HIV Awareness

𝐅𝐃𝐀-𝐀𝐏𝐏𝐑𝐎𝐕𝐄𝐃 𝐑𝐀𝐏𝐈𝐃 𝐇𝐈𝐕 𝐀𝐍𝐓𝐈𝐁𝐎𝐃𝐘 𝐒𝐂𝐑𝐄𝐄𝐍𝐈𝐍𝐆 𝐓𝐄𝐒𝐓𝐒

Rapid tests are often referred to as point-of-care tests because rather than sending a blood sample to a laboratory, the test can be conducted and the result read in a doctor’s office or a community setting, without specialized laboratory equipment.

Most rapid tests detect HIV antibodies. They are not part of HIV itself but are produced by the human body in response to HIV infection. In the weeks after exposure to HIV, the immune system recognizes some components of the virus and begins to generate HIV antibodies in order to damage, neutralize or kill it (this period is known as ‘seroconversion’). These antibodies persist for life.

Key advantages of rapid testing are:
• lower test cost and ease of use;
• test accuracy;
• posttest counseling on the day of
testing;
• more rapid referral to medical treatment for those testing positive;
• and potential for those who test positive to change behaviors that might expose others to HIV.

Confirmation of a positive rapid test result is accomplished by administering another rapid test, preferably a different brand than that of the first rapid test. All FDA-approved rapid tests have been found to be highly sensitive and specific. The reported high specificity of rapid tests means that, if a rapid test is positive, the patient is most likely infected with HIV.

The accuracy of point-of-care tests is 𝗻𝗼𝘁 𝗮𝗹𝘄𝗮𝘆𝘀 𝗲𝗾𝘂𝗮𝗹 to those of laboratory tests, especially in relation to recent infection. This is for two main reasons:

𝙒𝙝𝙖𝙩 𝙩𝙝𝙚 𝙩𝙚𝙨𝙩 𝙡𝙤𝙤𝙠𝙨 𝙛𝙤𝙧. While one antibody/antigen test is available, the other tests look for antibodies only. Moreover, some can only detect immunoglobulin G (IgG) antibodies, but not immunoglobulin M (IgM) antibodies, which appear sooner.

𝙏𝙝𝙚 𝙨𝙖𝙢𝙥𝙡𝙚 𝙩𝙖𝙠𝙚𝙣. Point-of-care tests are usually performed on whole blood taken from a fingerprick. This has a lower concentration of antibodies and p24 than plasma. Samples of oral fluid have a concentration of antibodies that is lower still. (Plasma is the colorless fluid part of blood, separated from whole blood using laboratory equipment. Fingerprick blood is produced by pricking the finger with a lancet, whereas oral fluid is obtained by swabbing the gums.)


𝘙𝘦𝘧𝘦𝘳𝘦𝘯𝘤𝘦𝘴:
Durham, J. and Lashley, F. (2010). 𝘛𝘩𝘦 𝘗𝘦𝘳𝘴𝘰𝘯 𝘸𝘪𝘵𝘩 𝘏𝘐𝘝/𝘈𝘐𝘋𝘚: 𝘕𝘶𝘳𝘴𝘪𝘯𝘨 𝘗𝘦𝘳𝘴𝘱𝘦𝘤𝘵𝘪𝘷𝘦𝘴 𝘍𝘰𝘶𝘳𝘵𝘩 𝘌𝘥𝘪𝘵𝘪𝘰𝘯. Springer Publishing Company, LLC
Pebody R. (2019).𝘏𝘰𝘸 𝘢𝘤𝘤𝘶𝘳𝘢𝘵𝘦 𝘢𝘳𝘦 𝘳𝘢𝘱𝘪𝘥, 𝘱𝘰𝘪𝘯𝘵-𝘰𝘧-𝘤𝘢𝘳𝘦 𝘵𝘦𝘴𝘵𝘴 𝘧𝘰𝘳 𝘏𝘐𝘝?. namaidsmap HIV & AIDS - sharing knowledge, changing lives. Retrieved July 28, 2021 from https://www.aidsmap.com/about-hiv/how-accurate-are-rapid-point-care-tests-hiv

𝗠𝗬𝗧𝗛 𝗔𝗡𝗗 𝗙𝗔𝗖𝗧 𝗢𝗙 𝗧𝗛𝗘 𝗗𝗔𝗬!

𝗠𝗬𝗧𝗛

I don't need to worry about getting HIV. Drugs will keep me well.

𝗙𝗔𝗖𝗧

There's no cure for HIV. And drug-resistant strains of HIV can make treatment harder.

Antiretroviral drugs (ART) improve the lives of many people who have HIV and help them live longer. But many of these drugs are expensive and have serious side effects. There's no cure for HIV. And drug-resistant strains of HIV can make treatment harder.

Prevention is cheaper and easier than managing a lifelong condition and the problems it brings.

