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Nicholls EJ, Samba P, McCabe L, Gafos M, Philips AN, Trevelion R, Rodger AJ, Burns FM, Weatherburn P, Witzel TC. Experiences of and attitudes towards HIV testing for Asian, Black and Latin American men who have sex with men (MSM) in the SELPHI (HIV Self-Testing Public Health Intervention) randomized controlled trial in England and Wales: implications for HIV self-testing. BMC Public Health 2022; 22:809. [PMID: 35459233 PMCID: PMC9034480 DOI: 10.1186/s12889-022-13189-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 04/01/2022] [Indexed: 11/11/2022] Open
Abstract
Background HIV self-testing (HIVST) could play an important role in improving access to testing and therefore reducing inequalities related to late diagnosis of HIV, while also improving access to HIV prevention interventions such as HIV pre-exposure prophylaxis. This study sought to understand the potential role of HIVST by exploring the experiences of Asian, Black and Latin American men who have sex with men (MSM) accessing the gay scene and the circulation of HIV testing norms; experiences of accessing HIV testing services; HIVST acceptability and preferences for intervention adaptations. Methods Twenty-nine qualitative interviews were conducted with Asian, Black and Latin American MSM who had participated in SELPHI, an HIVST randomised controlled trial. Topics included HIV testing history, HIV testing patterns, experiences of accessing sexual health services, mental health, engagement with HIVST and SELPHI, and experiences of the gay scene. Interviews were audio recorded, transcribed and then analysed using a thematic framework. Results The gay scene was identified as an important site for learning about HIV and being exposed to norms reinforcing the importance of protective behaviours. However, experiences of discomfort due to perceptions of ‘whiteness’ on the scene or experiences of racism may hinder the protective function the scene could play in developing norms influencing HIV testing behaviour. Discomfort in clinic waiting rooms was identified as a substantial barrier to accessing clinical services and many interviewees expressed preferences regarding the personal characteristics of healthcare providers. HIVST was found to be acceptable and some interviewees suggested potential adaptations of the HIVST offer, such as packaging HIVST with at home sexually transmitted infections testing options. Conclusions HIVST responds to some service access barriers experienced by Asian, Black and Latin American MSM. The decoupling of HIV testing and clinic attendance may be particularly valuable for MSM of minority ethnic backgrounds who are likely to experience anxiety and discomfort in clinic waiting rooms more acutely than White MSM due to concerns around implied disclosure. This suggests that HIVST may have the potential to increase testing uptake and frequency, particularly for those with complex relationships with clinical services. Trial Registration SELPHI was prospectively registered with the ISRCTN (ref: ISRCTN 20312003).
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Affiliation(s)
- Emily Jay Nicholls
- Department of Public Health, Environment and Society, London School of Hygiene and Tropical Medicine, 5-17 Tavistock Place, London, WC1H 9SH, UK. .,Institute for Global Health, University College London, Royal Free Hospital, Rowland Hill Street, London, NW3 2PF, UK.
| | - Phil Samba
- Department of Public Health, Environment and Society, London School of Hygiene and Tropical Medicine, 5-17 Tavistock Place, London, WC1H 9SH, UK
| | - Leanne McCabe
- Medical Research Council Clinical Trials Unit at University College London, 90 High Holborn, London, WC1V 6LJ, UK
| | - Mitzy Gafos
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 5-17 Tavistock Place, London, WC1H 9SH, UK
| | - Andrew N Philips
- Institute for Global Health, University College London, Royal Free Hospital, Rowland Hill Street, London, NW3 2PF, UK
| | - Roy Trevelion
- HIV I-Base, 107 The Maltings, 169 Tower Bridge Road, London, SE1 3LJ, UK
| | - Alison J Rodger
- Institute for Global Health, University College London, Royal Free Hospital, Rowland Hill Street, London, NW3 2PF, UK
| | - Fiona M Burns
- Institute for Global Health, University College London, Royal Free Hospital, Rowland Hill Street, London, NW3 2PF, UK
| | - Peter Weatherburn
- Department of Public Health, Environment and Society, London School of Hygiene and Tropical Medicine, 5-17 Tavistock Place, London, WC1H 9SH, UK
| | - T Charles Witzel
- Department of Public Health, Environment and Society, London School of Hygiene and Tropical Medicine, 5-17 Tavistock Place, London, WC1H 9SH, UK.,Institute for Global Health, University College London, Royal Free Hospital, Rowland Hill Street, London, NW3 2PF, UK
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Jamil MS, Eshun-Wilson I, Witzel TC, Siegfried N, Figueroa C, Chitembo L, Msimanga-Radebe B, Pasha MS, Hatzold K, Corbett E, Barr-DiChiara M, Rodger AJ, Weatherburn P, Geng E, Baggaley R, Johnson C. Examining the effects of HIV self-testing compared to standard HIV testing services in the general population: A systematic review and meta-analysis. EClinicalMedicine 2021; 38:100991. [PMID: 34278282 PMCID: PMC8271120 DOI: 10.1016/j.eclinm.2021.100991] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 06/08/2021] [Accepted: 06/10/2021] [Indexed: 11/25/2022] Open
Abstract
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. METHODS 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.
