United States)

    Tran, Jennifer M; Li, Alan; Owino, Maureen; English, Ken; Mascarenhas, Lyndon; Tan, Darrell H S

    2014-01-01

    HIV testing is mandatory for individuals wishing to immigrate to Canada. Since the Designated Medical Practitioners (DMPs) who perform these tests may have varying experience in HIV and time constraints in their clinical practices, there may be variability in the quality of pre- and posttest counseling provided. We surveyed DMPs regarding HIV testing, counseling, and immigration inadmissibility. A 16-item survey was mailed to all DMPs across Canada (N = 203). The survey inquired about DMP characteristics, knowledge of HIV, attitudes and practices regarding inadmissibility and counseling, and interest in continuing medical education. There were a total of 83 respondents (41%). Participants frequently rated their knowledge of HIV diagnostics, cultural competency, and HIV/AIDS service organizations as "fair" (40%, 43%, and 44%, respectively). About 25%, 46%, and 11% of the respondents agreed/strongly agreed with the statements "HIV infected individuals pose a danger to public health and safety," "HIV-positive immigrants cause excessive demand on the healthcare system," and "HIV seropositivity is a reasonable ground for denial into Canada," respectively. Language was cited as a barrier to counseling, which focused on transmission risks (46% discussed this as "always" or "often") more than coping and social support (37%). There was a high level of interest (47%) in continuing medical education in this area. There are areas for improvement regarding DMPs' knowledge, attitudes, and practices about HIV infection, counseling, and immigration criteria. Continuing medical education and support for DMPs to facilitate practice changes could benefit newcomers who test positive through the immigration process.

  12. HIV testing in developing countries: what is required?

    Science.gov (United States)

    Alemnji, George; Nkengasong, John N; Parekh, Bharat S

    2011-12-01

    HIV diagnostic and follow up testing are usually done in laboratory settings. However, in developing countries there is a need to decentralize testing as the majority of the population lives in rural settings. In developing countries stringent quality assurance (QA) practices, which include appropriate training, development of standard operating procedures, maintenance of operator proficiency, routine use of quality control (QC) specimens, standardized data management, equipment calibration and maintenance, and biohazard safety with proper disinfection/disposal procedures are not routinely followed to ensure reliability of results and a safe work environment. The introduction of point-of-care testing technologies involving the use of non-laboratorians in routine testing has further increased the complexity of QA. Therefore, a careful approach towards improvement of laboratories that encourages best practices, coupled with incentives, and review of government policies in point-of-care testing is needed to improve quality of testing as decentralization takes place. Development of a functional laboratory tiered network that facilitates communication, referral, training and problem solving could further enhance confidence in laboratory testing. There is also a need for special considerations in implementing a step-wise approach towards quality improvement, strengthening of the supply chain management, human capacity development, infrastructure upgrade, and strong public private partnerships to ensure long term sustainability of these efforts.

  13. The influence of relationship power dynamics on HIV testing in rural Malawi.

    Science.gov (United States)

    Conroy, Amy A

    2015-01-01

    Using the theory of gender and power (TGP) and data from the Tsogolo la Thanzi (TLT) study, we examined how relationship power shapes young people's decisions to test for HIV in rural Malawi (N=932), a high-HIV prevalence setting undergoing rapid expansions in testing services. We used generalized estimating equations (GEE) to examine associations among five constructs of relationship power (socioeconomic inequalities, relationship dominance, relationship violence, relationship unity, and mistrust), perceived risk, and receiving an HIV test over a 16-month period. The results indicate that young Malawians are testing for HIV at relatively high rates, repeatedly, and not just during pregnancy. Over the study period, 47.3% of respondents received at least one HIV test outside of TLT (range: 0-4). The GEE analysis revealed that men and women with higher levels of relationship unity were less likely to test for HIV. For men, being a victim of sexual coercion was an additional barrier to testing. Women's testing decisions were more strongly influenced by perceptions of a partner's risk for HIV than their own, whereas men relied more on self-assessments. The results highlight that testing decisions are deeply embedded within the relationship context, which should be considered in future HIV testing interventions.

  14. HIV Self-Testing: a Review of Current Implementation and Fidelity.

    Science.gov (United States)

    Estem, Kristecia S; Catania, Joseph; Klausner, Jeffrey D

    2016-04-01

    Oral HIV self-testing is an innovative and potentially high-impact means to increase HIV-case identification globally. As a screening test, oral HIV self-testing offers the potential for increased adoption through greater convenience and privacy, and the potential to increase the proportion of the population who test regularly. Research on how best to translate the innovation of oral self-testing to high-risk populations is underway. Currently only one oral HIV self-test kit is FDA-approved (OraQuick In-Home HIV Test) and available for retail sale. In the present report we review recent studies on the dissemination, adoption, and implementation of oral HIV testing. Prior work has focused primarily on adoption, but recent studies have begun to identify methods for improving dissemination and problems associated with self-implementation. At present a major barrier to wider adoption is the relatively high retail cost of the oral HIV test kit. Significant but minor barriers are represented by overly complex instructional materials for some population segments, and dissemination programs of unknown efficacy. Theoretical and practical suggestions for conducting research on dissemination, adoption, and implementation of oral HIV testing are discussed.

  15. Potential impact on HIV incidence of higher HIV testing rates and earlier antiretroviral therapy initiation in MSM

    DEFF Research Database (Denmark)

    Phillips, Andrew N; Cambiano, Valentina; Miners, Alec

    2015-01-01

    BACKGROUND: Increased rates of testing, with early antiretroviral therapy (ART) initiation, represent a key potential HIV-prevention approach. Currently, in MSM in the United Kingdom, it is estimated that 36% are diagnosed by 1 year from infection, and the ART initiation threshold is at CD4 cell...... count 350/μl. We investigated what would be required to reduce HIV incidence in MSM to below 1 per 1000 person-years (i.e. ... on HIV in MSM in the United Kingdom. Outcomes were projected according to future alternative HIV testing and ART initiation scenarios to 2030, considering also potential changes in levels of condomless sex. RESULTS: For ART use to result in an incidence of close to 1/1000 person-years requires...

  16. Cost effectiveness of expanded antenatal HIV testing in London

    NARCIS (Netherlands)

    Postma, MJ; Beck, EJ; Hankins, CA; Mandalia, S; Jager, JC; de Jong-van den Berg, LTW; Sherr, L

    2000-01-01

    Background: Recently the Department of Health announced the introduction in England of voluntary universal HIV screening in early pregnancy to prevent vertical transmission. New data have shown the importance of HIV infection in infants born to mothers who were HIV-negative in early pregnancy and

  17. Nurturing the continuum of HIV testing, treatment and prevention ...

    African Journals Online (AJOL)

    Background: Despite the shift in antiretroviral therapy (ARVs) eligibility cascade from CD4 ≤ 200 to CD4 ≤ 350 to CD4 ≤ 500 mm3, HIV related morbidity and mortality continue to escalate annually, as do HIV infections. The new paradigm of treatment for all HIV positives individual irrespective of CD4 count may ...

  18. Fogging the issue of HIV - barriers for HIV testing in a migrated population from Ethiopia and Eritrea.

    Science.gov (United States)

    Lindkvist, Pille; Johansson, Eva; Hylander, Ingrid

    2015-02-05

    The outcome of HIV treatment has dramatically improved since the introduction of antiretroviral therapy. Studies confirm that if treatment of HIV is initiated when the immune system is not severely affected by the virus the prognosis for the outcome is significantly better. There is also evidence that many immigrants come late for their first HIV test. If found to be HIV positive, and if the immune system is already significantly affected, this will compromise the treatment outcome. This study was performed in an attempt to understand the barriers for early HIV testing in a migrant population from Ethiopia and Eritrea in Stockholm, Sweden. Participants were theoretically sampled and consisted of individuals who had immigrated from Ethiopia and Eritrea. Data were collected using 14 focus group discussions and seven semi-structured interviews. The analysis was performed according to a Grounded Theory approach using the paradigm model. Denial and fear of knowing one's HIV status dominated all aspects of behavior in relation to HIV. The main strategy was a "fogging" of the issue of HIV. People were said to not want to know because this would bring social isolation and exclusion, and it was often believed that treatment did not help. This attitude had strong roots in their culture and past experiences that were brought along to the new country and maintained within the immigrant community. The length of time spent in Sweden seemed to be an important factor affecting the "fogging of the HIV issue". In bridging the gap between the two cultures, Swedish authorities need to find ways to meet the needs of both earlier and newly arrived immigrants as well as the second generation of immigrants. This will require adjusting and updating the information that is given to these different sub-groups of Ethiopian and Eritrean immigrants. Appropriate access to healthcare for a diverse population obviously requires more than simply providing the healthcare services.