𝑺𝒐𝒖𝒓𝒄𝒆:

WebMD. (2007, February 1). Common Myths About HIV and AIDS. https://www.webmd.com/hiv-aids/top-10-myths-misconceptions-about-hiv-aids

𝐇𝐨𝐰 𝐃𝐨𝐞𝐬 𝐇𝐈𝐕 𝐀𝐟𝐟𝐞𝐜𝐭 𝐖𝐨𝐦𝐞𝐧 𝐃𝐢𝐟𝐟𝐞𝐫𝐞𝐧𝐭𝐥𝐲?

HIV may cause some health problems that are unique to women, such as:

- Gynecological health issues
- Increased risk of cervical cancer
- Increased risk of heart disease
- HIV medicine side effects and drug interactions
- Aging-related issues
- Pregnancy and birth control also require careful management with a health care provider.

The good news is that women who take HIV medicine (called 𝗮𝗻𝘁𝗶𝗿𝗲𝘁𝗿𝗼𝘃𝗶𝗿𝗮𝗹 𝘁𝗵𝗲𝗿𝗮𝗽𝘆 𝗼𝗿 𝗔𝗥𝗧) daily as prescribed and get and keep an undetectable viral load can stay healthy and have effectively no risk of transmitting HIV to an HIV-negative partner through s*x.

𝐁𝐢𝐫𝐭𝐡 𝐂𝐨𝐧𝐭𝐫𝐨𝐥 𝐚𝐧𝐝 𝐇𝐈𝐕
Women with HIV can safely use any form of birth control to prevent pregnancy. But some HIV medicines can interact with hormonal birth control, including the shot, pills, or implants. This can raise the risk for pregnancy. Talk to your health care provider about which form of birth control is right for you.

𝐏𝐫𝐞𝐠𝐧𝐚𝐧𝐜𝐲 𝐚𝐧𝐝 𝐇𝐈𝐕
Women with HIV can have healthy pregnancies. But some may need to switch HIV medications. Talk with your provider if you are thinking of planning a pregnancy, including about how to prevent transmission if your partner is HIV-negative.

In addition, women with HIV can pass the virus to their baby during pregnancy, childbirth, or breastfeeding. The good news is that there are ways to lower the risk of passing HIV to your unborn baby to 1% or less.

Source:
HIV and Women’s Health Issues. (2021, April 8). HIV.Gov. https://www.hiv.gov/hiv-basics/staying-in-hiv-care/other-related-health-issues/womens-health-issues

𝗠𝗬𝗧𝗛 𝗔𝗡𝗗 𝗙𝗔𝗖𝗧 𝗢𝗙 𝗧𝗛𝗘 𝗗𝗔𝗬!

𝗠𝗬𝗧𝗛

I could tell if my partner was HIV-positive.

𝗙𝗔𝗖𝗧

The only way for you or your partner to know if you're positive is to get tested.

You can have HIV without any symptoms for years. The only way for you or your partner to know if you're positive is to get tested. The long period of asymptomatic infection is why the CDC recommends that everyone between 18 and 64 be tested at least once as part of routine blood work.

𝑺𝒐𝒖𝒓𝒄𝒆:

WebMD. (2007, February 1). Common Myths About HIV and AIDS. https://www.webmd.com/hiv-aids/top-10-myths-misconceptions-about-hiv-aids

𝐁𝐮𝐫𝐝𝐞𝐧 𝐨𝐟 𝐥𝐢𝐯𝐢𝐧𝐠 𝐰𝐢𝐭𝐡 𝐇𝐈𝐕 𝐚𝐦𝐨𝐧𝐠 𝐦𝐞𝐧 𝐰𝐡𝐨 𝐡𝐚𝐯𝐞 𝐬𝐞𝐱 𝐰𝐢𝐭𝐡 𝐦𝐞𝐧: 𝐚 𝐦𝐢𝐱𝐞𝐝-𝐦𝐞𝐭𝐡𝐨𝐝𝐬 𝐬𝐭𝐮𝐝𝐲

𝐀𝐛𝐬𝐭𝐫𝐚𝐜𝐭

𝐈𝐧𝐭𝐫𝐨𝐝𝐮𝐜𝐭𝐢𝐨𝐧:
In many parts of the world, HIV infection is currently seen as a manageable, chronic condition rather than a fatal disease.1 Several studies have investigated the experienced burden of HIV infection as a chronic illness.2–7 However, when most of these studies were done, antiretroviral therapy (ART) was initiated later after diagnosis and had more side-effects than currently used regimens. In the past decade, changes in the clinical management of HIV (eg, immediate ART initiation, less toxic ART regimens), undetectable=untransmittable (U=U) perceptions, and the introduction of HIV pre-exposure prophylaxis (PrEP) have probably changed the experienced burden of living with HIV. Yet, few studies have objectified the burden in this contemporary context. The personally experienced burden of a chronic illness goes further than the clinical manifestation of a disease. It incorporates stigma, social discourse, and changes in interpersonal interactions and intimate relationships, and it has an impact on various other aspects of daily life.

