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📃Scientific paper: Determinants of HIV voluntary counseling and testing: a multilevel modelling of the Ethiopian Demographic and Health Survey Abstract: BACKGROUND: Human immunodeficiency virus (HIV) counseling and testing services are vital to reduce the spread of HIV infection, and to create an opportunity for early treatment and reduction of HIV/AIDS-related mortality. However, only 12 sub-Saharan African (SSA) countries reached the first 90% target (90% of people living with HIV to know their status). Hence, this study aimed to investigate the determinants of HIV counseling and testing among reproductive-age women in Ethiopia. METHODS: Ethiopian Demographic and Health Survey (EDHS 2016) data was used to identify the determinants of HIV counseling and testing among reproductive-age women in Ethiopia. A weighted sample of 14,599 reproductive age women was included in the study. A multilevel binary logistic regression model was fitted to identify the determinants of HIV counseling and testing. The odds’ ratio with a 95% Confidence Interval (CI) and the corresponding P-value ≤ 0.05 was employed to declare the statistically significant variables. RESULTS: In this study, both individual and community-level variables were significantly associated with Voluntary Counseling and Testing (VCT) uptake among women. Women aged 25–34 years (Adjusted Odds Ratio (AOR) 2.29, 95% CI 2.05, 2.56), aged ≥ 35 years (AOR 1.55, 95% CI 1.38, 1.75), attending primary education (AOR 1.68, 95% CI 1.51, 1.88), secondary education (AOR 3.07, 95% CI 2.64, 3.58), and higher education (AOR 5.15, 95% CI 4.17, 6.36), women with medium household we... Discover the rest of the scientific article on es/iode ➡️https://etcse.fr/Cwob

📃Scientific paper: Barriers and facilitators of access to HIV prevention, care, and treatment services among people living with HIV in Kerman, Iran: a qualitative study Abstract: Background Low access to HIV prevention, care, and treatment services among people living with HIV (PLWH) is a barrier to the control of the epidemic worldwide. The present study aimed to assess the barriers and facilitators to HIV services among PLWH in Kerman, Iran. Methods In this qualitative study, a convenience sample of 25 PLWH who had received HIV prevention, treatment, or care services, and six PLWH who had not yet received services were recruited between August-October 2020. Data were collected using a semi-structured, face-to-face interview. Data were examined by inductive content analysis using MAXQDA 10 software. Results Nine categories of facilitators and 11 categories of barriers to HIV services were identified. Facilitating factors included: maintaining health status, feeling scared, trust in the health system, how they were treated by service providers, provision of suitable hours by the service provider center, changing attitudes towards HIV in society, acceptance of the disease by the patient's family, hope for the future and feeling the need for consulting services. Barriers included financial problems, side effects and belief in efficacy, distance and transportation problems, fear of being recognized, stigma towards PLWH, organization of services, improper treatment by service providers, unsuitable hours by the service provider center, lack of trust in the health system, lack of family support, and inadequate or low-quality service. Conclusion Ma... Discover the rest of the scientific article on es/iode ➡️https://etcse.fr/jXYs

📃Scientific paper: Assessing behavioral economic biases among young adults who have increased likelihood of acquiring HIV: a mixed methods study in Baltimore, Maryland Abstract: Background Behavioral economic (BE) biases have been studied in the context of numerous health conditions, yet are understudied in the field of HIV prevention. This aim of this study was to quantify the prevalence of four common BE biases—present bias, information salience, overoptimism, and loss aversion—relating to condom use and HIV testing in economically-vulnerable young adults who had increased likelihood of acquiring HIV. We also qualitatively examined participants’ perceptions of these biases. Methods 43 participants were enrolled in the study. Data were collected via interviews using a quantitative survey instrument embedded with qualitative questions to characterize responses. Interviews were transcribed and analyzed using descriptive statistics and deductive-inductive content analyses. Results 56% of participants were present-biased, disproportionately discounting future rewards for smaller immediate rewards. 51% stated they were more likely to spend than save given financial need. Present-bias relating to condom use was lower with 28% reporting they would engage in condomless sex rather than wait one day to access condoms. Most participants (72%) were willing to wait for condom-supported sex given the risk. Only 35% knew someone living with HIV, but 67% knew someone who had taken an HIV test, and 74% said they often think about preventing HIV (e.g., high salience). Yet, 47% reported optimistically planning for condom use, HIV discussions with partners... Discover the rest of the scientific article on es/iode ➡️https://etcse.fr/xMG