  19. HIV seroconversion among Baltimore City residents tested at a mobile van programme.

    Science.gov (United States)

    Puryear, Sarah; Burnett, Phyllis; Page, Kathleen R; Muvva, Ravikiran; Chaulk, Patrick; Ghanem, Khalil G; Monroe, Anne

    2017-09-12

    Many individuals with HIV in the USA are unaware of their diagnosis, and therefore cannot be engaged in treatment services, have worse clinical outcomes and are more likely to transmit HIV to others. Mobile van testing may increase HIV testing and diagnosis. Our objective was to characterise risk factors for HIV seroconversion among individuals using mobile van testing. A case cohort study (n=543) was conducted within an HIV surveillance dataset of mobile van testing users with at least two HIV tests between September 2004 and August 2009 in Baltimore, Maryland. A subcohort (n=423) was randomly selected; all additional cases were added from the parent cohort. Cases (n=122 total, two from random subcohort) had documented seroconversion at the follow-up visit. A unique aspect of the analysis was use of Department of Corrections data to document incarceration between the times of initial and subsequent testing. Multivariate Cox proportional hazards models were used to compare HIV transmission risk factors between individuals who seroconverted and those who did not. One hundred and twenty-two HIV seroconversions occurred among 8756 individuals (1.4%), a rate higher than that in Baltimore City Health Department's STD Clinic clients (1%). Increased HIV seroconversion risk was associated with men who have sex with men (MSM) (HR 32.76, 95% CI 5.62 to 191.12), sex with an HIV positive partner (HR 70.2, 95% CI 9.58 to 514.89), and intravenous drug use (IDU) (HR 5.65, 95% CI 2.41 to 13.23). HIV testing is a crucial first step in the HIV care continuum and an important HIV prevention tool. This study confirmed the need to reach high-risk populations (MSM, sex with HIV-positive individuals, individuals with IDU) and to increase comprehensive prevention services so that high-risk individuals stay HIV uninfected. HIV testing in mobile vans may be an effective outreach strategy for identifying infection in certain populations at high risk for HIV. © Article author(s) (or

  20. A prospective controlled trial of routine opt-out HIV testing in a men's jail.

    Directory of Open Access Journals (Sweden)

    Ravi Kavasery

    2009-11-01

    Full Text Available Approximately 10 million Americans enter jails annually. The Centers for Disease Control and Prevention now recommends routine opt-out HIV testing in these settings. The logistics for performing routine opt-out HIV testing within jails, however, remain controversial. The objective of this study was to evaluate the optimal time to routinely HIV test newly incarcerated jail detainees using an opt-out strategy.This prospective, controlled trial of routine opt-out HIV testing was conducted among 298 newly incarcerated male inmates in an urban men's jail in New Haven, Connecticut. 298 sequential entrants to the men's jail over a three week period in March and April 2008 were assigned to be offered routine opt-out HIV testing at one of three points after incarceration: immediate (same day, n = 103, early (next day, n = 98, or delayed (7 days, n = 97. The primary outcome was the proportion of men in each group consenting to testing.Routine opt-out HIV testing was significantly higher for the early (53%: AOR = 2.6; 95% CI = 1.5 to 4.7 and immediate (45%: AOR = 2.3; 95% CI = 1.3 to 4.0 testing groups compared to the delayed (33% testing group. The immediate and early testing groups, however, did not significantly differ (p = 0.67. In multivariate analyses, factors significantly associated with routine opt-out HIV testing were assignment to the 'early' testing group (p = 0.0003 and low (bond > or = $5,000, immigration or federal charges or pre-sentencing > 30 days likelihood of early release (p = 0.04. Two subjects received preliminary positive results and one of them was subsequently confirmed HIV seropositive.In this men's jail where attrition was high, routine opt-out HIV testing was not only feasible, but resulted in the highest rates of HIV testing when performed within 24 hours of incarceration.ClinicalTrials.gov NCT00624247.

  1. Uptake of HIV and syphilis testing of pregnant women and their male partners in a programme for prevention of mother-to-child HIV transmission in Uganda

    OpenAIRE

    Kizito, D; Woodburn, PW; Kesande, B; Ameke, C; Nabulime, J; Muwanga, M; Grosskurth, H; Elliott, AM

    2008-01-01

    Objective To describe uptake of HIV and syphilis testing in a prevention of mother-to-child HIV transmission programme in Uganda. Methods Analysis of data from routine HIV and syphilis testing at Entebbe Hospital antenatal services. Results A total of 20 738 women attended antenatal services. Exactly 62.8% of women, but only 1.8% of their male partners, accepted testing for HIV; 82.2% of women, but only 1.1% of their male partners accepted syphilis testing. Partners of women with positive HIV...

  2. Prevalence of HIV testing and counseling and associated factors among secondary school students in Botswana.

    Science.gov (United States)

    Bodika, Stephane M; Lekone, Phenyo E; Loeto, Peter; Alwano, Mary G; Zulu, Thekiso C; Kim, Evelyn; Machao, Gape; Voetsch, Andrew C

    2016-05-01

    The World Health Organization recommends HIV testing and counseling (HTC) for all adolescents living in countries with generalized HIV epidemics. In Botswana, HIV prevalence among adolescents 15-19 years is 3.7% and among pregnant adolescents is 10%. We describe the proportion and characteristics of secondary school students who have accessed HTC. A multistage sample survey was conducted among students in Botswana's public secondary schools in 2010. The survey was self-administered using a personal digital assistant device. The HTC rate was estimated using self-reported history of HIV testing. Of 1,632 participants, 52% were girls, 43% aged below 16 years, and 27% had ever had sexual intercourse. Most (81%) students knew where to get tested for HIV. Overall, 2.2% of students were HIV positive by self-report. The HTC rate was 23% overall, 34% among students who had ever had sexual intercourse, and 45% among students who had sexual intercourse in the past 12 months. Being pregnant or having made someone pregnant and having had sexual intercourse in the past 12 months were associated with having been tested for HIV among students who had ever had sexual intercourse. Overall, the HTC rate was low, and the self- reported HIV prevalence was high among secondary students in Botswana. Most sexually active students have never been tested for HIV. Health communications efforts for adolescents that increase demand for HTC, routine opt-out HIV testing in healthcare facilities, and school-based HIV testing are needed as part of a national HIV prevention strategy.

  3. HIV testing in US tuberculosis care settings: a survey of current practice and perceived barriers.

    Science.gov (United States)

    Naureckas, Caitlin; Carter, E Jane; Gardner, Adrian

    2015-01-01

    Extent of and challenges to implementation of the Centers for Disease Control and Prevention (CDC) 2006 recommendation for routine HIV testing have not been reviewed specifically within tuberculosis (TB) care settings. To determine current adherence to the CDC's HIV testing recommendations in TB care settings and identify barriers. An online survey was designed and distributed via Survey Monkey. The 2011 National TB Conference attendees, National TB Nurse Controllers, and the CDC's TB-educate mailing list were invited to participate via e-mail. A total of 153 respondents from US states: 30 physicians, 91 nurses, 19 public health practitioners, and 13 other. Perceived importance of HIV testing, current HIV testing practices, perceived barriers to HIV testing, and understanding of state HIV testing laws. One hundred forty-one of 153 (92.2%) reported that patients with TB disease were "always" or "almost always" HIV tested; 65 of 153 (42.5%) reported the same for patients with latent TB infection (LTBI). Among those not routinely testing LTBI patients, "patient refusal of test" (53/88; 60.2%), "cost" (41/88; 46.6%), and "prevalence too low to justify" (33/88; 37.5%) were the most commonly identified barriers to opt-out testing. Forty-seven of 59 providers (79.7%) who reported that their state required written consent for HIV testing had incorrect knowledge regarding HIV testing legislation. Rates of HIV testing are high for patients with TB disease, but fewer than half of providers' care settings routinely test LTBI patients. Knowledge of HIV status is required to appropriately interpret TST results and make decisions regarding treatment in TB infection, since HIV coinfection increases risk of progression to active TB. Lack of HIV testing in LTBI patients represents a missed opportunity to prevent TB disease and its resultant morbidity and mortality. In addition, incorrect knowledge regarding testing legislation was a common problem among our TB providers. Further

  4. Indeterminate rapid HIV-1 test results among antenatal and postnatal mothers.

    Science.gov (United States)

    Matemo, D; Kinuthia, J; John, F; Chung, M; Farquhar, C; John-Stewart, G; Kiarie, J

    2009-11-01

    The sensitivity and specificity of rapid HIV-1 tests may be altered during pregnancy and postpartum. We conducted a study to determine the prevalence and correlates of false-positive Abbott Determine and false-negative Uni-Gold rapid HIV-1 test results among antenatal and postnatal mothers attending a primary care clinic in Nairobi, Kenya. Mothers were tested for HIV-1 using Abbott Determine and non-reactive results were considered HIV-1 antibody negative. Reactive samples by Determine were re-tested by Uni-Gold. Vironostika HIV-1 and Uni-FORM II Enzyme-linked immunosorbent assays were used to confirm samples that had positive Abbott Determine and negative Uni-Gold. Among 2311 women who accepted HIV-1 testing, 1238 (54%) were tested antenatally and 1073 (46%) were tested postnatally. Of tested women, 274 (12%) women were reactive by Abbott Determine and on retesting with Uni-Gold 30 (11%) had indeterminate results. The prevalence of indeterminate results was significantly higher in antenatal women than in postnatal women (2% versus 1%, P = 0.03). In conclusion, indeterminate rapid HIV-1 test results are more common in the antenatal period and appropriate safeguards to confirm HIV-1 infection status should be implemented in antenatal programmes.