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Affiliation(s)
- Muhammad S. Jamil
- Global HIV, Hepatitis and STIs Programmes, World Health Organization, Geneva, Switzerland
- Corresponding author.
| | - Ingrid Eshun-Wilson
- Washington University School of Medicine in St. Louis, St Louis, United States
| | - T. Charles Witzel
- Department of Public Health, Environments & Society, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Nandi Siegfried
- Independent Clinical Epidemiologist, Cape Town, South Africa
| | - Carmen Figueroa
- Global HIV, Hepatitis and STIs Programmes, World Health Organization, Geneva, Switzerland
| | - Lastone Chitembo
- World Health Organization Country Office for Zambia, Lusaka, Zambia
| | | | - Muhammad S. Pasha
- World Health Organization Country Office for Pakistan, Islamabad, Pakistan
| | - Karin Hatzold
- Population Services International, Cape Town, South Africa
| | - Elizabeth Corbett
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
- TB/HIV Group, Malawi–Liverpool–Wellcome Clinical Research Programme, Blantyre, Malawi
| | | | - Alison J. Rodger
- Institute for Global Health, University College London, London, United Kingdom
| | - Peter Weatherburn
- Department of Public Health, Environments & Society, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Elvin Geng
- Washington University School of Medicine in St. Louis, St Louis, United States
| | - Rachel Baggaley
- Global HIV, Hepatitis and STIs Programmes, World Health Organization, Geneva, Switzerland
| | - Cheryl Johnson
- Global HIV, Hepatitis and STIs Programmes, World Health Organization, Geneva, Switzerland
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Eshun-Wilson I, Jamil MS, Witzel TC, Glidded DV, Johnson C, Le Trouneau N, Ford N, McGee K, Kemp C, Baral S, Schwartz S, Geng EH. A Systematic Review and Network Meta-analyses to Assess the Effectiveness of Human Immunodeficiency Virus (HIV) Self-testing Distribution Strategies. Clin Infect Dis 2021; 73:e1018-e1028. [PMID: 34398952 PMCID: PMC8366833 DOI: 10.1093/cid/ciab029] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Indexed: 12/02/2022] Open
Abstract
Background We conducted a systematic review and network meta-analysis to identify which human immunodeficiency virus (HIV) self-testing (HIVST) distribution strategies are most effective. Methods We abstracted data from randomized controlled trials and observational studies published between 4 June 2006 and 4 June 2019. Results We included 33 studies, yielding 6 HIVST distribution strategies. All distribution strategies increased testing uptake compared to standard testing: in sub-Saharan Africa, partner HIVST distribution ranked highest (78% probability); in North America, Asia, and the Pacific regions, web-based distribution ranked highest (93% probability), and facility based distribution ranked second in all settings. Across HIVST distribution strategies HIV positivity and linkage was similar to standard testing. Conclusions A range of HIVST distribution strategies are effective in increasing HIV testing. HIVST distribution by sexual partners, web-based distribution, as well as health facility distribution strategies should be considered for implementation to expand the reach of HIV testing services.
