scholarly journals Opt-out provider-initiated HIV testing and counselling in primary care outpatient clinics in Zambia

2011 ◽  
Vol 89 (5) ◽  
pp. 328-335A ◽  
Author(s):  
Stephanie M Topp ◽  
Julien M Chipukuma ◽  
Matimba M Chiko ◽  
Chibesa S Wamulume ◽  
Carolyn Bolton-Moore ◽  
...  
Keyword(s):  
Primary Care ◽  
Hiv Testing ◽  
Outpatient Clinics ◽  
Opt Out ◽  
Hiv Testing And Counselling

scholarly journals 964. Opt-Out HIV- Hepatitis C (HCV) Testing at a Primary Care Resident Clinic in Columbia, SC: Who Gets Tested and Who Opts Out of Testing?

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S512-S512
Author(s):  
Jodian Pinkney ◽  
Divya Ahuja ◽  
Caroline Derrick ◽  
Martin Durkin
Keyword(s):  
Primary Care ◽  
Hiv Testing ◽  
Demographic Variables ◽  
Demographic Characteristics ◽  
Categorical Variables ◽  
Newly Diagnosed ◽  
Opting Out ◽  
Opt Out ◽  
Primary Care Resident ◽  
Hcv Testing

Abstract Background South Carolina (SC) remains one of the most heavily affected states for both HIV and HCV infections. Males account for the majority of cases. Implementation of universal opt-out testing has improved screening rates but not much has been published describing the characteristics of those who opt out of testing. This becomes important as 10-50% of patients have opted out in previous studies. Methods Between February and August 2019, we conducted a quality improvement (QI) project which implemented opt- out HIV-HCV testing at a single primary care resident clinic in SC with the primary aim of increasing screening rates for HIV-HCV by 50%. Secondary aims included describing the demographic characteristics of the opt-out population. Persons were considered eligible for testing if they were between the ages of 18-65 years for HIV and 18-74 years for HCV. This was prior to the USPSTF 2020 guidelines which recommend HCV screening for adults aged 18-79 years. A retrospective chart review was used to obtain screening rates, opt status and demographic data. Logistic regression and the firth model were used to determine linkages between categorical variables. We present 3-month data. Results 1253 patients were seen between May 1, 2019- July 31, 2019 (See Table 1). 985 (78%) were eligible for HIV testing. 482 (49%) were tested for HIV as a result of our QI project and all tests were negative. 212 (22%) of eligible patients opted out of HIV testing. Males were 1.59 times more likely to opt out (p=0.008). (see Table 2,3) Regarding HCV, 1136 (90.7%) were deemed eligible for testing. 503 (44%) were tested for HCV as a result of our QI project. 12 (2.4%) were HCV antibody positive with viremia. 11 (90%) of antibody positive with viremia cases were in the 1945-1965 birth cohort (see Table 4). 244 (21%) opted out of HCV testing. Males and persons without a genitourinary chief complaint were more likely to opt out (p=0.02). Table 1: Demographic characteristics of the population seen at the internal medicine resident clinic between May- July 2019 Table 2: Relationship between demographic variables and the odds of being tested for HIV or HCV within the last 12 months. Logistic Model. Table 3: Relationship between demographic variables and the odds of opting out of testing for HIV or HCV. Firth Model. Conclusion Although implementation of routine HIV-HCV opt-out testing led to increased screening rates for both HIV and HCV, roughly 1 in 5 eligible patients chose to opt out of testing. Males were more likely to opt out despite accounting for the majority of newly diagnosed HCV cases. Future studies investigating drivers for opting-out in the male population could improve testing and assist with early diagnosis. Table 4: Characteristics of patients newly diagnosed with HCV positive with viremia. Disclosures All Authors: No reported disclosures

Behavior intention to use routine opt-out HIV testing in primary care settings among men who have sex with men in China

AIDS Care ◽  
2019 ◽  
Vol 31 (12) ◽  
pp. 1565-1573 ◽  
Author(s):  
Lu Niu ◽  
Zixin Wang ◽  
Yuan Fang ◽  
Mary Ip ◽  
Joseph T.F. Lau
Keyword(s):  
Primary Care ◽  
Hiv Testing ◽  
Intention To Use ◽  
Behavior Intention ◽  
Primary Care Settings ◽  
Opt Out ◽  
Sex With Men

scholarly journals A Cross-Sectional Study Comparing Two Opt-Out HIV Testing Strategies in the Out-Patient Setting

2021 ◽  
Vol 9 ◽  
Author(s):  
Greta Tam ◽  
Samuel Yeung Shan Wong
Keyword(s):  
Primary Care ◽  
Hiv Testing ◽  
Care Setting ◽  
Hiv Infections ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Testing Strategies ◽  
Opt Out ◽  
Hiv Test