𝗠𝗲𝘁𝗵𝗼𝗱𝘀:
In this mixed-methods study, in-depth interviews on HIV-related burden with MSM diagnosed with HIV between 2014 and 2018. Interviewees were recruited at three HIV treatment centres and the Public Health Service of Amsterdam in the Netherlands. Using the transcripts from all interviewees, the qualitative analysis was done by two independent researchers applying an open-coding process. Results were used to generate a questionnaire measuring HIV-related burden, which was distributed via gay dating apps or sites and social media. MSM diagnosed with HIV before 2019 who completed the questionnaire were included in the quantitative analyses. Descriptive analyses were used to report burden prevalence and to explore differences in burden among MSM diagnosed at different antiretroviral therapy periods. Sociodemographic determinants of burden were explored using multinomial logistic regression.

𝐃𝐢𝐬𝐜𝐮𝐬𝐬𝐢𝐨𝐧:
In this mixed-methods study, we describe and quantify the present-day burden of living with HIV among MSM in the context of easy access to highly effective and tolerable ART, U=U, and growing availability of PrEP. Whereas two-thirds of participants experienced low or no burden of living with HIV, one-third perceived their infection as burdensome. Our findings point towards two chronological types of burden: the first emerging shortly after diagnosis but subsiding over time and the second emerging later in time and tending to persist.

𝐑𝐞𝐬𝐮𝐥𝐭𝐬:
Findings highlight that despite medical advancements, further stigma reduction programmes and adapted psychosocial support for specific profiles of MSM living with HIV are needed. The interviewees revealed that aspects related to medicalization and emotional consequences were burdensome temporarily after diagnosis, whereas aspects related to HIV status disclosure, stigma, and the s*xual and social life were mentioned to be burdensome more persistently.

𝗖𝗼𝗻𝗰𝗹𝘂𝘀𝗶𝗼𝗻:
To conclude, in high-resource settings where MSM with HIV are faring well in the treatment cascade, HIV-related burden manifests itself primarily in ongoing social and interpersonal difficulties. Our findings serve as a reminder of the implications that HIV still has for many individuals over the course of their life, especially for those diagnosed in the well-tolerated ART period and those isolated from peers with HIV. These results highlight the importance of continuing stigma reduction programmes and adapting psychosocial guidance and counselling to the present realities of living with HIV as a chronic illness.

Keywords: 𝘏𝘐𝘝, 𝘵𝘩𝘦 𝘣𝘶𝘳𝘥𝘦𝘯 𝘰𝘧 𝘭𝘪𝘷𝘪𝘯𝘨 𝘸𝘪𝘵𝘩 𝘏𝘐𝘝, 𝘮𝘪𝘹𝘦𝘥-𝘮𝘦𝘵𝘩𝘰𝘥𝘴 𝘴𝘵𝘶𝘥𝘺, 𝘏𝘐𝘝 𝘴𝘵𝘢𝘵𝘶𝘴 𝘥𝘪𝘴𝘤𝘭𝘰𝘴𝘶𝘳𝘦, 𝘴𝘦𝘹𝘶𝘢𝘭 𝘢𝘯𝘥 𝘴𝘰𝘤𝘪𝘢𝘭 𝘭𝘪𝘧𝘦, 𝘢𝘯𝘵𝘪𝘳𝘦𝘵𝘳𝘰𝘷𝘪𝘳𝘢𝘭 𝘵𝘩𝘦𝘳𝘢𝘱𝘺

Reference:
Bilsen, W et al., (2020). 𝘉𝘶𝘳𝘥𝘦𝘯 𝘰𝘧 𝘭𝘪𝘷𝘪𝘯𝘨 𝘸𝘪𝘵𝘩 𝘏𝘐𝘝 𝘢𝘮𝘰𝘯𝘨 𝘮𝘦𝘯 𝘸𝘩𝘰 𝘩𝘢𝘷𝘦 𝘴𝘦𝘹 𝘸𝘪𝘵𝘩 𝘮𝘦𝘯: 𝘢 𝘮𝘪𝘹𝘦𝘥-𝘮𝘦𝘵𝘩𝘰𝘥𝘴 𝘴𝘵𝘶𝘥𝘺. ScienceDirect. Retrieved from July 16, 2021 https://www.sciencedirect.com/science/article/abs/pii/S2352301820301971

EDUCATION: AN ANTIDOTE FOR THE SPREAD OF HIV/AIDS

ABSTRACT
AIDS has become the greatest pandemic ever, and indications are that it will continue to increase. There is no universally accepted curative drug for the treatment of the epidemic. This report describes an attempt at providing education as a preventive method for the spread of the deadly disease. It is also an attempt to rise to this challenge by a systematic analysis of appropriate theories.