  5. Unconsented HIV testing in cases of occupational exposure: ethics, law, and policy.

    Science.gov (United States)

    Cowan, Ethan; Macklin, Ruth

    2012-10-01

    Postexposure prophylaxis (PEP) has substantially reduced the risk of acquiring human immunodeficiency virus (HIV) after an occupational exposure; nevertheless, exposure to HIV remains a concern for emergency department providers. According to published guidelines, PEP should be taken only when source patients are HIV-positive or have risk factors for HIV. Initiating PEP when source patients are uninfected puts exposed persons at risk from taking toxic drugs with no compensating benefit. Forgoing PEP if the source is infected results in increased risk of acquiring HIV. What should be done if source patients refuse HIV testing? Is it justifiable to test the blood of these patients over their autonomous objection? The authors review current law and policy and perform an ethical analysis to determine if laws permitting unconsented testing in cases of occupational exposure can be ethically justified. © 2012 by the Society for Academic Emergency Medicine.

  6. A social work plan to promote HIV testing: A social marketing approach.

    Science.gov (United States)

    Morgan-Siebe, J P

    2017-03-01

    Many people living with human immunodeficiency virus (HIV) do not know that they are infected. It is important for infected persons to get tested for HIV in order to be diagnosed and medically treated. HIV has no known cure, but it can be controlled and sometimes prevented with proper medical care. The social work profession has ideal positioning to be extraordinarily helpful in work that promotes HIV testing, leading to reducing then eliminating new HIV diagnoses. Social marketing interventions, along with audience segmenting are explained. Specific attention is given to two separate subjects-minority health disparities and impulsive and/or sensation seeking sex practices-to showcase the versatility of social marketing in the promotion of HIV testing. Further ideas about how social workers can participate in these interprofessional social marketing campaigns are provided.

  7. Field accuracy of fourth-generation rapid diagnostic tests for acute HIV-1: a systematic review.

    Science.gov (United States)

    Lewis, Joseph M; Macpherson, Peter; Adams, Emily R; Ochodo, Eleanor; Sands, Anita; Taegtmeyer, Miriam

    2015-11-28

    Fourth-generation HIV-1 rapid diagnostic tests (RDTs) detect HIV-1 p24 antigen to screen for acute HIV-1. However, diagnostic accuracy during clinical use may be suboptimal. Clinical sensitivity and specificity of fourth-generation RDTs for acute HIV-1 were collated from field evaluation studies in adults identified by a systematic literature search. Four studies with 17 381 participants from Australia, Swaziland, the United Kingdom and Malawi were identified. All reported 0% sensitivity of the HIV-1 p24 component for acute HIV-1 diagnosis; 26 acute infections were missed. Specificity ranged from 98.3 to 99.9%. Fourth-generation RDTs are currently unsuitable for the detection of acute HIV-1.

  8. [Introduction of a rapid HIV test in Sexually Transmitted Infections Units].

    Science.gov (United States)

    Cuesta, María del Mar; López, María del Carmen; Nieto, Paula; Junquera, María Luisa; Varela, José Antonio; Vázquez, Fernando

    2012-04-01

    The aim of the study was to analyze the implementation of a rapid HIV test in Asturias (Spain). The study was conducted in two STI Units using the Determine® HIV-1/2 test. A total of 1011 people were tested, of whom 65.3% had never been tested for HIV previously, and 71.4% were heterosexual men. Twenty-one tests were confirmed positive by Enzyme Immunoassay/Western Blot (EIA/WB) assay An increase was observed in the diagnosis of HIV. Awareness campaigns and rapid tests could be effective methods for the early diagnosis of HIV. Copyright © 2010 Elsevier España, S.L. All rights reserved.

  9. Risk factors for "late-to-test" HIV diagnosis in Riverside County, California.

    Science.gov (United States)

    Gardner, Aaron T; Napier, Rachaline; Brown, Brandon

    2016-09-01

    Patients diagnosed late in the course of HIV infection are at an increased risk of negative health outcomes and are more likely to transmit HIV to others. Using the CDC's definition for AIDS, we analyzed case report data from persons diagnosed with AIDS within 12 months of an HIV diagnosis ("late-to-test") in Riverside County, CA, between 2009 and 2014. Of 1385 HIV cases, 422 (30.5%) were late-to-test. Factors associated with late-to-test were: having no insurance (P = 0.005), being Hispanic (P = 0.002) and being between 45 and 64 years of age (P test. In the absence of universal HIV testing, interventions to decrease late testing are needed.

  10. Routine HIV Testing of Family Members of Hospitalized Patients in Nigeria

    Directory of Open Access Journals (Sweden)

    Olusegun Busari

    2012-04-01

    Full Text Available Background: HIV testing for family members of HIV-positive patients may enhance disclosure of status of spouses, encourage family social support and improve access to HIV services. Objective was to employ the approach of routine HIV testing to determine the prevalence of HIV among family members of both HIV positive and negative patients on admission in a federal HIV treatment designated hospital in Western Nigeria Methodology: This prospective study was conducted between January 2006 and June 2009. Ethical clearance was obtained from the Research and Ethics committee of the hospital prior to the study. Informed consent was obtained from each participant. HIV testing was offered to consenting family members of HIV positive and negative patients on admission. The family members included spouses, children of patients, parents of paediatric patients and other family members. Analysis was done in frequencies and percentages Results: 162 family members of 184 patients were tested. Spouses were, 81 (50.0%; fathers, 14 (8.6%; mothers, 20 (12.3%; children, 19 (11.7% and others family members, 28 (17.3%. 151 (93.2% of testers were first timers. Majority of those tested (82.1% had post-test counseling. The overall HIV prevalence was 12.3% (20/162. HIV prevalence within different family members was 14.8% (12/81, 20% (4/20, 7.1% (1/14, 10.5% (2/19 and 3.6% (1/28 for spouses, mothers, fathers, children and others respectively.In addition, the prevalence of HIV among family members of HIV positive and negative patients was 15.6% (14/90 and 8.3% (6/72 respectively. Of 12 spouses that were positive, 7 (13.5% were HIV-discordant; and in 71.4% (5/7 of discordant couples, the spouse was positive while the patient on admission was negative. Conclusion: The results indicate that routine HIV testing of family members of patients on admission is a strategy for identification of vast number of HIV infected persons. This method is not only innovative, but also a novel

  11. Reliability of testing and potential impact on HIV prevention in Nigeria.

    Science.gov (United States)

    Odaibo, G N; Donbraye, E; Adewumi, M O; Bakarey, A S; Ibeh, M A; Olaleye, D O

    2006-12-01

    Several factors including variability of human immunodeficiency virus (HIV), laboratory facilities, cost and competence of personnel handling the tests are some of the important factors that affect accuracy and reliability of HIV testing in most parts of Africa. Recently investigators in Africa have observed that antibody detection assays based on antigens derived from HIV-1 subtype B show moderate to significantly lower sensitivity for detection of infection by various non-B subtypes. In this study, we evaluated the reliability of two EIA and 12 rapid HIV-1/2 test kits that are commercially available in Nigeria using the Western immunoblotting technique as reference. A panel of 100 sera from Western blot confirmed symptomatic or asymptomatic HIV-1 infected persons and 90 seronegative patients from those referred for testing in our laboratory were used for this study. Each sample was tested with two HIV-1/2 EIA, and 12 HIV-1/2 rapid test kits commercially available at one time or the other for HIV-1/2 testing in Nigeria. Overall, the sensitivity of the two EIA kits were 100% and 91.0% with specificity of 96.7% and 91.1% respectively. The sensitivity of the rapid test kits ranged from 88% to 98.0% with specificity of 92.2% to 100%. Further analysis showed significant variation in the sensitivity and specificity of the same kit based on whether an individual had asymptomatic or symptomatic infection The results of this study highlight the problem of diagnosis of HIV infections in Africa. It shows that the sensitivity of most of the rapid assays shall not be adequate for detection of early infection. The implications of possible misdiagnosis on the various intervention strategies that rely predominantly on correct HIV status of an individual are enormous. Thus, there is an urgent need for review of the current HIV testing assays or algorithms in Nigeria and other parts of Africa.

