scholarly journals “I Don’t Want to go for an HIV Test Out of Fear that I Might be Positive”: Barriers and Facilitators to the Uptake of HIV testing Services Among Adolescents and Young Adults in Machinga District, Malawi.

2020 ◽  
Author(s):  
Joseph Jasper Sakala ◽  
William Stones

Abstract Background: While studies generally indicate low utilization of HIV testing services (HTS) by young people in Sub-Saharan Africa, other reports also indicate a worrying HIV burden among the same group, evidenced by a recent trends in new infections. The low uptake of HTS among young people means that for many, new infections remain undiagnosed, hindering public health efforts for disease controlWe aimed to explore the factors that hinder – as well as those that encourage – HIV testing among adolescents and young adults in at individual, interpersonal, community and health system levels in a Malawi district.Methods: 24 In-depth interviews (IDIs) and 4 key-informant interviews (KIIs) were used to collect data, and purposive sampling was used to identify the respondents. IDIs targeted adolescents and young adults aged 15-24 years, whereas KIIs targeted HTS and youth-friendly health service (YFHS) providers. Coding and analysis were done using a modified Social-Ecological Framework.Results: Fear of a positive result, poor communication in relationships and families, cultural norms as well as lack of youth-friendly HIV testing services were key barriers to HIV testing. Perceived susceptibility to infection, presence of partner support, availability of community-level youth clubs or support groups, and the provision of HTS through outreach clinics were key facilitators for HIV testing. Conclusions: There is a pressing need for widespread mobile HIV testing at the community level to encourage uptake among young people who fail to visit health facilities for various reasons. Access to HIV self-testing through the distribution of kits at government health facilities is a promising strategy for young people who distrust service providers when it comes to maintaining the confidentiality of their results.

2019 ◽  
Author(s):  
Ucheoma Nwaozuru ◽  
iwelunmor juliet ◽  
Jason J. Ong ◽  
Sawsan Salah ◽  
Chisom Obiezu-Umeh ◽  
...  

Abstract Background Despite high HIV incidence rates among young people in Nigeria, less than 24% of this population have ever tested for HIV. These low HIV testing rates suggest that current testing services may not align with their testing preferences. To address this gap, the objective of this study was to assess preferences for HIV testing options among young people in Nigeria.Methods We conducted a cross-sectional study using survey to assess preferences for HIV testing options among 113 youth aged 14-24 years residing in Nigeria. The survey included a series of hypothetical HIV testing options, comprised of six characteristics centered around HIV testing service (i.e. location of testing, test administrator, mode of pre-test, mode of post-test counseling, type of HIV test, and cost of HIV test). For each characteristic, participants were asked to select one of the options that they prefer or indicate none of the above. A descriptive analysis of the preferences made by participants was conducted, summarizing proportions of participants who selected different options for HIV testing.Results The mean age of study participants was 19.5 years old (SD=2.7). Most youth (73, 64.6%) had at least a secondary school degree. There was pronounced heterogeneity in HIV testing preferences among young people. Although most youth preferred free HIV testing, 14 (16.7%) reported preferring paying a small amount compared to free testing. More youth preferred blood-based HIV self-testing 39(48.8%) compared to facility-based HIV testing and oral HIV self-testing.Conclusions Our finding suggest that young people have a range of HIV testing preferences in Nigeria. This suggests that a “one-size-fits-all” approach to delivering services to youth may be challenging in this context. HIV testing services can be optimized to reach young people if a variety options are provided to meet their unique preferences.


2019 ◽  
Author(s):  
Ucheoma Nwaozuru ◽  
iwelunmor juliet ◽  
Jason J. Ong ◽  
Sawsan Salah ◽  
Chisom Obiezu-Umeh ◽  
...  

Abstract Background Despite high HIV incidence rates among young people in Nigeria, less than 24% of this population have ever tested for HIV. These low HIV testing rates suggest that current testing services may not align with their testing preferences. To address this gap, the objective of this study was to assess preferences for HIV testing options among young people in Nigeria.Methods We conducted a cross-sectional study using survey to assess preferences for HIV testing options among 113 youth aged 14-24 years residing in Nigeria. The survey included a series of hypothetical HIV testing options, comprised of six characteristics centered around HIV testing service (i.e. location of testing, test administrator, mode of pre-test, mode of post-test counseling, type of HIV test, and cost of HIV test). For each characteristic, participants were asked to select one of the options that they prefer or indicate none of the above. A descriptive analysis of the preferences made by participants was conducted, summarizing proportions of participants who selected different options for HIV testing.Results The mean age of study participants was 19.5 years old (SD=2.7). Most youth (73, 64.6%) had at least a secondary school degree. There was pronounced heterogeneity in HIV testing preferences among young people. Although most youth preferred free HIV testing, 14 (16.7%) reported preferring paying a small amount compared to free testing. More youth preferred blood-based HIV self-testing 39(48.8%) compared to facility-based HIV testing and oral HIV self-testing.Conclusions Our finding suggest that young people have a range of HIV testing preferences in Nigeria. This suggests that a “one-size-fits-all” approach to delivering services to youth may be challenging in this context. HIV testing services can be optimized to reach young people if a variety options are provided to meet their unique preferences.