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Affiliation(s)
| | - Muhammad S Jamil
- Global HIV, Hepatitis and STI Programme, World Health Organization, Geneva, Switzerland
| | - T Charles Witzel
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - David V Glidded
- Department of Epidemiology, University of California, San Francisco, California, USA
| | - Cheryl Johnson
- Global HIV, Hepatitis and STI Programme, World Health Organization, Geneva, Switzerland
| | - Noelle Le Trouneau
- Department of Epidemiology, University of California, San Francisco, California, USA
| | - Nathan Ford
- Global HIV, Hepatitis and STI Programme, World Health Organization, Geneva, Switzerland
| | - Kathleen McGee
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Chris Kemp
- Department of Epidemiology, University of California, San Francisco, California, USA
| | - Stefan Baral
- Department of Epidemiology, John Hopkins School of Public Health, Baltimore, Maryland, USA
| | - Sheree Schwartz
- Department of Epidemiology, John Hopkins School of Public Health, Baltimore, Maryland, USA
| | - Elvin H Geng
- Washington University School of Medicine, St Louis, Missouri, USA
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Witzel TC, Eshun-Wilson I, Jamil MS, Tilouche N, Figueroa C, Johnson CC, Reid D, Baggaley R, Siegfried N, Burns FM, Rodger AJ, Weatherburn P. Comparing the effects of HIV self-testing to standard HIV testing for key populations: a systematic review and meta-analysis. BMC Med 2020; 18:381. [PMID: 33267890 PMCID: PMC7713313 DOI: 10.1186/s12916-020-01835-z] [Citation(s) in RCA: 96] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 10/30/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We update a previous systematic review to inform new World Health Organization HIV self-testing (HIVST) recommendations. We compared the effects of HIVST to standard HIV testing services to understand which service delivery models are effective for key populations. METHODS We did a systematic review of randomised controlled trials (RCTs) which compared HIVST to standard HIV testing in key populations, published from 1 January 2006 to 4 June 2019 in PubMed, Embase, Global Index Medicus, Social Policy and Practice, PsycINFO, Health Management Information Consortium, EBSCO CINAHL Plus, Cochrane Library and Web of Science. We extracted study characteristic and outcome data and conducted risk of bias assessments using the Cochrane ROB tool version 1. Random effects meta-analyses were conducted, and pooled effect estimates were assessed along with other evidence characteristics to determine the overall strength of the evidence using GRADE methodology. RESULTS After screening 5909 titles and abstracts, we identified 10 RCTs which reported on testing outcomes. These included 9679 participants, of whom 5486 were men who have sex with men (MSM), 72 were trans people and 4121 were female sex workers. Service delivery models included facility-based, online/mail and peer distribution. Support components were highly diverse and ranged from helplines to training and supervision. HIVST increased testing uptake by 1.45 times (RR=1.45 95% CI 1.20, 1.75). For MSM and small numbers of trans people, HIVST increased the mean number of HIV tests by 2.56 over follow-up (mean difference = 2.56; 95% CI 1.24, 3.88). There was no difference between HIVST and SoC in regard to positivity among tested overall (RR = 0.91; 95% CI 0.73, 1.15); in sensitivity analysis of positivity among randomised HIVST identified significantly more HIV infections among MSM and trans people (RR = 2.21; 95% CI 1.20, 4.08) and in online/mail distribution systems (RR = 2.21; 95% CI 1.14, 4.32). Yield of positive results in FSW was not significantly different between HIVST and SoC. HIVST reduced linkage to care by 17% compared to SoC overall (RR = 0.83; 95% CI 0.74, 0.92). Impacts on STI testing were mixed; two RCTs showed no decreases in STI testing while one showed significantly lower STI testing in the intervention arm. There were no negative impacts on condom use (RR = 0.95; 95% CI 0.83, 1.08), and social harm was very rare. CONCLUSIONS HIVST is safe and increases testing uptake and frequency as well as yield of positive results for MSM and trans people without negative effects on linkage to HIV care, STI testing, condom use or social harm. Testing uptake was increased for FSW, yield of positive results were not and linkage to HIV care was worse. Strategies to improve linkage to care outcomes for both groups are crucial for effective roll-out.
