Showing 41 - 60 of 61 Results for "HIV testing"

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Improved screening technologies to distinguish transient HPV infections from longer duration cancer-inducing infections to improve HPV test-based screening is needed.
Meeting the Sexual and Reproductive Health Needs of Women Living With HIV
1 study
Increased support is needed for HIV serostatus disclosure, particularly at key times such as delivery, infant weaning, and at the resumption of sexual activity. Studies found that disclosure to partners was low and women reported needing additional support to disclose.
Antenatal Care - Testing and Counseling
1 study
Multiple strategies are needed to promote male involvement in ways that meet pregnant women’s needs. Studies found that some women found their partners’ involvement controlling and/or violent and other women wanted more autonomy in health decision-making. Studies also found men lacked information on vertical transmission and felt excluded from PMTCT programs. Other studies found that women indicated that they could not discuss their HIV serostatus with their husbands.
Antenatal Care - Testing and Counseling
1 study
Pregnant women living with HIV need timely access to CD4 count testing and results to access treatment. [See %{s:45}]
Provision and Access
1 study
Scale up of testing is needed with competent staff and labs in order to assess CD4 counts and link those who test HIV-positive to treatment. Studies are finding that in some countries, those who test HIV-positive are presenting with AIDS and that patients do not initiate ART despite eligibility. Those who test HIV-positive yet not eligible to receive antiretroviral therapy according to their national guidelines often did not remain in care until they were eligible for treatment.
Provision and Access
1 study
Additional efforts are needed to reduce HIV stigma so that women will present at health care settings with malaria symptoms and be willing to test for HIV before the development of more serious complications.
Malaria
1 study
Efforts are needed to further research and repeal laws that criminalize HIV non-disclosure, exposure or transmission — including vertical transmission of HIV—, which can discourage people from testing for HIV, and undermine the relationship between patients and physicians and other service providers. Because women are more likely to be tested, legal mandates to disclose HIV-positive serostatus may discourage women from accessing needed services and may lead to increased risk of abandonment and violence (see sections on VAW, HTC, etc).
Advancing Human Rights and Access to Justice for Women and Girls
1 study
Changes in strategies are needed for efforts that stigmatize sex workers and force mandatory testing without confidentiality. Studies in China found that sex workers are mandated to be tested for HIV in re-education camps but many are not informed of their serostatus. Studies found that sex workers were sent to labor re-education camps, were publicly shamed as sex workers and IDUs and had low rates of testing, condom use and access to services. Studies also found that cities in China that detain sex workers have a higher mean HIV prevalence compared to cities that do not detain sex workers.
Female Sex Workers
1 study
Programs are needed to reduce violence against women who test HIV-positive and/or are already living with HIV. A study found that HIV-positive women report that they were subjected to violence upon disclosure of their serostatus. Women living with HIV continue to experience violence (Hale and Vazquez, 2011). A study of serodiscordant couples found that intimate partner violence was more frequent in those who were HIV positive (2.7% as compared to 2.2%). Those women who suffered from violence prior to couples testing continued to experience violence (Were et al., 2011).
Addressing Violence Against Women
1 study
Judicial action, legislation, and training on legal rights can protect people living with HIV from discrimination. Studies found that people reported being denied housing or being evicted for testing HIV-positive but that peer education on legal rights may increase protect people from discrimination. [See also %{s:61}]
Reducing Stigma and Discrimination
1 study
Health care settings need to offer appropriate, non-discriminatory services—and be attentive to HIV risk behaviors—to meet the sexual and reproductive health needs of WSW. Studies found that a number of WSW also have sexual relationships with men yet did not get tested for HIV.
Women Who Have Sex With Women (WSW)
1 study
More research is needed to understand the relationship between maternal single-dose nevirapine administered during delivery and postpartum nevirapine resistance found in breastmilk, and its impact on postnatal transmission to infants. [See also %{s:45}] A study detected nevirapine resistance in 40% of breast milk samples collected from 30 HIV-positive mothers after four weeks of single-dose nevirapine exposure. Breastmilk samples were collected from 19 mothers whose infants tested HIV negative and 11 mothers who infants tested HIV positive by 6 weeks of age.
Postpartum
1 study
Further interventions are needed to reduce stigma and discrimination against women, specifically, who are at high risk or living with HIV. [See also %{s:45}] Studies found that women and girls are highly stigmatized if they test positive for HIV. Stigma impacts the HIV-positive woman, herself, as well as her children, her siblings and her family. Some providers also discriminate against those living with HIV.
Reducing Stigma and Discrimination
1 study
Additional evidence- and rights-based interventions are needed for couples counseling in sero-discordant relationships; counseling that clearly explains serodiscordance and can identify women at risk of violence and make appropriate links to other services. While WHO issued recommendations on couples testing and counseling (WHO, 2012g), more evidence-based interventions are needed for counseling for couples in sero-discordant relationships. These interventions may need to differ by sex, as in one study, women living with HIV were likely to report an HIV-negative or unknown serostatus partner and men living with HIV were more likely to report multiple sexual partners.