  12. Heterogeneous HIV testing preferences in an urban setting in Tanzania: results from a discrete choice experiment.

    Directory of Open Access Journals (Sweden)

    Jan Ostermann

    Full Text Available BACKGROUND: Efforts to reduce Human Immunodeficiency Virus (HIV transmission through treatment rely on HIV testing programs that are acceptable to broad populations. Yet, testing preferences among diverse at-risk populations in Sub-Saharan Africa are poorly understood. We fielded a population-based discrete choice experiment (DCE to evaluate factors that influence HIV-testing preferences in a low-resource setting. METHODS: Using formative work, a pilot study, and pretesting, we developed a DCE survey with five attributes: distance to testing, confidentiality, testing days (weekday vs. weekend, method for obtaining the sample for testing (blood from finger or arm, oral swab, and availability of HIV medications at the testing site. Cluster-randomization and Expanded Programme on Immunization (EPI sampling methodology were used to enroll 486 community members, ages 18-49, in an urban setting in Northern Tanzania. Interviewer-assisted DCEs, presented to participants on iPads, were administered between September 2012 and February 2013. RESULTS: Nearly three of five males (58% and 85% of females had previously tested for HIV; 20% of males and 37% of females had tested within the past year. In gender-specific mixed logit analyses, distance to testing was the most important attribute to respondents, followed by confidentiality and the method for obtaining the sample for the HIV test. Both unconditional assessments of preferences for each attribute and mixed logit analyses of DCE choice patterns suggest significant preference heterogeneity among participants. Preferences differed between males and females, between those who had previously tested for HIV and those who had never tested, and between those who tested in the past year and those who tested more than a year ago. CONCLUSION: The findings suggest potentially significant benefits from tailoring HIV testing interventions to match the preferences of specific populations, including males and females

  13. Clinical color vision testing and correlation with visual function.

    Science.gov (United States)

    Zhao, Jiawei; Davé, Sarita B; Wang, Jiangxia; Subramanian, Prem S

    2015-09-01

    To determine if Hardy-Rand-Rittler (H-R-R) and Ishihara testing are accurate estimates of color vision in subjects with acquired visual dysfunction. Assessment of diagnostic tools. Twenty-two subjects with optic neuropathy (aged 18-65) and 18 control subjects were recruited prospectively from an outpatient clinic. Individuals with visual acuity (VA) color blindness were excluded. All subjects underwent a comprehensive eye examination including VA, color vision, and contrast sensitivity testing. Color vision was assessed using H-R-R and Ishihara plates and Farnsworth D-15 (D-15) discs. D-15 is the accepted standard for detecting and classifying color vision deficits. Contrast sensitivity was measured using Pelli-Robson contrast sensitivity charts. No relationship was found between H-R-R and D-15 scores (P = .477). H-R-R score and contrast sensitivity were positively correlated (P = .003). On multivariate analysis, contrast sensitivity (β = 8.61, P color identification in patients with optic neuropathy. Both H-R-R and Ishihara testing are correlated with contrast sensitivity, and these tests may be useful clinical surrogates for contrast sensitivity testing. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Update to: Application of Bayesian decision-making to laboratory testing for Lyme disease and comparison with testing for HIV

    Directory of Open Access Journals (Sweden)

    Cook MJ

    2017-09-01

    Full Text Available Michael J Cook,1 Basant K Puri21Independent researcher, Highcliffe, UK; 2Department of Medicine, Hammersmith Hospital, Imperial College London, London, UKIn our recent Bayesian analysis paper, false-negative results were compared between Lyme disease and HIV using a recommended test algorithm.1 When the two-tier test methodology for Lyme disease was compared with HIV two-stage testing, false negatives could be more than 500 times higher for Lyme disease testing.

  15. The Pareidolia Test: A Simple Neuropsychological Test Measuring Visual Hallucination-Like Illusions.

    Directory of Open Access Journals (Sweden)

    Yasuyuki Mamiya

    Full Text Available Visual hallucinations are a core clinical feature of dementia with Lewy bodies (DLB, and this symptom is important in the differential diagnosis and prediction of treatment response. The pareidolia test is a tool that evokes visual hallucination-like illusions, and these illusions may be a surrogate marker of visual hallucinations in DLB. We created a simplified version of the pareidolia test and examined its validity and reliability to establish the clinical utility of this test.The pareidolia test was administered to 52 patients with DLB, 52 patients with Alzheimer's disease (AD and 20 healthy controls (HCs. We assessed the test-retest/inter-rater reliability using the intra-class correlation coefficient (ICC and the concurrent validity using the Neuropsychiatric Inventory (NPI hallucinations score as a reference. A receiver operating characteristic (ROC analysis was used to evaluate the sensitivity and specificity of the pareidolia test to differentiate DLB from AD and HCs.The pareidolia test required approximately 15 minutes to administer, exhibited good test-retest/inter-rater reliability (ICC of 0.82, and moderately correlated with the NPI hallucinations score (rs = 0.42. Using an optimal cut-off score set according to the ROC analysis, and the pareidolia test differentiated DLB from AD with a sensitivity of 81% and a specificity of 92%.Our study suggests that the simplified version of the pareidolia test is a valid and reliable surrogate marker of visual hallucinations in DLB.

  16. HIV Rapid Testing in Substance Abuse Treatment: Implementation Following a Clinical Trial

    Science.gov (United States)

    Haynes, L. F.; Korte, J. E.; Holmes, B. E.; Gooden, L.; Matheson, T.; Feaster, D. J.; Leff, J. A.; Wilson, L.; Metsch, L. R.; Schackman, B. R.

    2011-01-01

    The Substance Abuse Mental Health Services Administration has promoted HIV testing and counseling as an evidence-based practice. Nevertheless, adoption of HIV testing in substance abuse treatment programs has been slow. This article describes the experience of a substance abuse treatment agency where, following participation in a clinical trial,…

  17. Why might clinicians in Malawi not offer HIV testing to their patients ...

    African Journals Online (AJOL)

    In order to identify reasons clinicians in Malawi might not offer HIV testing to patients, a cross-sectional descriptive postal census with telephone and fax follow-up was conducted. Proportions were calculated for each reason given for not offering HIV testing. Multiple logistic regression was used to determine whether ...

  18. How Patient Interactions with a Computer-Based Video Intervention Affect Decisions to Test for HIV

    Science.gov (United States)

    Aronson, Ian David; Rajan, Sonali; Marsch, Lisa A.; Bania, Theodore C.

    2014-01-01

    The current study examines predictors of HIV test acceptance among emergency department patients who received an educational video intervention designed to increase HIV testing. A total of 202 patients in the main treatment areas of a high-volume, urban hospital emergency department used inexpensive netbook computers to watch brief educational…

  19. "It Is Not Easy": Challenges for Provider-Initiated HIV Testing and Counseling in Flanders, Belgium

    Science.gov (United States)

    Manirankunda, Lazare; Loos, Jasna; Debackaere, Pieterjan; Nostlinger, Christiana

    2012-01-01

    This study identified physicians' HIV testing practices and their barriers toward implementing provider-initiated HIV testing and counseling (PITC) for Sub-Saharan African migrants (SAM) in Flanders, Belgium. In-depth interviews were conducted on a purposive sample of 20 physicians (ten GPs and ten internists). GPs performed mainly…

  20. HIV testing in community based research: a case study of female ...

    African Journals Online (AJOL)

    HIV testing is a major issue of concern in developing countries. This paper aims at documenting field experiences in regard to testing for HIV in a community- based research. Detailed protocol was followed and participation in the study was on voluntary basis. Focus group discussions were held in study community.

  1. High-Risk Behaviors among Youth and Their Reasons for Not Getting Tested for HIV

    Science.gov (United States)

    Moyer, Matthew B.; Silvestre, Anthony J.; Lombardi, Emilia L.; Taylor, Christopher A.

    2007-01-01

    Concerned about reports of a 15% decline in HIV testing among high-risk youth in an earlier study in Pittsburgh, this study was initiated to explore reasons why young people are not getting tested for HIV, while gathering data on their respective level of risk taking behaviors. A total of 580 surveys were collected from youth aged between 14 and…

  2. The quality of rapid HIV testing in South Africa: an assessment of ...

    African Journals Online (AJOL)

    Abstract. Background: The aim of this study was to assess the quality of rapid HIV testing in South Africa. Method: A two-stage sampling procedure was used to select HCT sites in eight provinces of South Africa. The study employed both semi-structured interviews with HIV testers and observation of testing sessions as a ...