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Affiliation(s)
- T Charles Witzel
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK.
| | | | - Muhammad S Jamil
- Global HIV, Hepatitis and STI Programme, World Health Organization, Geneva, Switzerland
| | - Nerissa Tilouche
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Carmen Figueroa
- Global HIV, Hepatitis and STI Programme, World Health Organization, Geneva, Switzerland
| | - Cheryl C Johnson
- Global HIV, Hepatitis and STI Programme, World Health Organization, Geneva, Switzerland
| | - David Reid
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Rachel Baggaley
- Global HIV, Hepatitis and STI Programme, World Health Organization, Geneva, Switzerland
| | - Nandi Siegfried
- Independent Clinical Epidemiologist, Cape Town, Republic of South Africa
| | - Fiona M Burns
- Institute for Global Health, University College London, London, UK
| | - Alison J Rodger
- Institute for Global Health, University College London, London, UK
| | - Peter Weatherburn
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
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Witzel TC, Weatherburn P, Bourne A, Rodger AJ, Bonell C, Gafos M, Trevelion R, Speakman A, Lampe F, Ward D, Dunn DT, Gabriel MM, McCabe L, Harbottle J, Collaco Moraes Y, Michie S, Phillips AN, McCormack S, Burns FM. Exploring Mechanisms of Action: Using a Testing Typology to Understand Intervention Performance in an HIV Self-Testing RCT in England and Wales. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17020466. [PMID: 31936798 PMCID: PMC7014239 DOI: 10.3390/ijerph17020466] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 12/12/2019] [Accepted: 12/17/2019] [Indexed: 12/02/2022]
Abstract
SELPHI involves two interventions: A provides one HIV self-testing (HIVST) kit; B offers 3-monthly repeat HIVST kits if participants report ongoing risk. A logic model underpinned by the Behaviour Change Wheel informed the design of the intervention. SELPHI recruited 10,135 cis-men and trans people in England and Wales, all reporting anal sex with a man. This paper explores how the interventions were experienced and the mechanisms of action leading to impact for different groups of trial participants. In-depth interviews with 37 cis-men who have sex with men (MSM) were used to inductively categorise participants based on sexual and HIV testing histories. Themes relating to intervention experiences and impacts were mapped onto SELPHI-hypothesised intermediate outcomes to consider intervention impacts. Three groups were identified: ‘inexperienced testers’ engaged with SELPHI to overcome motivational and social and physical opportunity testing barriers. For ‘pro self-testers’, testing frequency was constrained by psychological and social barriers and lack of opportunity. ‘Opportunistic adopters’ engaged in HIVST for novelty and convenience. Perceived impacts for inexperienced testers were most closely aligned with the logic model, but for opportunistic adopters there was little evidence of impact. Distinctive groups were discernible with divergent intervention experiences. Using COM-B as a model for understanding behaviour change in relation to HIVST, our results indicate how HIVST interventions could be adapted to respond to different needs based on the target population’s demographic and behavioural features.
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Affiliation(s)
- T. Charles Witzel
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK; (P.W.); (C.B.)
- Correspondence:
| | - Peter Weatherburn
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK; (P.W.); (C.B.)
| | - Adam Bourne
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne 3086, Australia;
| | - Alison J. Rodger
- Institute for Global Health, University College London, London NW3 2PF, UK; (A.J.R.); (A.S.); (F.L.); (A.N.P.); (F.M.B.)
| | - Chris Bonell
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK; (P.W.); (C.B.)
| | - Mitzy Gafos
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London WC1h 9SH, UK;
| | | | - Andrew Speakman
- Institute for Global Health, University College London, London NW3 2PF, UK; (A.J.R.); (A.S.); (F.L.); (A.N.P.); (F.M.B.)
| | - Fiona Lampe
- Institute for Global Health, University College London, London NW3 2PF, UK; (A.J.R.); (A.S.); (F.L.); (A.N.P.); (F.M.B.)
| | - Denise Ward
- Medical Research Council Clinical Trials Unit, University College London, London, WC1V 6LJ, UK; (D.W.); (D.T.D.); (M.M.G.); (L.M.); (Y.C.M.); (S.M.)