2020 ◽  
Vol 31 (4) ◽  
pp. 483-492
Author(s):  
Anjuli D. Wagner ◽  
Kate S. Wilson ◽  
Joseph B. Babigumira ◽  
Cyrus Mugo ◽  
Peter M. Mutiti ◽  
...  

2019 ◽  
Author(s):  
Ucheoma Nwaozuru ◽  
iwelunmor juliet ◽  
Jason J. Ong ◽  
Sawsan Salah ◽  
Chisom Obiezu-Umeh ◽  
...  

Abstract Background Despite high HIV incidence rates among young people in Nigeria, less than 24% of this population have ever tested for HIV. These low HIV testing rates suggest that current testing services may not align with their testing preferences. To address this gap, the objective of this study was to assess preferences for HIV testing options among young people in Nigeria.Methods We conducted a cross-sectional study using survey to assess preferences for HIV testing options among 113 youth aged 14-24 years residing in Nigeria. The survey included a series of hypothetical HIV testing options, comprised of six characteristics centered around HIV testing service (i.e. location of testing, test administrator, mode of pre-test, mode of post-test counseling, type of HIV test, and cost of HIV test). For each characteristic, participants were asked to select one of the options that they prefer or indicate none of the above. A descriptive analysis of the preferences made by participants was conducted, summarizing proportions of participants who selected different options for HIV testing.Results The mean age of study participants was 19.5 years old (SD=2.7). Most youth (73, 64.6%) had at least a secondary school degree. There was pronounced heterogeneity in HIV testing preferences among young people. Although most youth preferred free HIV testing, 14 (16.7%) reported preferring paying a small amount compared to free testing. More youth preferred blood-based HIV self-testing 39(48.8%) compared to facility-based HIV testing and oral HIV self-testing.Conclusions Our finding suggest that young people have a range of HIV testing preferences in Nigeria. This suggests that a “one-size-fits-all” approach to delivering services to youth may be challenging in this context. HIV testing services can be optimized to reach young people if a variety options are provided to meet their unique preferences.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ucheoma Nwaozuru ◽  
Juliet Iwelunmor ◽  
Jason J. Ong ◽  
Sawsan Salah ◽  
Chisom Obiezu-Umeh ◽  
...  

Abstract Background Despite high HIV incidence rates among young people in Nigeria, less than 24% of this population have ever tested for HIV. These low HIV testing rates suggest that current testing services may not align with their testing preferences. To address this gap, the objective of this study was to assess preferences for HIV testing options among young people in Nigeria. Methods We conducted a cross-sectional study using survey to assess preferences for HIV testing options among 113 youth aged 14–24 years residing in Nigeria. The survey included a series of hypothetical HIV testing options, comprised of six characteristics centered around HIV testing service (i.e. location of testing, test administrator, mode of pre-test, mode of post-test counseling, type of HIV test, and cost of HIV test). For each characteristic, participants were asked to select one of the options that they prefer or indicate none of the above. A descriptive analysis of the preferences made by participants was conducted, summarizing proportions of participants who selected different options for HIV testing. Results The mean age of study participants was 19.5 years old (SD = 2.7). Most youth (73, 64.6%) had at least a secondary school degree. There was pronounced heterogeneity in HIV testing preferences among young people. Although most youth preferred free HIV testing, 14 (16.7%) reported preferring paying a small amount compared to free testing. More youth preferred blood-based HIV self-testing 39(48.8%) compared to facility-based HIV testing and oral HIV self-testing. Conclusions Our finding suggest that young people have a range of HIV testing preferences in Nigeria. This suggests that a “one-size-fits-all” approach to delivering services to youth may be challenging in this context. HIV testing services can be optimized to reach young people if a variety options are provided to meet their unique preferences.


PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253745
Author(s):  
Andrea L. Koris ◽  
Kearsley A. Stewart ◽  
Tiarney D. Ritchwood ◽  
Daniel Mususa ◽  
Getrude Ncube ◽  
...  