DISCUSSION

I. Theories

•The Chimpanzee Theory
HIV is a part of family of viruses called the lent\nviruses. Lent viruses other than HIV have been found in a wide range of human primates. These other lent viruses are known collectively as simian (monkey) immunodeficiency viruses (SIV); a subscript character is used to denote their species of origin (Fritzen, 2000). Certain SIVs bear a very close resemblance to the two types of HIV: HIV-1 and HIV-2. The finding "strongly supports" the hypothesis that HIV came from a simian virus, Ho says.

•Polio Vaccine Theory
Dennis Hooper postulates that humans in the early testing of a polio vaccine in Africa in the 1950s accidentally brought on AIDS. Hooper's theory has not been proven to have scientific merit, but the time and place of the earliest cases of AIDS and the testing of the vaccine do occur do nearly inaccordionally from 1957 to 1960. If Hooper is correct, the simian ancestor of HIV grew in the batches of vaccine used in the experimental trial. When the oral vaccine was administered to humans, the virus would have passed through a sore and entered the bloodstream, evolving into HIV-1.

•The Pathogenitical Transfer Theory
One theory is that polio vaccines played a role in the transfer of HIV, but this was disapproved. Another theory contends that HIV was transmitted iatrogenically, or via medical experiments. The first known case of HIV infection was in 1959 from a plasma sample taken in what is now the Democratic Republic of the Congo.

•The 1930 Theory
In 2000, a study suggested that the first case of HIV infection occurred around 1930 in West Africa. The study was carried out by Dr. Bette Korba of Los Alamos National\n\n Laboratory in New Mexico. It is not known when the emergence of HIV in humans took place. But what is clear is that sometime in the middle of 20th century, HIV infection in humans developed into AIDS. Some researchers, led by Korba, worked out that this probably happened between 1915 and 1941. The most likely year was 1931. “The possibilities are that it was transmitted from apes to human beings near the turn of the century and remained isolated in a small population until that time, or that the virus jumped to humans in about 1930 and started spreading immediately or some years later”

•Conspiracy Theory
A conspiracy theory says that HIV/AIDS was a weapon developed by someone's germ warfare experiments and released accidentally or deliberately. The key technical issue is whether anyone knew enough to have created the AIDS virus. Almost all the evidence supAdesoji A. Oni/ / Education: An Antidote for HIVAIDS 43 concerns only the possibility that germ warfare may have happened, not whether it actually did.

II. Factors Involved in the Spread of HIV/AIDS

•Morality
A lack of clear moral standards evidently promotes the spread of the disease. This analysis appears to be confirmed by the conduct of young people between the ages of 12 and 17 who had engaged in s*xual in*******se.

•Sexually Transmitted Disease
Research results have shown that cases of s*xually transmitted disease are more common among adolescents or youth and that there is a high tendency that people who suffer one s*xually transmitted disease are likely to be prone to HIV/AIDS.

•Poverty
Many countries are battling poverty, and this creates a climate favorable to the spread of AIDS. Large communities have no electricity and no access to clean drinking water, roads are inadequate or nonexistent, many residents suffer from malnutrition, and medical facilities are minimal. All these are contributory facts to the spread of the disease.

•Ignorance
A large number of those infected with HIV are unaware of it. Many do not want to be tested because of the stigma attached to the disease. “People with, or suspected of having, HIV may be turned away from health care services, denied housing and employment, shunned by their friends and colleagues, turned down for insurance coverage, or refused entry into foreign countries”

•Culture
Cultural beliefs often reflect ignorance and denial about AIDS. For example, the illness may be blamed on witchcraft, and help may be sought from witch doctors.

III. HIV as an issue
Sociologists have seen HIV/AIDS as an issue that needs to be handled sociologically. The major causes of AIDS are prostitution, multiple s*x partners, and r**e. Social responses to HIV depend less on scientific certainties than on the social construction of the syndrome. In a study, 77% of respondents ascribed HIV or AIDS to social issues.

IV. Education as an Antidote to HIV/AIDS
HIV/AIDS is very common among a vulnerable group (adolescents) across the world today. Education can be a means to stop the spread of the disease. Without education, there is no society. Education is a socially significant institution of society and HIV/AIDS as a social issue could be brought into education with the aim of bringing about a change in behavior within the society. Education can be a means to stop the spread of the disease. Schools should serve as channels for educating adolescents about HIV/AIDs. Teachers should be trained to expose HIV-AIDS knowledge to students, and some of the students should be peer educators.

CONCLUSION
The report ultimately presented education as a durable solution to the spread of the epidemic, and stressing that HIV/AIDS awareness, education, and prevention among the vulnerable groups (adolescents) should be reinvigorated. HIV/AIDS debate is over as an academic exercise and as a practical matter. Education should be intensified to avert spread of the virus in the community. With the foregoing, it is evident that curtailing the HIV epidemic poses enormous challenges for behavioral sciences research and nursing practice in the development of effective HIV prevention models. The complex psychological, social, cultural, and biological determinants of s*x also create unusual challenges for HIV primary prevention. HIV prevention efforts through education and nursing practice are likely to be the most successful.