| | - David T. Dunn
- Medical Research Council Clinical Trials Unit, University College London, London, WC1V 6LJ, UK; (D.W.); (D.T.D.); (M.M.G.); (L.M.); (Y.C.M.); (S.M.)
| | - Michelle M. Gabriel
- Medical Research Council Clinical Trials Unit, University College London, London, WC1V 6LJ, UK; (D.W.); (D.T.D.); (M.M.G.); (L.M.); (Y.C.M.); (S.M.)
| | - Leanne McCabe
- Medical Research Council Clinical Trials Unit, University College London, London, WC1V 6LJ, UK; (D.W.); (D.T.D.); (M.M.G.); (L.M.); (Y.C.M.); (S.M.)
| | | | - Yolanda Collaco Moraes
- Medical Research Council Clinical Trials Unit, University College London, London, WC1V 6LJ, UK; (D.W.); (D.T.D.); (M.M.G.); (L.M.); (Y.C.M.); (S.M.)
| | - Susan Michie
- Centre for Behaviour Change, University College London, London WC1N 3AZ, UK;
| | - Andrew N. Phillips
- Institute for Global Health, University College London, London NW3 2PF, UK; (A.J.R.); (A.S.); (F.L.); (A.N.P.); (F.M.B.)
| | - Sheena McCormack
- Medical Research Council Clinical Trials Unit, University College London, London, WC1V 6LJ, UK; (D.W.); (D.T.D.); (M.M.G.); (L.M.); (Y.C.M.); (S.M.)
| | - Fiona M. Burns
- Institute for Global Health, University College London, London NW3 2PF, UK; (A.J.R.); (A.S.); (F.L.); (A.N.P.); (F.M.B.)
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Taylor TN, DeHovitz J, Hirshfield S. Intersectional Stigma and Multi-Level Barriers to HIV Testing Among Foreign-Born Black Men From the Caribbean. Front Public Health 2020; 7:373. [PMID: 31998675 PMCID: PMC6965168 DOI: 10.3389/fpubh.2019.00373] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 11/21/2019] [Indexed: 01/08/2023] Open
Abstract
Testing is the entry point into the HIV care continuum that includes linkage to and retention in prevention services, and adherence to prevention strategies, including repeat HIV testing. Despite US policy approaches to expand HIV testing to diverse clinical care and community settings, disparities in HIV testing among Black populations persist. Foreign-born (FB) Black persons from the Caribbean have higher annual rates of HIV diagnosis and a higher percentage of late-stage HIV diagnosis, compared with US-born Black persons; and most HIV infections among FB Blacks are among men. In this article, we provide an overview of HIV testing barriers among FB Black men who engage in HIV risk-taking behaviors (e.g., condomless sex with male and/or female partners of unknown HIV serostatus). Barriers to HIV testing for both FB and US-born Black men, include HIV stigma (anticipated, perceived, internalized), low perceived HIV risk, medical or government mistrust, and perceived low access to testing resources. We examine beliefs about masculinity and gender roles that may perpetuate heteronormative stereotypes associated with perceptions of low HIV risk and barriers to HIV testing. We also discuss the impact of recent immigration policies on accessing HIV testing and treatment services and how intersectional stigmas and structural forms of oppression, such as racism, prejudice against select immigrant groups, and homophobia that may further amplify barriers to HIV testing among FB Black men. Finally, we review comprehensive prevention approaches, and suggest innovative approaches, that may improve the uptake of HIV testing among FB Black men.