The HIV Prevention Trials Network (HPTN) 083 study is a significant trial within the field of HIV prevention, marking a pivotal shift towards long-acting pre-exposure prophylaxis (PrEP) options. This randomized controlled trial compared the efficacy and safety of long-acting injectable cabotegravir (CAB-LA) administered every eight weeks against daily oral tenofovir disoproxil fumarate-emtricitabine (TDF-FTC) in preventing HIV among cisgender men and transgender women who have sex with men. Conducted across multiple global sites including the United States, Latin America, Asia, and Africa, the study enrolled approximately 4,570 participants. DTHF is proud to have been part of enrolling and managing a South African cohort. Key findings revealed that CAB-LA significantly reduced the incidence of HIV compared to TDF-FTC, with a 66% reduction in HIV infections in the CAB arm. This demonstrated not only the high efficacy of CAB-LA but also highlighted its potential as a more convenient and equally effective alternative to daily oral pills, potentially enhancing adherence and preference among users. The positive outcomes of the HPTN 083 study have the potential to transform HIV prevention strategies by providing an effective and long-acting PrEP option that aligns better with some users' lifestyles and preferences. This advancement is particularly significant in the ongoing effort to reduce new HIV infections globally and could lead to broader implementation of injectable PrEP options in future HIV prevention programs. For more detailed information about the study and its implications, you can visit the HIV Prevention Trials Network's official pages: https://giveprepashot.org/ #hptn083 #HIVprevention #CABLA #longactinginjectables #PrEP #collaboration

📃Scientific paper: Implementation of Client-Centered Care Coordination for HIV Prevention with Black Men Who Have Sex with Men: Activities, Personnel Costs, and Outcomes—HPTN 073 Abstract: Background Black men who have sex with men (MSM) experience disproportionate rates of HIV infection in the USA, despite being no more likely to engage in sexual risk behaviors than other MSM racial/ethnic groups. HIV pre-exposure prophylaxis (PrEP) has been shown to reduce risk of HIV acquisition; however, rates of PrEP use among Black MSM remain low. Clinical, psychosocial, and structural factors have been shown to impact PrEP use and adherence among Black MSM. Care coordination of HIV prevention services has the potential to improve PrEP use and adherence for Black MSM, as it has been shown to improve HIV-related care outcomes among people living with HIV. Methods Client-centered care coordination (C4) is a multi-level intervention designed to address clinical, psychosocial, and structural barriers to HIV prevention services for Black MSM within HPTN 073, a PrEP demonstration project among Black MSM in three cities in the USA. The current study examined the implementation process of C4, specifically investigating the activities, cost, time, and outcomes associated with the C4 intervention. Results On average, participants engaged in five care coordination encounters. The vast majority of care coordination activities were conducted by counselors, averaging 30 min per encounter. The cost of care coordination was relatively low with a mean cost of $8.70 per client encounter. Conclusion Although client-centered care coordination was initially implemented in well-reso... Discover the rest of the scientific article on es/iode ➡️https://etcse.fr/r5bD

Globally, significant progress has been made in HIV prevention and care. In the past three decades, having access to antiretroviral therapy (ART) has prevented about 21 million deaths caused by HIV and AIDS. However, more still needs to be done among adolescents and young people (AYP) because they carry the highest burden of the disease. Biological, socioeconomic, and cultural factors are some of the contributing factors to this discrepancy.  Although AYP are more affected by HIV and AIDS, they are less likely to have an HIV test, to have a timely link to HIV care, and to remain in care compared to older adults. Comprehensive, high-quality, and integrated HIV prevention services are necessary to lower HIV transmission among AYP. In this article, we discuss barriers and strategies to improve HIV testing services, linkage to HIV care and treatment, retention in HIV care and viral suppression, other support services such as psychosocial support, financial assistance, legal services, and HIV prevention services among AYP. AYP may fail to access these services due to several reasons that can be divided into individual, provider, health system, and contextual-level factors.  Strategies that can be used to improve the uptake of HIV services among AYP should be tailored to their needs and priorities. Tafadzwa. A Dzinamarira, PhD, Leaders of Africa https://lnkd.in/d9aDqpNj

📃Scientific paper: Barriers to and facilitators of accessing HIV services for street-involved youth in Canada and Kenya Abstract: Introduction UNICEF estimates that there are as many as 100 million street-involved youth (SIY) globally. Marginalized conditions put SIY at higher risk of HIV and adverse outcomes once HIV-positive. The objective of this analysis was to describe barriers and facilitators of accessing HIV prevention, testing, and treatment services as Phase I of an implementation study evaluating the use of peer navigators to increase access to HIV services. Methods Semi-structured interviews, focus group discussions (FGD), and theatre testing were conducted with individuals who identify as SIY, health care providers, and community stakeholders living in Canada (Toronto, Montreal, London) and Kenya (Eldoret, Huruma, Kitale). Data were analyzed using a directed content approach, guided by the socio-ecological model (SEM). Results Across the six sites were 195 participants: 64 SIY, 42 healthcare providers, and 97 community-based stakeholders. Barriers were identified at the societal (e.g. intersectional stigma and discrimination), public policy (e.g., inadequate access to basic needs, legal documentation, lack of health insurance, and limited community-based funding), institutional (e.g. lack of inclusive education and training, inadequate HIV educational outreach, and restrictive service provision), interpersonal (e.g., ineffective communication from healthcare providers), and intrapersonal levels (e.g. lack of trust and associated fear, low perception for healthcare, and lack of self-... Discover the rest of the scientific article on es/iode ➡️https://etcse.fr/iV2

For us to attain sustainable epidemic control by 2030, it is essential people living with HIV are at the centre of the response. In these recently released survey results, we can hear the voices of over 4,500 people living with diagnosed HIV.