Reference: https://sci-hub.se/https://doi.org/10.1016/j.jana.2005.01.003

𝐂𝐨𝐦𝐩𝐚𝐫𝐢𝐬𝐨𝐧 𝐨𝐟 𝐨𝐮𝐭𝐜𝐨𝐦𝐞𝐬 𝐢𝐧 𝐇𝐈𝐕-𝐩𝐨𝐬𝐢𝐭𝐢𝐯𝐞 𝐚𝐧𝐝 𝐇𝐈𝐕-𝐧𝐞𝐠𝐚𝐭𝐢𝐯𝐞 𝐩𝐚𝐭𝐢𝐞𝐧𝐭𝐬 𝐰𝐢𝐭𝐡 𝐂𝐎𝐕𝐈𝐃-𝟏𝟗

Abstract

𝗕𝗮𝗰𝗸𝗴𝗿𝗼𝘂𝗻𝗱:
South Africa has the highest prevalence of HIV in the world and to date has recorded the highest number of cases of COVID-19 in Africa. There is uncertainty as to what the significance of this dual infection is, and whether people living with HIV (PLWH) have worse outcomes compared to HIV-negative patients with COVID-19. This study compared the outcomes of COVID-19 in a group of HIV-positive and HIV-negative patients admitted to a tertiary referral centre in Johannesburg, South Africa.
𝗠𝗲𝘁𝗵𝗼𝗱𝘀:
Data was collected on all adult patients with known HIV status and COVID-19, confirmed by reverse-transcriptase polymerase chain reaction (RT-PCR), admitted to the medical wards and intensive care unit (ICU) between 6 March and 11 September 2020. The data included demographics, co-morbidities, laboratory results, severity of illness scores, complications and mortality, and comparisons were made between the HIV-positive and HIV negative groups.
𝗥𝗲𝘀𝘂𝗹𝘁𝘀:
Three-hundred and eighty-four patients, 108 HIV-positive and 276 HIV-negative, were included in the study. Median 4C score was significantly higher in the HIV-positive patients compared to the HIV-negative patients, but there was no significant difference in mortality between the HIV-positive and HIV-negative groups (15% vs 20%, p = 0.31). In addition, HIV-positive patients who died were younger than their HIV-negative counterparts, but this was not statistically significant (47.5 vs 57 years, p = 0.06).
𝗖𝗼𝗻𝗰𝗹𝘂𝘀𝗶𝗼𝗻:
Our findings suggest that HIV is not a risk factor for moderate or severe COVID-19 disease neither is it a risk factor for mortality. However, HIV-positive patients with COVID-19 requiring admission to hospital are more likely to be younger than their HIV-negative counterparts. These findings need to be confirmed in future, prospective, studies

𝘒𝘦𝘺 𝘞𝘰𝘳𝘥𝘴: 𝘏𝘐𝘝𝘊𝘖𝘝𝘐𝘋-19𝘔𝘰𝘳𝘵𝘢𝘭𝘪𝘵𝘺𝘚𝘰𝘶𝘵𝘩 𝘈𝘧𝘳𝘪𝘤𝘢
𝘙𝘦𝘧𝘦𝘳𝘦𝘯𝘤𝘦:
Venturas et al. (2021). Comparison of outcomes in HIV-positive and HIV-negative patients with COVID-19. Journal of Infection. Retrieved from: https://www.sciencedirect.com/science/article/abs/pii/S0163445321002620

𝗧𝗵𝗲 𝗖𝗵𝗮𝗻𝗴𝗶𝗻𝗴 𝗺𝗼𝗹𝗲𝗰𝘂𝗹𝗮𝗿 𝗲𝗽𝗶𝗱𝗲𝗺𝗶𝗼𝗹𝗼𝗴𝘆 𝗼𝗳 𝗛𝗜𝗩 𝗶𝗻 𝘁𝗵𝗲 𝗣𝗵𝗶𝗹𝗶𝗽𝗽𝗶𝗻𝗲𝘀

𝗔𝗯𝘀𝘁𝗿𝗮𝗰𝘁

𝗕𝗮𝗰𝗸𝗴𝗿𝗼𝘂𝗻𝗱
The Philippines has one of the fastest-growing HIV epidemics in the world. Possible reasons for this include increased testing, increased local transmission, and possibly more aggressive strains of HIV. This study sought to determine whether local molecular subtypes of HIV have changed.

𝗠𝗲𝘁𝗵𝗼𝗱𝘀
Viruses from 81 newly diagnosed, treatment-naive HIV patients were genotyped using protease and reverse transcriptase genes. Demographic characteristics and CD4 count data were collected.