Background: HIV infections are generally asymptomatic, leading to undetected infections and late-stage diagnoses. There are a lack of acceptable testing strategies for routine opt-out HIV screening. Our aim was to evaluate and compare the diagnostic yield of routine opt-out HIV testing strategies in two out-patient settings in a low HIV prevalence country: The public primary care and specialist out-patient care settingMethods: A cross-sectional study was conducted in a primary care clinic over a four-week period in 2016 to 2017 and in a specialist out-patient clinic over a concurrent 11-month period. Patients were invited to complete a questionnaire assessing demographic characteristics, acceptance of opt-out HIV testing as a policy in all out-patient clinics in Hong Kong and reasons if refusing the HIV test. All respondents were offered an HIV test.Results: This study included 648 and 1,603 patients in the primary care and specialist out-patient clinic, respectively. Test acceptability was 86 and 87% in the primary care and specialist out-patient setting, respectively. Test uptake was 35 and 68% in the primary care and specialist out-patient setting, respectively. No HIV infections were detected.Conclusion: Opt-out HIV testing during routine blood taking in the specialist out-patient setting achieved a high test uptake and acceptability. In contrast, opt-out HIV testing using rapid finger-prick tests in the primary care setting was not effective.

scholarly journals Pediatric Primary Care Providers' Attitudes Towards Routine, Opt-Out HIV Testing

2016 ◽  
Vol 3 (suppl_1) ◽  
Author(s):  
Noemi Spinazzi ◽  
Ann Petru ◽  
Teresa Courville ◽  
Tricia Smallwood
Keyword(s):  
Primary Care ◽  
Hiv Testing ◽  
Primary Care Providers ◽  
Pediatric Primary Care ◽  
Care Providers ◽  
Opt Out

Effectiveness of provider-initiated testing and counseling in increasing HIV testing and counselling utilization and HIV detection rates in Ebonyi State, South-Eastern Nigeria

2018 ◽  
Vol 29 (14) ◽  
pp. 1362-1367 ◽  
Author(s):  
Reward Nsirim ◽  
Golibe Ugochukwu ◽  
Maxwell Onuoha ◽  
Ikechukwu Okoroezi ◽  
Chiwetalu Ani ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Fold Increase ◽  
Outpatient Clinics ◽  
Case Detection ◽  
Intervention Period ◽  
Similar Time ◽  
Detection Rates ◽  
Voluntary Counselling ◽  
Hiv Testing And Counselling ◽  
Voluntary Counselling And Testing

HIV testing and counselling is crucial in identifying new HIV cases and linking them to treatment. Provider-initiated testing and counselling can help to increase uptake of HIV testing and counselling and HIV case detection. We implemented provider-initiated testing and counselling in 32 health facilities in Ebonyi State, South-East Nigeria in order to achieve both objectives. Provider-initiated testing and counselling was implemented across the 32 facilities from January to June 2016. Provider-initiated testing and counselling data were compared with the preceding six months (July–December 2015) when only voluntary counselling and testing was done. A total of 11,787 out of 22,153 who visited the outpatient clinics within the intervention period (53%) were tested. In the preceding six months, only 3172 clients were tested via voluntary counselling and testing out of 50,898 clients who visited the outpatient clinics (6.2%). This was a 3.72-fold increase over the numbers tested via voluntary counselling and testing, within a similar time frame. Also, 158 new cases were diagnosed during the period from provider-initiated testing and counselling compared to 24 from voluntary counselling and testing in the preceding six months – an increase of 4.65-fold in case detection. Apart from the 11,787 tested through provider-initiated testing and counselling, another 6999 clients were tested through community-based outreaches during the intervention period. Comparison of case detection between both strategies shows that provider-initiated testing and counselling accounted for 158 cases (97%) while outreaches accounted for only five cases (3%). Provider-initiated testing and counselling led to an increase in uptake of HIV testing and counselling services as well as in HIV case detection across the 32 facilities where our programme was implemented.

scholarly journals Determinants of Demand for HIV Testing

2007 ◽  
Vol 5 (4) ◽  
pp. 52-75
Author(s):  
Dan Friesner ◽  
Peter Cashel-Cordo ◽  
Matthew Q. McPherson
Keyword(s):  
Primary Care ◽  
Hiv Testing ◽  
Empirical Analysis ◽  
Financial Constraints ◽  
Outpatient Clinics ◽  
The Impact ◽  
Hiv Aids

This paper provides an initial empirical analysis of the impact of changing epidemiological, economic and sociological conditions on the amount of HIV testing in primary care, outpatient clinics. Particular attention is paid to examining whether changes in HIV/AIDS prevalence impact the amount of testing these clinics perform, and also how financial constraints impact this relationship. Using a sample of California clinics, we find that changing epidemiological conditions do impact the demand for HIV testing. Additionally, certain clinic characteristics, such as the type of practitioners providing care and the socio-economic characteristics of patients treated at each clinic also affect the demand for testing. However, we find little evidence supporting increased government or private grants, contracts and donations as a means of enhancing the demand for HIV testing.

scholarly journals Princess Marina Hospital HIV rates:Interrupted time series analysis for policy review