  3. The quality of rapid HIV testing in South Africa: an assessment of ...

    African Journals Online (AJOL)

    Background: The aim of this study was to assess the quality of rapid HIV testing in South Africa. Method: A two-stage sampling procedure was used to select HCT sites in eight provinces of South Africa. The study employed both semi-structured interviews with HIV testers and observation of testing sessions as a means of ...

  4. Total control: a critical analysis of mandatory HIV testing in U.S. prisons.

    Science.gov (United States)

    Gagnon, Marilou; Jacob, Jean Daniel; Cormier, Luc

    2013-01-01

    The aim of this paper is to explore the relationship between mandatory HIV testing and the institutional management of inmates in U.S. prisons. Mandatory HIV testing has been largely overlooked by the nursing community even though it has important human rights and ethical implications. Drawing on the work of Goffman (1990) on the inner workings of total institutions, the present article critically examines the deployment of mandatory HIV testing in U.S. prisons. To set the stage, we define mandatory HIV testing and describe the methods of HIV testing currently used in U.S. prison settings. Then, we provide a brief overview of the concept of total institution and the mortification process. Finally, we expand on the relationship between mandatory HIV testing and much larger institutional objectives of total control, total structuring, total isolation, and separation of inmates from society (as summarized by Farrington, 1992). And lastly, we provide a brief discussion on the implications of mandatory HIV testing (as a method of HIV testing) from a nursing perspective.

  5. Response to “Rapid tests for HIV type discrimination in West Africa may perform differently”

    National Research Council Canada - National Science Library

    Tchounga, Boris K; Ekouevi, Didier K; Eholie, Serge P

    2015-01-01

    ... of each test used for the initial discrimination of HIV‐positive patients. Our team previously conducted in 2004 a field evaluation of rapid HIV serologic tests in Côte d'Ivoire and highlighted the lower accuracy of Genie II for differentiating between HIV‐1, HIV‐2 and dually reactive patients [ 4 ]. In our most recent study, the initial HIV diag...

  6. Rapid HIV Testing and Counselling in Labour in a Northern Nigeria ...

    African Journals Online (AJOL)

    Between April and August 2004, all pregnant women in labour at JUTH, were offered rapid HIV testing and counseling with opportunity to decline testing. HIV positive women were offered the standard nevirapine mono-therapy prophylaxis regimen (HIVNET 012). Four hundred and thirty (99.8%) of the 431 pregnant women ...

  7. Women and HIV

    Science.gov (United States)

    ... Consumer Information by Audience For Women Women and HIV: Get the Facts on HIV Testing, Prevention, and Treatment Share Tweet Linkedin Pin ... How can you lower your chance of HIV? HIV Quick Facts What is HIV? HIV is the ...

  8. Discordance of voluntary HIV testing with HIV sexual risk-taking and self-perceived HIV infection risk among social media-using black, Hispanic, and white young-men-who-have-sex-with-men (YMSM).

    Science.gov (United States)

    Alexovitz, Kelsey A; Merchant, Roland C; Clark, Melissa A; Liu, Tao; Rosenberger, Joshua G; Bauermeister, Jose; Mayer, Kenneth H

    2018-01-01

    Discordance between self-perceived HIV risk and actual risk-taking may impede efforts to promote HIV testing among young adult men-who-have-sex-with-men (YMSM) in the United States (US). Understanding the extent of, and reasons for, the discordance of HIV risk self-perception, HIV risk-taking and voluntary HIV testing among black, Hispanic and white YMSM could aid in the development of interventions to increase HIV testing among this higher HIV risk population. HIV-uninfected 18-24-year-old black, Hispanic, and white YMSM were recruited from across the US through multiple social media websites. Participants were queried about their voluntary HIV testing history, perception of currently having an undiagnosed HIV infection, and condomless anal intercourse (CAI) history. We assessed the association between previous CAI and self-perceived possibility of currently having an HIV infection by HIV testing status using Cochran-Mantel-Haenszel testing. Of 2275 black, Hispanic and white social media-using 18-24 year-old YMSM, 21% had never been tested for HIV voluntarily, 87% ever had CAI with another man, 77% believed that it was perhaps possible (as opposed to not possible at all) they currently could have an undiagnosed HIV infection, and 3% who reported CAI with casual or exchange partners, but had not been tested for HIV, self-perceived having no possibility of being HIV infected. Of 471 YMSM who had not been HIV tested, 57% reported CAI with casual or exchange partners, yet self-perceived having no possibility of being HIV infected. Per the Cochran-Mantel-Haenszel test results, among those reporting HIV risk behaviors, the self-perception of possibly being HIV-infected was not greater among those who had never been tested for HIV, as compared to those who had been tested. Future interventions should emphasize promoting self-realization of HIV risk and translating that into seeking and accepting voluntary HIV testing among this higher HIV risk population.

  9. HIV self-testing could "revolutionize testing in South Africa, but it has got to be done properly": perceptions of key stakeholders.

    Science.gov (United States)

    Makusha, Tawanda; Knight, Lucia; Taegtmeyer, Miriam; Tulloch, Olivia; Davids, Adlai; Lim, Jeanette; Peck, Roger; van Rooyen, Heidi

    2015-01-01

    South Africa bears the world's largest burden of HIV with over 6.4 million people living with the virus. The South African government's response to HIV has yielded remarkable results in recent years; over 13 million South Africans tested in a 2012 campaign and over 2 million people are on antiretroviral treatment. However, with an HIV & AIDS and STI National Strategic Plan aiming to get 80 percent of the population to know their HIV status by 2016, activists and public health policy makers argue that non-invasive HIV self-testing should be incorporated into the country HIV Counseling and Testing [HCT] portfolios. In-depth qualitative interviews (N = 12) with key stakeholders were conducted from June to July 2013 in South Africa. These included two government officials, four non-governmental stakeholders, two donors, three academic researchers, and one international stakeholder. All stakeholders were involved in HIV prevention and treatment and influenced HCT policy and research in South Africa and beyond. The interviews explored: interest in HIV self-testing; potential distribution channels for HIV self-tests to target groups; perception of requirements for diagnostic technologies that would be most amenable to HIV self-testing and opinions on barriers and opportunities for HIV-linkage to care after receiving positive test results. While there is currently no HIV self-testing policy in South Africa, and several barriers exist, participants in the study expressed enthusiasm and willingness for scale-up and urgent need for further research, planning, establishment of HIV Self-testing policy and programming to complement existing facility-based and community-based HIV testing systems. Introduction of HIV self-testing could have far-reaching positive effects on holistic HIV testing uptake, giving people autonomy to decide which approach they want to use for HIV testing, early diagnosis, treatment and care for HIV particularly among hard-to reach groups, including men.

  10. HIV self-testing could "revolutionize testing in South Africa, but it has got to be done properly": perceptions of key stakeholders.

    Directory of Open Access Journals (Sweden)

    Tawanda Makusha

    Full Text Available South Africa bears the world's largest burden of HIV with over 6.4 million people living with the virus. The South African government's response to HIV has yielded remarkable results in recent years; over 13 million South Africans tested in a 2012 campaign and over 2 million people are on antiretroviral treatment. However, with an HIV & AIDS and STI National Strategic Plan aiming to get 80 percent of the population to know their HIV status by 2016, activists and public health policy makers argue that non-invasive HIV self-testing should be incorporated into the country HIV Counseling and Testing [HCT] portfolios. In-depth qualitative interviews (N = 12 with key stakeholders were conducted from June to July 2013 in South Africa. These included two government officials, four non-governmental stakeholders, two donors, three academic researchers, and one international stakeholder. All stakeholders were involved in HIV prevention and treatment and influenced HCT policy and research in South Africa and beyond. The interviews explored: interest in HIV self-testing; potential distribution channels for HIV self-tests to target groups; perception of requirements for diagnostic technologies that would be most amenable to HIV self-testing and opinions on barriers and opportunities for HIV-linkage to care after receiving positive test results. While there is currently no HIV self-testing policy in South Africa, and several barriers exist, participants in the study expressed enthusiasm and willingness for scale-up and urgent need for further research, planning, establishment of HIV Self-testing policy and programming to complement existing facility-based and community-based HIV testing systems. Introduction of HIV self-testing could have far-reaching positive effects on holistic HIV testing uptake, giving people autonomy to decide which approach they want to use for HIV testing, early diagnosis, treatment and care for HIV particularly among hard-to reach

  11. Trial and error: evaluating and refining a community model of HIV testing in Australia.

    Science.gov (United States)

    Ryan, Kathleen E; Pedrana, Alisa; Leitinger, David; Wilkinson, Anna L; Locke, Peter; Hellard, Margaret E; Stoové, Mark