𝗥𝗲𝘀𝘂𝗹𝘁𝘀
The cohort had an average age of 29 years (range 19–51 years), CD4+ count of 255 cells/mm3 (range 2–744 cells/mm3), and self-reported acquisition time of 2.42 years (range 0.17–8.17 years). All were male, including 79 men who have s*x with men (MSM). The genotype distribution was 77% CRF01_AE, 22% B, and 1% C. Previous data from 1985–2000 showed that most Philippine HIV infections were caused by subtype B (71%, n = 100), followed by subtype CRF01_AE (20%). Comparison with the present cohort showed a significant shift in subtype (p < 0.0001). Comparison between CRF01_AE and B showed a lower CD4+ count (230 vs. 350 cells/mm3, p = 0.03). Survival data showed highly significant survival associated with antiretroviral (ARV) treatment (p < 0.0001), but no significant difference in mortality or CD4 count increase on ARVs between subtypes.

𝗖𝗼𝗻𝗰𝗹𝘂𝘀𝗶𝗼𝗻𝘀
The molecular epidemiology of HIV in the Philippines has changed, with the more aggressive CRF01_AE now being the predominant subtype.

𝗞𝗲𝘆𝘄𝗼𝗿𝗱𝘀: HIV-1CRF01_AEPhilippines

𝗥𝗲𝗳𝗲𝗿𝗲𝗻𝗰𝗲:
Salvaña, E.M.T., Schwem, B.E., Ching, P.R., Frost, S.D.W., Ganchua, S.K.C., Itable, J.R. (2017, August 1). The changing molecular epidemiology of HIV in the Philippines. ScienceDirect. https://www.sciencedirect.com/science/article/pii/S1201971217301546

𝐄𝐱𝐚𝐦𝐢𝐧𝐢𝐧𝐠 𝐭𝐡𝐞 𝐞𝐟𝐟𝐞𝐜𝐭𝐬 𝐨𝐟 𝐇𝐈𝐕 𝐬𝐞𝐥𝐟-𝐭𝐞𝐬𝐭𝐢𝐧𝐠 𝐜𝐨𝐦𝐩𝐚𝐫𝐞𝐝 𝐭𝐨 𝐬𝐭𝐚𝐧𝐝𝐚𝐫𝐝 𝐇𝐈𝐕 𝐭𝐞𝐬𝐭𝐢𝐧𝐠 𝐬𝐞𝐫𝐯𝐢𝐜𝐞𝐬 𝐢𝐧 𝐭𝐡𝐞 𝐠𝐞𝐧𝐞𝐫𝐚𝐥 𝐩𝐨𝐩𝐮𝐥𝐚𝐭𝐢𝐨𝐧: 𝐀 𝐬𝐲𝐬𝐭𝐞𝐦𝐚𝐭𝐢𝐜 𝐫𝐞𝐯𝐢𝐞𝐰 𝐚𝐧𝐝 𝐦𝐞𝐭𝐚-𝐚𝐧𝐚𝐥𝐲𝐬𝐢𝐬

𝗕𝗮𝗰𝗸𝗴𝗿𝗼𝘂𝗻𝗱
We updated a 2017 systematic review and compared the effects of HIV self-testing (HIVST) to standard HIV testing services to understand effective service delivery models among the general population.

𝗠𝗲𝘁𝗵𝗼𝗱
We included randomized controlled trials (RCTs) comparing testing outcomes with HIVST to standard testing in the general population and published between January 1, 2006 and June 4, 2019. Random effects meta-analysis was conducted and pooled risk ratios (RRs) were reported. The certainty of evidence was determined using the GRADE methodology.

𝗙𝗶𝗻𝗱𝗶𝗻𝗴𝘀
We identified 14 eligible RCTs, 13 of which were conducted in sub-Saharan Africa. Support provided to self-testers ranged from no/basic support to one-on-one in-person support. HIVST increased testing uptake overall (RR:2.09; 95% confidence interval: 1.69–2.58; p < 0.0001;13 RCTs; moderate certainty evidence) and by service delivery model including facility-based distribution, HIVST use at facilities, secondary distribution to partners, and community-based distribution. The number of persons diagnosed HIV-positive among those tested (RR:0.81, 0.45–1.47; p = 0.50; 8 RCTs; moderate certainty evidence) and number linked to HIV care/treatment among those diagnosed (RR:0.95, 0.79–1.13; p = 0.52; 6 RCTs; moderate certainty evidence) were similar between HIVST and standard testing. Reported harms/adverse events with HIVST were rare and appeared similar to standard testing (RR:2.52: 0.52–12.13; p = 0.25; 4 RCTs; very low certainty evidence).