Background Targeted HIV testing strategies are needed to reach remaining undiagnosed people living with HIV and achieve the UNAIDS’ 95-95-95 goals for 2030. HIV self-testing (HIVST) can increase uptake of HIV testing among young people, but user perspectives on novel distribution methods are uncertain. We assess the acceptability, perceived challenges, and recommendations of young adult lay counselor-led campus-based HIVST delivery among tertiary school students aged 18–24 years in Zimbabwe. Methods We purposively sampled participants from an intervention involving campus-based HIVST using lay workers for distribution. We conducted in-depth interviews (IDIs) and focus group discussions (FGDs) among young adults from 10 universities and colleges in Zimbabwe who: (1) self-tested on campus; (2) self-tested off campus; and (3) opted not to self-test. We audio recorded and transcribed all interviews. Using applied thematic analysis, two investigators identified emergent themes and independently coded transcripts, achieving high inter-coder agreement. Results Of the 52 young adults (53.8% male, 46.1% female) interviewed through 26 IDIs and four FGDs, most IDI participants (19/26, 73%) favored campus-based HIVST, describing it as a more autonomous, convenient, and socially acceptable experience than other facility or community-based HIV testing services. Despite general acceptability, participants identified challenges with this delivery model, including: perceived social coercion, insufficient privacy and access to post-test counseling. These challenges influenced some participants to opt against self-testing (6/52, 11.5%). Recommendations for improved implementation included integrating secondary distribution of test kits and increased HIV counseling options into campus-based programs. Conclusions Barriers to HIV testing among young people are numerous and complex. As the number of new HIV infections among youth continue to grow worldwide, targeted strategies and youth friendly approaches that increase access to testing are needed to close the diagnostic coverage gap. This is the first study to describe young adult acceptance of campus-based delivery of HIVST by lay counselors in Zimbabwe.


2020 ◽  
Vol 62 (1) ◽  
pp. 38-42
Author(s):  
Anna Kostiukow ◽  
Wojciech Strzelecki ◽  
Mateusz W. Romanowski ◽  
Marta Rosołek ◽  
Ewa Mojs ◽  
...  

Introduction: The study is aimed at drawing the attention of the medical environment to the mental health aspects of young patients as a factor that significantly influences the efficiency of their rheumatic disease treatment. Aim: This paper is to check the risk of depression among a group of adolescents and young adults with rheumatic diseases. Material and Methods: The study was conducted among a group of 68 late adolescents and young adults (18-22 years old) with rheumatic diseases. The control group consisted of 102 young people (18-22 years old) without a diagnosed chronic disease. Risk of depression was measured using a screening tool – the Kutcher Adolescent Depression Scale (KADS). Results: The analysis showed that the probability of depression in the study group was 35.3%. In the control group, this rate was 19.6%. The results were statistical significance (p=0.028). Conclusions: The results of this study prove that the risk of depression among adolescents and young adults with rheumatic diseases is significantly higher than in healthy young people. The highest risk of depression is related to feeling tired, fatigue, low energy levels and lack of motivation as well as feeling worried, nervous, panicky, tense, keyed-up and anxious.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rohan D. Jeremiah ◽  
Dhruvi R. Patel ◽  
Ellen Chirwa ◽  
Esnath Kapito ◽  
Xiaohan Mei ◽  
...  

Abstract Background HIV testing at antenatal care (ANC) is critical to achieving zero new infections in sub-Saharan Africa. Although most women are tested at ANC, they remain at risk for HIV exposure and transmission to their infant when their partners are not tested. This study evaluates how an HIV-enhanced and Centering-based group ANC model-Group ANC+ that uses interactive learning to practice partner communication is associated with improvements in partner HIV testing during pregnancy. Methods A randomized pilot study conducted in Malawi and Tanzania found multiple positive outcomes for pregnant women (n = 218) assigned to Group ANC+ versus individual ANC. This analysis adds previously unpublished results for two late pregnancy outcomes: communication with partner about three reproductive health topics (safer sex, HIV testing, and family planning) and partner HIV testing since the first antenatal care visit. Multivariate logistic regression models were used to assess the effect of type of ANC on partner communication and partner testing. We also conducted a mediation analysis to assess whether partner communication mediated the effect of type of care on partner HIV testing. Results Nearly 70% of women in Group ANC+ reported communicating about reproductive health with their partner, compared to 45% of women in individual ANC. After controlling for significant covariates, women in group ANC were twice as likely as those in individual ANC to report that their partner got an HIV test (OR 1.99; 95% CI: 1.08, 3.66). The positive effect of the Group ANC + model on partner HIV testing was fully mediated by increased partner communication. Conclusions HIV prevention was included in group ANC health promotion without compromising services and coverage of standard ANC topics, demonstrating that local high-priority health promotion needs can be integrated into ANC using a Group ANC+. These findings provide evidence that greater partner communication can promote healthy reproductive behaviors, including HIV prevention. Additional research is needed to understand the processes by which group ANC allowed women to discuss sensitive topics with partners and how these communications led to partner HIV testing.


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