    2017-10-10

    The 2012 regulatory approval of HIV rapid point of care (RPOC) tests in Australia and a national strategic focus on HIV testing provided a catalyst for implementation of non-clinical HIV testing service models. PRONTO! opened in 2013 as a two-year trial delivering peer-led community-based HIV RPOC tests targeting gay, bisexual and other men who have sex with men (GBM), with the aim of increasing HIV testing frequency. Initial data suggested this aim was not achieved and, as part of a broader service evaluation, we sought to explore client acceptability and barriers to testing at PRONTO! to refine the service model. We present descriptive and thematic analyses of data from two in-depth evaluation surveys and four focus groups with PRONTO! clients focused on service acceptability, client testing history, intentions to test and barriers to testing for HIV and other sexually transmitted infections (STIs). The three novel aspects of the PRONTO! model, testing environment, rapid-testing, peer-staff, were reported to be highly acceptable among survey and focus group participants. Focus group discussions revealed that the PRONTO! model reduced anxiety associated with HIV testing and created a comfortable environment conducive to discussing sexual risk and health. However, an absence of STI testing at PRONTO!, driven by restrictions on medical subsidies for STI testing and limited funds available at the service level created a barrier to HIV testing. An overwhelming majority of PRONTO! clients reported usually testing for STIs alongside HIV and most reported plans to seek STI testing after testing for HIV at PRONTO!. When deciding where, when and what to test for, clients reported balancing convenience and relative risk and consequences for each infection as guiding their decision-making. A community-based and peer-led HIV testing model reduced previously reported barriers to HIV testing, while introducing new barriers. The absence of STI testing at PRONTO! and the need to

  12. [Evaluation of an immunochromatographic fourth generation test for the rapid diagnosis of acute HIV infection].

    Science.gov (United States)

    Kawahata, Takuya; Nagashima, Mami; Sadamasu, Kenji; Kojima, Yoko; Mori, Haruyo

    2013-07-01

    The early diagnosis of human immunodeficiency virus (HIV) infection is important to provide effective antiviral treatment and to prevent transmission of HIV. One of the key issues to achieve this goal is to shorten the so-called "diagnostic window period" when the humoral immune response toward the virus is not fully developed during the acute phase of HIV-1 infection. In 2008, the Espline HIV Ag/Ab test kit (E4G, Fujirebio Inc. Japan) was marketed in Japan belonging to the fourth generation of HIV test kits characterized by its ability to detect both viral antigens (Ag) and anti-HIV-1/2 antibodies (Ab). E4G is the first and only fourth generation immunochromatographic HIV test kit approved in Japan at present. To evaluate its performance to diagnose acute HIV infection (AHI), E4G was compared with fourth generation Ag/Ab ELISA test kits, a third generation PA test kit, WB and real-time PCR for the testing of 25 AHI clinical specimens. E4G detected HIV infection in 18/25 specimens (sensitivity : 72.0%), of which the viral Ag was detected in only 2 specimens (8.0%) bearing a viral load > 10 million copies/mL. No spesimens were simultaneously reactive to both Ag and Ab against HIV. The third generation PA achieved a positive score of 17/ 25 specimens (68.0%), which was almost the same as the E4G figure. In contrast the fourth generation Ag/ Ab ELISA scored all the 25 AHI specimens positive (sensitivity : 100%). Overall, although having the merit of offering a rapid diagnostic test for HIV infection, E4G does not provide a sensitivity in AHI diagnosis superior to test kits currently available.

  13. Household HIV Testing Uptake among Contacts of TB Patients in South Africa.

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    Kavindhran Velen

    Full Text Available In high HIV prevalence settings, offering HIV testing may be a reasonable part of contact tracing of index tuberculosis (TB patients. We evaluated the uptake of HIV counselling and testing (HCT among household contacts of index TB patients and the proportion of newly diagnosed HIV-infected persons linked into care as part of a household TB contact tracing study.We recruited index TB patients at public health clinics in two South African provinces to obtain consent for household contact tracing. During scheduled household visits we offered TB symptom screening to all household members and HCT to individuals ≥14years of age. Factors associated with HCT uptake were investigated using a random effects logistic regression model.Out of 1,887 listed household members ≥14 years old, 984 (52% were available during a household visit and offered HCT of which 108 (11% self-reported being HIV infected and did not undergo HCT. Of the remaining 876, a total of 304 agreed to HCT (35%; 26 (8.6% were newly diagnosed as HIV positive. In multivariable analysis, factors associated with uptake of HCT were prior testing (odds ratio 1.6; 95% confidence interval [CI]: 1.1-2.3 and another member in the household testing (odds ratio 2.4; 95% CI: 1.7-3.4. Within 3 months of testing HIV-positive, 35% reported initiating HIV care.HCT as a component of household TB contact tracing reached individuals without prior HIV testing, however uptake of HIV testing was poor. Strategies to improve HIV testing in household contacts should be evaluated.

  14. Contraceptive Use and Uptake of HIV-Testing among Sub-Saharan African Women.

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    Katherine E Center

    Full Text Available Despite improved availability of simple, relatively inexpensive, and highly effective antiretroviral treatment for HIV/AIDS, the disease remains a major public health challenge for women in sub-Saharan Africa (SSA. Given the numerous barriers in access to care for women in this region, every health issue that brings them into contact with the health system should be optimized as an opportunity to integrate HIV/AIDS prevention. Because most non-condom forms of modern contraception require a clinical appointment for use, contraception appointments could provide a confidential opportunity for access to HIV counseling, testing, and referral to care. This study sought to investigate the relationship between contraceptive methods and HIV testing among women in SSA. Data from the Demographic and Health Survey from four African countries-Congo, Mozambique, Nigeria, and Uganda-was used to examine whether modern (e.g., pills, condom or traditional (e.g., periodic abstinence, withdrawal forms of contraception were associated with uptake of HIV testing. Data for the current analyses were restricted to 35,748 women with complete information on the variables of interest. Chi-square tests and logistic regression models were used to assess the relationship between uptake of HIV testing and respondents' baseline characteristics and contraceptive methods. In the total sample and in Mozambique, women who used modern forms of contraception were more likely to be tested for HIV compared to those who did not use contraception. This positive association was not demonstrated in Congo, Nigeria, or Uganda. That many women who access modern contraception are not tested for HIV in high HIV burden areas highlights a missed opportunity to deliver an important intervention to promote maternal and child health. Given the increasing popularity of hormonal contraception methods in low-income countries, there is an urgent need to integrate HIV counseling, testing, and treatment

  15. Optimal HIV testing and earlier care: the way forward in Europe

    DEFF Research Database (Denmark)

    Coenen, T; Lundgren, J; Lazarus, Jeff

    2008-01-01

    representing advocacy, clinical and policy areas of the HIV field, was convened in an effort to gain a common understanding on the role of HIV testing and counselling in optimizing diagnosis and the need for earlier care. Key topics discussed at the conference and described in the following articles include...... in Europe and an outline of an indicator disease-guided approach to HIV testing proposed by a committee of experts from the European AIDS Clinical Society (EACS). We hope that consideration of the issues discussed in this supplement will help to shift the HIV field closer towards our ultimate goal...

  16. Clinic-based routine voluntary HIV testing in a refugee settlement in Uganda.

    Science.gov (United States)

    OʼLaughlin, Kelli N; Kasozi, Julius; Walensky, Rochelle P; Parker, Robert A; Faustin, Zikama M; Doraiswamy, Sathyanarayanan; Owino, Chris Omara; Bassett, Ingrid V

    2014-12-01

    We implemented and evaluated a clinic-based routine voluntary HIV testing intervention in Nakivale Refugee Settlement in Uganda. Comparing the standard of care period (40 d) with the intervention period (168 d), the mean HIV-infected clients identified per week increased from 0.9 to 5.6, and there was no significant difference between the HIV prevalence in the 2 periods (standard of care: 3.3%; intervention: 4.5%; P > 0.5). Clinic-based routine HIV testing in a refugee settlement is effective and should be considered for implementation in refugee settlements in other high-prevalence regions in sub-Saharan Africa.

  17. Clinic-based routine voluntary HIV testing in a refugee settlement in Uganda

    OpenAIRE

    O’Laughlin, Kelli N.; Kasozi, Julius; Walensky, Rochelle P.; Parker, Robert A.; Faustin, Zikama M.; Doraiswamy, Sathyanarayanan; Owino, Chris Omara; Bassett, Ingrid V.

    2014-01-01

    We implemented and evaluated a clinic-based routine voluntary HIV testing intervention in Nakivale Refugee Settlement in Uganda. Comparing the SOC period (40 days) to the Intervention period (168 days), the mean HIV-infected clients identified per week increased from 0.9 to 5.6, and there was no significant difference between the HIV prevalence in the two periods (standard of care: 3.3%, intervention: 4.5%; p > 0.5). Clinic-based routine HIV testing in a refugee settlement is effective and sh...