𝗜𝗻𝘁𝗲𝗿𝗽𝗿𝗲𝘁𝗮𝘁𝗶𝗼𝗻
HIVST appears to be safe and effective among the general population in sub-Saharan Africa with a range of delivery models. It identified and linked additional people with HIV to care. These findings support the wider availability of HIVST to reach those who may not otherwise access testing.

𝐾𝑒𝑦𝑤𝑜𝑟𝑑𝑠: 𝐻𝐼𝑉 𝑡𝑒𝑠𝑡𝑖𝑛𝑔 𝑠𝑒𝑟𝑣𝑖𝑐𝑒𝑠𝐻𝐼𝑉 𝑠𝑒𝑙𝑓-𝑡𝑒𝑠𝑡𝑖𝑛𝑔𝑔𝑒𝑛𝑒𝑟𝑎𝑙 𝑝𝑜𝑝𝑢𝑙𝑎𝑡𝑖𝑜𝑛𝑆𝑦𝑠𝑡𝑒𝑚𝑎𝑡𝑖𝑐 𝑅𝑒𝑣𝑖𝑒𝑤𝑀𝑒𝑡𝑎-𝑎𝑛𝑎𝑙𝑦𝑠𝑖𝑠

𝗥𝗲𝗳𝗲𝗿𝗲𝗻𝗰𝗲: Examining the effects of HIV self-testing compared to standard HIV testing services in the general population: A systematic review and meta-analysis. (2021, August). Retrieved from Science Direct: https://www.sciencedirect.com/science/article/pii/S2589537021002716

𝐒𝐞𝐱𝐮𝐚𝐥 𝐛𝐞𝐡𝐚𝐯𝐢𝐨𝐫 𝐜𝐡𝐚𝐧𝐠𝐞 𝐟𝐨𝐥𝐥𝐨𝐰𝐢𝐧𝐠 𝐇𝐈𝐕 𝐭𝐞𝐬𝐭𝐢𝐧𝐠 𝐬𝐞𝐫𝐯𝐢𝐜𝐞𝐬: 𝐚 𝐬𝐲𝐬𝐭𝐞𝐦𝐚𝐭𝐢𝐜 𝐫𝐞𝐯𝐢𝐞𝐰 𝐚𝐧𝐝 𝐦𝐞𝐭𝐚-𝐚𝐧𝐚𝐥𝐲𝐬𝐢𝐬

𝗜𝗻𝘁𝗿𝗼𝗱𝘂𝗰𝘁𝗶𝗼𝗻
Learning one’s HIV status through HIV testing services (HTS) is an essential step toward accessing treatment and linking to preventive services for those at high HIV risk. HTS may impact subsequent s*xual behaviour, but the degree to which this varies by population or is true in the setting of contemporary HIV prevention activities is largely unknown. As part of the 2019 World Health Organization Consolidated Guidelines on HTS, we undertook a systematic review and meta‐analysis to determine the effect of HTS on s*xual behaviour.

𝗠𝗲𝘁𝗵𝗼𝗱𝘀
We searched nine electronic databases for studies published between July 2010 and December 2019. We included studies that reported on at least one outcome (condom use [defined as the frequency of condom use or condom‐protected s*x], number of s*x partners, HIV incidence, STI incidence/prevalence). We included studies that prospectively assessed outcomes and that fit into one of three categories: (1) those evaluating more versus less‐intensive HTS, (2) those of populations receiving HTS versus not and (3) those evaluating outcomes after versus before HTS. We conducted meta‐analyses using random‐effects models.

𝗥𝗲𝘀𝘂𝗹𝘁𝘀 𝗮𝗻𝗱 𝗱𝗶𝘀𝗰𝘂𝘀𝘀𝗶𝗼𝗻
Of 29 980 studies screened, 76 studies were included. Thirty‐eight studies were randomized controlled trials, 36 were cohort studies, one was quasi‐experimental and one was a serial cross‐sectional study. There was no significant difference in condom use among individuals receiving more‐intensive HTS compared to less‐intensive HTS (relative risk [RR]=1.03; 95% CI: 0.99 to 1.07). Condom use was significantly higher after receiving HTS compared to before HTS for individuals newly diagnosed with HIV (RR = 1.65; 95% CI: 1.36 to 1.99) and marginally significantly higher for individuals receiving an HIV‐negative diagnosis (RR = 1.63; 95% CI: 1.01 to 2.62). Individuals receiving more‐intensive HTS reported fewer s*x partners at follow‐up than those receiving less‐intensive HTS, but the finding was not statistically significant (mean difference = −0.28; 95% CI: −3.66, 3.10).

𝗖𝗼𝗻𝗰𝗹𝘂𝘀𝗶𝗼𝗻𝘀
Our findings highlight the importance of using limited resources towards HTS strategies that focus on early HIV diagnosis, treatment and prevention services rather than resources dedicated to supplementing or enhancing HTS with additional counselling or other interventions.