Staying Healthy and Reducing Transmission
1 study
Laws and practices that obstruct adolescents’ access to services, such as parental consent requirements, age, and marital status requirements, must be aligned with the actual behavior of adolescents. Studies found that legal requirements restricted adolescents from getting tested for HIV even if they were sexually active and at risk for HIV. "There is a strong evidence base that the stigma, discrimination and criminalization affecting adolescent key populations aged 10 to 17 is intensified due to domestic and international legal constructs that rely on law-enforcement based interventions dependent upon arrests, pre-trial detention, incarceration and compulsory ‘rehabilitation’ in institutional placements," particularly among adolescents who sell sex or inject drugs (Conner, 2015: para 1).
Increasing Access to Services
1 study
Mandating pregnant women to enroll in ART on the same day they test HIV positive may violate their human rights and may result in loss-to-follow up, increasing the risk of mortality, morbidity and drug resistance. Providing enough counseling and information to pregnant women found positive before being initiated on lifelong treatment helps in reducing cases of loss to follow up. Active tracing of women lost to follow up in a way that does not violate consent, confidentiality and human rights, may be warranted. An analysis of national facilities with over 20,000 women started on cART under Option B+ found that loss to follow up was highest in patients who began cART at large clinics on the day they were diagnosed with HIV. After controlling for age and facility type, Option B+ patients who started on ART on the same day of testing were almost twice as likely to never return to the clinic than other Option B+ patients. Note: WHO September 2015 guidelines do not specify when during pregnancy a woman living with HIV should be initiated on cART
Antenatal Care - Treatment
1 study
A combination of infection control strategies may significantly reduce the rate of TB transmission, including drug-resistant TB, in high-risk, low-resourced health care settings. A mathematical model was created to simulate TB transmission in high TB/HIV prevalent settings. The model showed that masks alone would prevent 10% of new transmission in an overall epidemic, but could prevent a large proportion of XDR-TB cases among hospital staff. The combination of mask and reduced hospitalization with a shift to outpatient treatment could prevent nearly one-third of XDR-TB cases. Approximately 48% of XDR-TB cases could be averted by the end of 2012, if a combination of mask, reduced hospitalization with shift to outpatient treatment, improved ventilation, rapid drug resistance testing, HIV treatment and TB isolation facilities for highly infectious patients were implemented.
Structuring Health Services to Meet Women’s Needs
1 study
Successful strategies are needed to increase adherence to ART among adolescents and reduce loss to follow up. A study found that adolescents and young adults aged 15 to 24 living with HIV were more likely, following treatment initiation, to have higher viral loads, higher rates of virological failure and greater low to follow up from services. Another study found that adolescents (ages 9 to 19) had poorer virological outcomes compared to young adults (ages 20 to 28). A review found few estimates on viral suppression among ages 10 to 19 (All in End Adolescent AIDS, 2015c). A specialized HIV management program could not retain a substantial proportion of those who tested positive for HIV in care. A review of studies of adherence among adolescents and children in Lower and Middle Income countries found that most studies were cross-sectional with age data ranging from six months to 21, limiting the ability to define which strategies are key to increasing adherence among ages 10 to 19. Cognitive behavioral therapy can be further explored as a strategy to increase adherence in adolescent populations.
Increasing Access to Services
1 study
Efforts are needed to eliminate compulsory drug detention and instead, provide PWID with HIV prevention and testing services and effective drug dependency treatment by medical professionals. Detention centers are administered by police, military or other national government public security authorities and operate outside the form criminal justice system with detainees held without trial or right of appeal and those detained do not allow people to leave voluntarily (Wolfe, 2012). Studies found that women who use drugs were not given reproductive health services, including PMTCT services in compulsory detention and/or prison settings. Detoxification programs were substandard and ineffective. Despite high rates of HIV, antiretroviral treatment is largely unavailable in compulsory drug detention centers. One study found high rates of injecting drug use within prison and high rates of syringe sharing within prisons plus incarceration was not associated with reduction in drug use, with over a quarter of these female drug users. PWID in and out of prison who have started antiretroviral treatment should be able to continue treatment with access to medical supervision. Treatment in compulsory drug detention takes the form of sanction rather than therapy, with high relapse rates.
Women Who Use Drugs and Female Partners of Men Who Use Drugs
1 study
Initiatives that provide for early diagnosis and appropriate longitudinal care prior to treatment eligibility are needed to reduce mortality rates and costs among adults accessing treatment. A review found that early mortality among adults accessing antiretroviral therapy can be attributed to late diagnosis of HIV. Despite multiple interactions with parts of the healthcare system, a study of women in Uganda found that late presentation for HIV care resulted largely from the, “inability of the medical system to link women to appropriate care,” (McGrath et al., 2012: 1095). Women entered care only when symptomatic. Another study found that more than a quarter of HIV patients in care prior to ART initiation did not start ART according to national guideline criteria. Another study found that women did not know where to go to access treatment. A review found that a process is needed to optimize transfers of care without treatment interruption and with appropriate medical documentation. Another study found that over half of patients who were not yet known to be eligible for ART at enrollment but who had tested HIV-positive, including a quarter who had CD4 counts taken, were lost to follow up. Another review found that asymptomatic patients perceived little need to initiate ART. Another study found that those with higher CD4 counts who were not yet eligible for ART lacked social support and social capital, yet needed this support.
Provision and Access
1 study