  18. High HIV Prevalence among Asylum Seekers Who Gave Birth in the Netherlands: A Nationwide Study Based on Antenatal HIV Tests.

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    Simone Goosen

    Full Text Available Asylum seekers are considered to be a particularly vulnerable group with respect to HIV. Data on the HIV prevalence among asylum seekers, however, are scarce. The aim of this study is to map the HIV prevalence among asylum seekers who gave birth in The Netherlands.We used a nationwide electronic medical records database from the community health services for asylum seekers (MOA. The study population consisted of 4,854 women and girls who delivered in asylum reception between 2000 and 2008. A unique electronic health data base was used and case allocation was based on ICPC-codes.The number of women and girls that was HIV positive during their last pregnancy was 80, of which 79 originated from sub-Saharan Africa. The prevalence for women from this region of origin (3.4% was high compared to women from all other regions of origin (0.04%; OR = 90.2; 95%CI 12.5-648.8. The highest HIV prevalence rates were found for women from Rwanda (17.0% and Cameroon (13.2%. HIV prevalence rates were higher among women who arrived in reception without partner (OR = 1.82; 95%CI 0.75-4.44 and unaccompanied minors (OR = 2.59; 95%CI 0.79-8.49, compared to women who arrived in reception with partner.We conclude that, among asylum-seeking women from sub-Saharan Africa giving birth in The Netherlands, the HIV prevalence is high compared to the host population. For women from other regions of origin, the prevalence is at the same level as in the host population. The high HIV prevalence underlines the importance of preventive interventions and voluntary HIV testing for sub-Saharan African asylum seekers as from shortly after arrival.

  19. Performance evaluation of the point-of-care INSTI™ HIV-1/2 antibody test in early and established HIV infections.

    Science.gov (United States)

    Adams, Sarah; Luo, Wei; Wesolowski, Laura; Cohen, Stephanie E; Peters, Philip J; Owen, S Michele; Masciotra, Silvina

    2017-06-01

    The flow-through INSTI™ HIV-1/HIV-2 Rapid Antibody (INSTI) test is a 60s FDA-approved test for HIV-1 and HIV-2 antibody testing using whole blood and plasma. We evaluated the performance of INSTI using plasma and simulated whole blood specimens. INSTI's performance in plasma specimens from commercial seroconversion panels was assessed by estimating the relative sensitivity using a 50% cumulative frequency analysis and by comparing its performance with other FDA-approved rapid tests (RTs). INSTI was further evaluated using 320 HIV-1 plasma specimens collected during a cross-sectional study and with 107 HIV-1 and 24 HIV-2 simulated whole blood specimens. Sensitivity and specificity were calculated using 615 known HIV-1 group M/O and 80 HIV-2 (Western blot (WB)-positive), and 497 HIV-negative plasma specimens, respectively. In HIV-1 seroconversion panels, INSTI became reactive 9days before a positive WB. When compared to FDA-approved antibody-based lateral flow RTs, INSTI detected significantly more early infections. Among HIV-1-infected cross-sectional plasma samples, INSTI detected 23 (27%) of 85 Architect-positive/Multispot-negative or indeterminate specimens. For plasma specimens, the sensitivity was 99.84% for HIV-1 and 100% for HIV-2, and the specificity was 99.80%. Using simulated whole blood from seroconverters, INSTI performed similarly to plasma. INSTI performed significantly better than antibody-based lateral flow RTs during early stages of seroconversion. Sensitivity and specificity were within the manufacturer's reported ranges. Considering the observed test performance and the almost immediate results, INSTI is an accurate option to detect HIV-1/HIV-2 antibodies in point-of-care settings where lab testing is not feasible. Published by Elsevier B.V.

  20. A clinical test of dynamic visual acuity for children.

    Science.gov (United States)

    Rine, Rose Marie; Braswell, Jennifer

    2003-11-01

    Children with sensorineural hearing impairment (SNHI) and concomitant vestibular hypofunction demonstrate deficits in gaze stability that may affect reading. The objective of this study was to develop a reliable, valid clinical test of dynamic visual acuity (DVA) for children. Seventy-six typically developing children, 26 adults and 11 children with sensorineural hearing impairment participated. Visual acuity was tested under three conditions: (1) head stable (static acuity), (2) head tipped forward 30 degrees and passively rotated 30 degrees in the yaw plane at 2 Hz (horizontal dynamic acuity) and (3) head passively moved in the pitch plane 30 degrees at 2 Hz (vertical dynamic acuity, vDVA). The difference, in number of chart lines, between static dynamic acuity was calculated (dynamic acuity score). Based on normative data collected, results were scored as: (1) pass or =2S.D. from normative mean. Children were grouped by age to enable examination of the effect of age on scores. We found excellent test-retest and inter-tester reliability (ICC(2,2)=0.94 and ICC(3,2)=0.84) for the horizontal dynamic acuity (hDVA) test. Sensitivity, specificity, positive and negative predictive values were 100% to identify children with bilateral vestibular hypofunction (BVH). Although a statistical difference was found, the difference was not clinically significant (all achieved DVA scores <2 lines). The vertical dynamic acuity test was not tolerated by most children, precluding its usefulness. The clinical test of horizontal dynamic acuity is a reliable test for children as young as 3 years. It is simple and inexpensive, and will enable identification of those for whom more extensive testing is warranted.

  1. Feasibility and effectiveness of two community-based HIV testing models in rural Swaziland.

    Science.gov (United States)

    Parker, Lucy Anne; Jobanputra, Kiran; Rusike, Lorraine; Mazibuko, Sikhathele; Okello, Velephi; Kerschberger, Bernhard; Jouquet, Guillaume; Cyr, Joanne; Teck, Roger

    2015-07-01

    To evaluate the feasibility (population reached, costs) and effectiveness (positivity rates, linkage to care) of two strategies of community-based HIV testing and counselling (HTC) in rural Swaziland. Strategies used were mobile HTC (MHTC) and home-based HTC (HBHTC). Information on age, sex, previous testing and HIV results was obtained from routine HTC records. A consecutive series of individuals testing HIV-positive were followed up for 6 months from the test date to assess linkage to care. A total of 9 060 people were tested: 2 034 through MHTC and 7 026 through HBHTC. A higher proportion of children and adolescents (<20 years) were tested through HBHTC than MHTC (57% vs. 17%; P < 0.001). MHTC reached a higher proportion of adult men than HBHTC (42% vs. 39%; P = 0.015). Of 398 HIV-positive individuals, only 135 (34%) were enrolled in HIV care within 6 months. Of 42 individuals eligible for antiretroviral therapy, 22 (52%) started treatment within 6 months. Linkage to care was lowest among people who had tested previously and those aged 20-40 years. HBHTC was 50% cheaper (US$11 per person tested; $797 per individual enrolled in HIV care) than MHTC ($24 and $1698, respectively). In this high HIV prevalence setting, a community-based testing programme achieved high uptake of testing and appears to be an effective and affordable way to encourage large numbers of people to learn their HIV status (particularly underserved populations such as men and young people). However, for community HTC to impact mortality and incidence, strategies need to be implemented to ensure people testing HIV-positive in the community are linked to HIV care. © 2015 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  2. Routine prenatal HIV testing: women's concerns and their strategies for addressing concerns.

    Science.gov (United States)

    Rothpletz-Puglia, Pamela; Storm, Deborah; Burr, Carolyn; Samuels, Deanne

    2012-02-01

    The purpose of this exploratory study was to solicit women's opinions about the process of routine prenatal HIV testing to identify strategies for routine testing that will address women's concerns, increase their level of comfort with testing, and support universal prenatal HIV testing. A convenience sample of English-speaking women between 18 and 45 years of age who were HIV-negative or of unknown HIV status were recruited for focus groups at four diverse community sites in four states. Focus group discussion questions addressed health care provider approaches and actions that would make a woman feel more comfortable with the process of routine prenatal HIV testing. Twenty-five women agreed to participate; most women (64%) were of Black, non-Hispanic race/ethnicity; 44% were 25-34 years of age. Thematic analysis of women's concerns about routine prenatal HIV testing fell into the following categories: fear, protecting the baby, protecting the woman, confidentiality, and stigma. Women's strategies for addressing these concerns were related to themes of education and information, normalizing HIV testing, patient-provider relationships, systems, and private communication. Participants offered numerous insightful and practical suggestions for addressing their concerns thereby supporting universal routine prenatal HIV testing. The themes that arose in this study support the conclusion that women will be more comfortable with routine prenatal HIV testing if they are fully informed and knowledgeable about the rationale for HIV testing during pregnancy and their right to decline, and if testing is carried out in a confidential and supportive health care environment.