𝘒𝘦𝘺𝘸𝘰𝘳𝘥𝘴: 𝘏𝘐𝘝 𝘵𝘦𝘴𝘵𝘪𝘯𝘨, 𝘴𝘦𝘹𝘶𝘢𝘭 𝘣𝘦𝘩𝘢𝘷𝘪𝘰𝘶𝘳 𝘤𝘩𝘢𝘯𝘨𝘦, 𝘤𝘰𝘯𝘥𝘰𝘮‐𝘱𝘳𝘰𝘵𝘦𝘤𝘵𝘦𝘥 𝘴𝘦𝘹, 𝘯𝘶𝘮𝘣𝘦𝘳 𝘰𝘧 𝘴𝘦𝘹𝘶𝘢𝘭 𝘱𝘢𝘳𝘵𝘯𝘦𝘳𝘴, 𝘴𝘺𝘴𝘵𝘦𝘮𝘢𝘵𝘪𝘤 𝘳𝘦𝘷𝘪𝘦𝘸, 𝘮𝘦𝘵𝘢‐𝘢𝘯𝘢𝘭𝘺𝘴𝘪𝘴

𝘙𝘦𝘧𝘦𝘳𝘦𝘯𝘤𝘦:
Tiwari, R. et al., (2020). 𝘚𝘦𝘹𝘶𝘢𝘭 𝘣𝘦𝘩𝘢𝘷𝘪𝘰𝘶𝘳 𝘤𝘩𝘢𝘯𝘨𝘦 𝘧𝘰𝘭𝘭𝘰𝘸𝘪𝘯𝘨 𝘏𝘐𝘝 𝘵𝘦𝘴𝘵𝘪𝘯𝘨 𝘴𝘦𝘳𝘷𝘪𝘤𝘦𝘴: 𝘢 𝘴𝘺𝘴𝘵𝘦𝘮𝘢𝘵𝘪𝘤 𝘳𝘦𝘷𝘪𝘦𝘸 𝘢𝘯𝘥 𝘮𝘦𝘵𝘢‐𝘢𝘯𝘢𝘭𝘺𝘴𝘪𝘴. PubMed Central (PMC). Retrieved from July 16, 2021 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7649006/

𝐈𝐬 𝐭𝐡𝐞 𝐏𝐡𝐢𝐥𝐢𝐩𝐩𝐢𝐧𝐞𝐬 𝐫𝐞𝐚𝐝𝐲 𝐟𝐨𝐫 𝐇𝐈𝐕 𝐬𝐞𝐥𝐟-𝐭𝐞𝐬𝐭𝐢𝐧𝐠?

𝐀𝐛𝐬𝐭𝐫𝐚𝐜𝐭

𝗕𝗮𝗰𝗸𝗴𝗿𝗼𝘂𝗻𝗱
The Philippines is facing a rapidly rising HIV epidemic among young men who have s*x with men (MSM). Testing rates among young populations is poor. 𝗛𝗜𝗩 𝘀𝗲𝗹𝗳-𝘁𝗲𝘀𝘁𝗶𝗻𝗴 (𝗛𝗜𝗩𝗦𝗧) is a promising strategy to address this testing gap. The study’s purpose was to explore the perceived acceptability, feasibility and programmatic challenges of HIVST among key informants and target users.

𝗠𝗲𝘁𝗵𝗼𝗱
A qualitative study involving semi-structured interviews and focus group discussions (FGD). We interviewed 15 key informants involved with HIV testing programs or policies and 42 target users in six FGD in Metro Manila. We held separate discussions with high socio-economic MSM (n = 12), urban poor MSM (n = 15) and transgender women (TGW) (n = 15). Results were analysed using a thematic framework approach.

𝗥𝗲𝘀𝘂𝗹𝘁𝘀
MSM and TGW welcomed the convenience and privacy HIVST could provide. They preferred an inexpensive accurate blood-based kit attained from reputable sites. Key informants at national and local level equally welcomed HIVST but identified a number of policy and regulatory issues. Both groups articulated the challenge of enrolling those who test reactive using HIVST to further testing and treatment in an environment characterised by acute stigma around HIV.

𝗖𝗼𝗻𝗰𝗹𝘂𝘀𝗶𝗼𝗻
HIVST was found to be highly acceptable to target users and was welcomed as an additional testing approach at national level. Strategic alliances are now needed between stakeholders to proactively deliver a patient-centred HIVST program that could provide an effective, safe means of increasing testing coverage in this escalating context.

𝐊𝐞𝐲𝐰𝐨𝐫𝐝𝐬: HIV self-testing, Philippines, Men who have s*x with men (MSM), Transgender women, TGW, Regulation, Policy

Source:
Is the Philippines ready for HIV self-testing? (2020). PubMed Central (PMC). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6953179/?fbclid=IwAR0rGM84aKoGbFGBn2QZRbsoLkdlx8BvKcQZm-dXeXy0PSKYVqpY4Q5AgVI