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Mooketsi Molefi
Keyword(s):  
Public Health ◽  
Time Series ◽  
Hiv Testing ◽  
Interrupted Time Series ◽  
Official Journal ◽  
Prevention Research ◽  
Opt Out ◽  
Hiv Testing And Counselling ◽  
Males And Females ◽  
Public Health Act

ObjectiveWe aimed to assess the effect of the amended Public Health act of 2013 on facility-based HIV testing in Princess Marina Hospital.IntroductionHIV testing remains the mainstay of optimal HIV care and is pivotal to control and prevention of the disease, however efforts to attain optimal testing levels have been undermined by low HIV testing especially in developing countries. Botswana in response, amended its Public Health Act in September 2013 but the effect of this action on facility based HIV testing rates has not been evaluated.MethodsWe carried out an effect assessment using interrupted time-series analysis method, where we accessed electronic medical records of patients seen in Princess Marina Hospital from June 2011 to May 2015. Rates were developed from the proportion of patients that tested each month out of the number that registered, and that figure used that as our data point in the series. September 2013 served as our intervention period in the series. We ran the (i) crude and (ii) sex-stratified model regression models in stata® yielding Newey-West coefficients with their 95% confidence intervals. Graphical display of the models were also produced to visual appreciation and inspection.ResultsTwo hundred and twenty-nine thousand six hundred and ninety two patients were registered between June 2011 and May 2015. Of those tested the significant majority being females (65%). From the Newey-regression output there was no significant change in the level of HIV testing immediately after the intervention however there was a change in trend(p=0.002) post the intervention. Stratification by gender, revealed no statistically significant difference between males and females, either in the levels nor the trend post intervention compared to pre-intervention.ConclusionsThe amendment of the Public Health act of 2013, has brought about trend change in HIV testing however there has not been any apparent difference in the levels nor trends on HIV testing between males and females. Nationwide health facility-based studies could assist assess the overall effect of the amended act on HIV testing rates.References1. Provider Initiated HIV Testing and Counseling: One Day Training Programme, Field Test Version. WHO Guidelines Approved by the Guidelines Review Committee. Geneva2011.2. Donnell D, Baeten JM, Kiarie J, Thomas KK, Stevens W, Cohen CR, et al. Heterosexual HIV-1 transmission after initiation of antiretroviral therapy: a prospective cohort analysis. The Lancet. 2010;375(9731):2092-8.3. Lawn SD, Harries AD, Anglaret X, Myer L, Wood R. Early mortality among adults accessing antiretroviral treatment programmes in sub-Saharan Africa. Aids. 2008;22(15):1897-908.4. McMahon JM, Pouget ER, Tortu S, Volpe EM, Torres L, Rodriguez W. Couple-based HIV counseling and testing: a risk reduction intervention for US drug-involved women and their primary male partners. Prevention science : the official journal of the Society for Prevention Research. 2015;16(2):341-51.5. Shan D, Duan S, Gao J, Yang Y, Ye R, Hu Y, et al. [Analysis of early detection of HIV infections by provider initiated HIV testing and counselling in regions with high HIV/AIDS epidemic in China]. Zhonghua yu fang yi xue za zhi [Chinese journal of preventive medicine]. 2015;49(11):962-6.6. Hensen B, Baggaley R, Wong VJ, Grabbe KL, Shaffer N, Lo YRJ, et al. Universal voluntary HIV testing in antenatal care settings: a review of the contribution of provider initiated testing & counselling. Tropical Medicine & International Health. 2012;17(1):59-70.7. Ijadunola K, Abiona T, Balogun J, Aderounmu A. Provider-initiated (Opt-out) HIV testing and counselling in a group of university students in Ile-Ife, Nigeria. The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception. 2011;16(5):387-96.8. Baisley K, Doyle AM, Changalucha J, Maganja K, Watson-Jones D, Hayes R, et al. Uptake of voluntary counselling and testing among young people participating in an HIV prevention trial: comparison of opt-out and opt-in strategies. PloS one. 2012;7(7):e42108.9. Topp SM, Chipukuma JM, Chiko MM, Wamulume CS, Bolton-Moore C, Reid SE. Opt-out provider-initiated HIV testing and counselling in primary care outpatient clinics in Zambia. Bulletin of the World Health Organization. 2011;89(5):328-35A.10. Tlhakanelo JT, Mulumba-Tshikuka JG, Molefi M, Magafu MG, Matchaba-Hove RB, Masupe T. The burden of opportunistic-infections and associated exposure factors among HIV-patients admitted at a Botswana hospital. 2015.11. Bernard EJ. BOTSWANA’S DRACONIAN PUBLIC HEALTH BILL APPROVED BY PARLIAMENT, BONELA WILL CHALLENGE IT AS UNCONSTITUTIONAL ONCE PRESIDENT SIGNS INTO LAW (UPDATE 3). HIV justice Network. 2013.12. Biglan A, Ary D, Wagenaar AC. The value of interrupted time-series experiments for community intervention research. Prevention science : the official journal of the Society for Prevention Research. 2000;1(1):31-49. 

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