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Affiliation(s)
- Tonya N. Taylor
- SUNY Downstate Health Sciences University, Brooklyn, NY, United States
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Fernández-Sotos P, Navarro E, Torio I, Dompablo M, Fernández-Caballero A, Rodriguez-Jimenez R. Pharmacological interventions in social cognition deficits: A systematic mapping review. Psychiatry Res 2018; 270:57-67. [PMID: 30245378 DOI: 10.1016/j.psychres.2018.09.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Revised: 08/08/2018] [Accepted: 09/07/2018] [Indexed: 12/17/2022]
Abstract
Social cognition is an important research field in psychiatry due to its relevance in the functioning and quality of life of patients. The objective of this work is to conduct a systematic mapping review of pharmacological strategies for improving social cognition deficits. Publications from 2006 to 2016 were reviewed in Scopus, PsycINFO, PubMed, and Embase. From the initial 1059 publications obtained, a final number of 110 were selected. The results show an increasing interest in pharmacological approaches in different medical fields (especially psychiatry, pharmacology, and endocrinology, with schizophrenia and autism as the most studied disorders), as can be observed in the progressive increase in the number of publications, the high degree of scientific evidence, and the high impact factor of publications. However, it is also observed that most studies were conducted with oxytocin, psychostimulants, and antipsychotics (mainly risperidone and olanzapine), with few studies using other drugs. In the different social cognition domains, the majority of publications were focused on emotional processing or theory of mind, with few studies in other domains. Thus, this systematic mapping review shows that, even though there are increasing research activities, there are some important gaps to cover in future investigation.
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Affiliation(s)
- Patricia Fernández-Sotos
- Department of Psychiatry, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain; CIBERSAM (Biomedical Research Networking Centre in Mental Health), Spain
| | - Elena Navarro
- CIBERSAM (Biomedical Research Networking Centre in Mental Health), Spain; Instituto de Investigación en Informática de Albacete, Albacete, Spain; Departamento de Sistemas Informáticos, Universidad de Castilla-La Mancha, Albacete, Spain
| | - Iosune Torio
- Department of Psychiatry, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain; CIBERSAM (Biomedical Research Networking Centre in Mental Health), Spain; Universidad Rey Juan Carlos, Madrid, Spain
| | - Mónica Dompablo
- Department of Psychiatry, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain; CIBERSAM (Biomedical Research Networking Centre in Mental Health), Spain
| | - Antonio Fernández-Caballero
- CIBERSAM (Biomedical Research Networking Centre in Mental Health), Spain; Instituto de Investigación en Informática de Albacete, Albacete, Spain; Departamento de Sistemas Informáticos, Universidad de Castilla-La Mancha, Albacete, Spain
| | - Roberto Rodriguez-Jimenez
- Department of Psychiatry, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain; CIBERSAM (Biomedical Research Networking Centre in Mental Health), Spain; CogPsy-Group, Universidad Complutense de Madrid (UCM), Madrid, Spain.
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Indravudh PP, Choko AT, Corbett EL. Scaling up HIV self-testing in sub-Saharan Africa: a review of technology, policy and evidence. Curr Opin Infect Dis 2018; 31:14-24. [PMID: 29232277 PMCID: PMC5768229 DOI: 10.1097/qco.0000000000000426] [Citation(s) in RCA: 100] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW HIV self-testing (HIVST) can provide complementary coverage to existing HIV testing services and improve knowledge of status among HIV-infected individuals. This review summarizes the current technology, policy and evidence landscape in sub-Saharan Africa and priorities within a rapidly evolving field. RECENT FINDINGS HIVST is moving towards scaled implementation, with the release of WHO guidelines, WHO prequalification of the first HIVST product, price reductions of HIVST products and a growing product pipeline. Multicountry evidence from southern and eastern Africa confirms high feasibility, acceptability and accuracy across many delivery models and populations, with minimal harms. Evidence on the effectiveness of HIVST on increased testing coverage is strong, while evidence on demand generation for follow-on HIV prevention and treatment services and cost-effective delivery is emerging. Despite these developments, HIVST delivery remains limited outside of pilot implementation. SUMMARY Important technology gaps include increasing availability of more sensitive HIVST products in low and middle-income countries. Regulatory and postmarket surveillance systems for HIVST also require further development. Randomized trials evaluating the effectiveness and cost-effectiveness under multiple distribution models, including unrestricted delivery and with a focus on linkage to HIV prevention and treatment, remain priorities. Diversification of studies from west and central Africa and around blood-based products should be addressed.
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Affiliation(s)
| | - Augustine T. Choko
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine
| | - Elizabeth L. Corbett
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, England, UK
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