  3. Evaluation of simple rapid HIV assays and development of national rapid HIV test algorithms in Dar es Salaam, Tanzania

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    Mbwana Judica

    2009-02-01

    Full Text Available Abstract Background Suitable algorithms based on a combination of two or more simple rapid HIV assays have been shown to have a diagnostic accuracy comparable to double enzyme-linked immunosorbent assay (ELISA or double ELISA with Western Blot strategies. The aims of this study were to evaluate the performance of five simple rapid HIV assays using whole blood samples from HIV-infected patients, pregnant women, voluntary counseling and testing attendees and blood donors, and to formulate an alternative confirmatory strategy based on rapid HIV testing algorithms suitable for use in Tanzania. Methods Five rapid HIV assays: Determine™ HIV-1/2 (Inverness Medical, SD Bioline HIV 1/2 3.0 (Standard Diagnostics Inc., First Response HIV Card 1–2.0 (PMC Medical India Pvt Ltd, HIV1/2 Stat-Pak Dipstick (Chembio Diagnostic System, Inc and Uni-Gold™ HIV-1/2 (Trinity Biotech were evaluated between June and September 2006 using 1433 whole blood samples from hospital patients, pregnant women, voluntary counseling and testing attendees and blood donors. All samples that were reactive on all or any of the five rapid assays and 10% of non-reactive samples were tested on a confirmatory Inno-Lia HIV I/II immunoblot assay (Immunogenetics. Results Three hundred and ninety samples were confirmed HIV-1 antibody positive, while 1043 were HIV negative. The sensitivity at initial testing of Determine, SD Bioline and Uni-Gold™ was 100% (95% CI; 99.1–100 while First Response and Stat-Pak had sensitivity of 99.5% (95% CI; 98.2–99.9 and 97.7% (95% CI; 95.7–98.9, respectively, which increased to 100% (95% CI; 99.1–100 on repeat testing. The initial specificity of the Uni-Gold™ assay was 100% (95% CI; 99.6–100 while specificities were 99.6% (95% CI; 99–99.9, 99.4% (95% CI; 98.8–99.7, 99.6% (95% CI; 99–99.9 and 99.8% (95% CI; 99.3–99.9 for Determine, SD Bioline, First Response and Stat-Pak assays, respectively. There was no any sample which was

  4. Achieving high acceptability of HIV testing in a population-based survey among immigrants in Finland.

    Science.gov (United States)

    Tiittala, Paula J; Kivelä, Pia S; Ristola, Matti A; Surcel, Heljä-Marja; Koponen, Päivikki M S; Mölsä, Mulki; Ollgren, Jukka; Liitsola, Kirsi

    2015-06-01

    The aim of this study was to assess the acceptability of human immunodeficiency virus (HIV) testing among migrants in Finland and the factors contributing to non-acceptance. The Finnish Migrant Health and Wellbeing Study 'Maamu' was the first national population-based Health Interview and Examination Survey (HIS/HES) among migrants in Finland. A total of 386 Kurdish, Russian and Somali immigrants in Helsinki participated in the study. Despite the participants' different sociodemographic backgrounds, a high rate of test acceptability (92%, 95% CI 90-95) was achieved. HIV test acceptance was associated with pretest counselling, ability to understand spoken Finnish or Swedish and employment status. No participants tested positive for HIV. The results imply that a universal HIV testing strategy is well accepted in a low-HIV prevalence immigrant population and can be included in a general health examination in immigrant population-based surveys. © 2015 the Nordic Societies of Public Health.

  5. What role can gender-transformative programming for men play in increasing men's HIV testing and engagement in HIV care and treatment in South Africa?

    Science.gov (United States)

    Fleming, Paul J; Colvin, Chris; Peacock, Dean; Dworkin, Shari L

    2016-11-01

    Men are less likely than women to test for HIV and engage in HIV care and treatment. We conducted in-depth interviews with men participating in One Man Can (OMC) - a rights-based gender equality and health programme intervention conducted in rural Limpopo and Eastern Cape, South Africa - to explore masculinity-related barriers to HIV testing/care/treatment and how participation in OMC impacted on these. Men who participated in OMC reported an increased capability to overcome masculinity-related barriers to testing/care/treatment. They also reported increased ability to express vulnerability and discuss HIV openly with others, which led to greater willingness to be tested for HIV and receive HIV care and treatment for those who were living with HIV. Interventions that challenge masculine norms and promote gender equality (i.e. gender-transformative interventions) represent a promising new approach to address men's barriers to testing, care and treatment.

  6. HIV Testing in Non-Injection Drug Users: Prevalence and Associated Factors.

    Science.gov (United States)

    Alves Guimarães, Rafael; Lucchese, Roselma; Lara Fernandes, Inaina; Vera, Ivânia; Goulart Rodovalho, Aurélio; Alves Guimarães, Vanessa; Cristina Silva, Graciele; Lopes de Felipe, Rodrigo; Alexandre de Castro, Paulo; Martins Ferreira, Priscilla

    2017-05-24

    The objective of this study was to estimate the prevalence of and identify factors associated with lifetime testing for the human immunodeficiency virus (HIV) in non-injection drug users (NIDU). A cross-sectional study was conducted with 323 individuals in clinics for chemical dependency in the state of Goiás in the Central-West region of Brazil. Logistic regression analysis was used to identify factors associated with lifetime HIV testing. Testing for HIV was associated with age, female gender, crack use, history of sexually transmitted infections, acquaintance with people living with HIV/AIDS and/or who had died from AIDS, and history of having received some instruction on HIV/AIDS prevention methods. It was found that only 26.6% reported having access to the HIV rapid test. We concluded determinants for HIV testing must be taken into account when planning prevention and programming strategies. These include the widening of testing coverage among NIDU, educational health actions, establishment of links between sexually transmitted infection prevention services and addiction treatment services, and the use of rapid tests to help people who are in contact with the virus learn about their HIV status, enter treatment, and improve their quality of life.

  7. Brazilian Program For HIV Point-Of-Care Test Evaluation: A Decade’s Experience

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    Orlando da Costa Ferreira Jr.

    2017-11-01

    Full Text Available The point-of-care tests (POCTs for HIV diagnosis have been widely used in Brazil in order to expand and to allow HIV diagnosis outside health units including remote areas, such as the Amazon region. In order to guarantee the quality of HIV diagnostics based on rapid tests, the Brazilian Ministry of Health (MoH implemented the HIV POCT Evaluation Program. This study compiles the Brazilian experience acquired over the last 13 years conducting the HIV POCT Evaluation Program.   Methods and Findings The selection of tests was based on the interest of manufacturers to qualify for the MoH tenders. Each round was performed with fresh whole blood and oral fluid samples, always including HIV positive and negative ones. In addition to the POCT, every sample was submitted to a reference testing protocol, based on an immunoassay followed by Western blot. The POCTs were evaluated for clinical sensitivity, clinical specificity, assay operational characteristics, detection of HIV-2 antibodies, sensitivity to subtypes panels; and sensitivity to seroconversion panels. Since its implementation in 2003, the POCT evaluation protocol has undergone some modifications aiming to improve and simplify the evaluation process, to know: (i  for HIV-positive samples, perform EIA and Western blot only if the POCT is non-reactive; (ii reduction from 800 to 600 HIV negative samples; (iii increase from one to three subtype panels (including HIV-2 samples; and (iv inclusion of seroconversion panel. We evaluated six tests, four of which met the sensitivity criteria of 99.5%: BD Chek™ HIV Multi-test (whole blood, HIV 1/2 Colloidal Gold (whole blood, OraQuick ADVANCE® Rapid HIV-1/2 Antibody Test (whole blood and oral fluid and TR DPP HIV-1/2 (whole blood, plasma and oral fluid. Regarding other evaluated criteria, all assays met the requirements.   Conclusions The successful Brazilian policy on POCT use for HIV infection diagnosis includes the evaluation of the POCT itself in

  8. Blood Donor Test-Seeking Motivation and Prior HIV Testing Experiences in São Paulo, Brazil.

    Science.gov (United States)

    Truong, Hong-Ha M; Blatyta, Paula F; Santos, Fernanda M; Montebello, Sandra; Esposti, Sandra P D; Hangai, Fatima N; Salles, Nanci Alves; Mendrone, Alfredo; Sabino, Ester C; McFarland, Willi; Gonçalez, Thelma T

    2015-09-01

    HIV test-seeking behavior among blood donors has been observed worldwide and may pose a threat to the safety of the blood supply. We evaluated current test-seeking motivations and prior alternative HIV testing experiences among blood donors in São Paulo, Brazil. All candidate or potential blood donors were consecutively approached and recruited to participate in the study upon presentation at Fundação Pró-Sangue Hemocentro, the largest blood bank in Brazil. Participants were recruited betw