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Available from: Scott Kellerman, Feb 18, 2014
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    • "States such as New York that have streamlined regulations regarding pre-test counseling have seen increases in HIV testing (Koo et al. 2006). Given the recent licensure of rapid tests with processing times as little as 60 seconds (FDA 2010), an expedited/express testing approach that excludes prevention counseling sessions could be provided through street outreach programs at large events such as gay pride. "
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    ABSTRACT: Men who have sex with men (MSM) continue to be disproportionately impacted by the Human Immunodeficiency Virus (HIV) epidemic in the United States (US). Testing for HIV is the cornerstone of comprehensive prevention efforts and the gateway to early engagement of infected individuals in medical care. We sought to determine attitudes towards six different HIV testing modalities presented collectively to internet-using MSM and identify which options rank higher than others in terms of intended usage preference. Between October and November 2012, we surveyed 973 HIV-negative or -unknown status MSM and assessed their acceptability of each of the following services hypothetically offered free of charge: Testing at a physician's office; Individual voluntary counseling and testing (VCT); Couples' HIV counseling and testing (CHCT); Expedited/express testing; Rapid home self-testing using an oral fluid test; Home dried blood spot (DBS) specimen self-collection for laboratory testing. Kruskal-Wallis tests were used to determine whether the stated likelihood of using each of these modalities differed by selected respondent characteristics. Men were also asked to rank these options in order of intended usage preference, and consensual rankings were determined using the modified Borda count (MBC) method. Most participants reported being extremely likely or somewhat likely to use all HIV testing modalities except DBS self-collection for laboratory testing. Younger MSM indicated greater acceptability for expedited/express testing (P < 0.001), and MSM with lower educational levels reported being more likely to use CHCT (P < 0.001). Non-Hispanic black MSM indicated lower acceptability for VCT (P < 0.001). Rapid home self-testing using an oral fluid test and testing at a physician's office were the two most preferred options across all demographic and behavioral strata. Novel approaches to increase the frequency of HIV testing among US MSM are urgently needed. Combination testing packages could enable high risk MSM in putting together annual testing strategies personalized to their circumstances, and warrant due consideration as an element of combination HIV prevention packages.
    SpringerPlus 02/2014; 3(1):109. DOI:10.1186/2193-1801-3-109
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    • "The first has been to increase the number of sites—fixed and mobile—in which people are offered VCT services (Marum, Taegtmeyer, and Chebet 2006; Yeatman 2007). A second method, more recent, has been to substitute what is alternately referred to as "provider-initiated," "routine," "opt-out" testing for more traditional VCT approaches (Beckwith et al. 2005; Koo et al. 2006; Weiser et al. 2007). While each of these methods has generated increases in proportions tested, the time-trends graphed in Figure 2 show that they have not modified the differences in HIV testing between educational groups. "
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    ABSTRACT: The plan to increase HIV testing is a cornerstone of the international health strategy against the HIV/AIDS epidemic, particularly in sub-Saharan Africa. This paper highlights a problematic aspect of that plan: the reliance on clinic- rather than home-based testing. First, drawing on DHS data from across Africa, we demonstrate the substantial differences in socio-demographic and economic profiles between those who report having ever had an HIV test, and those who report never having had one. Then, using data from a random household survey in rural Malawi, we show that substituting home-based for clinic-based testing may eliminate this source of inequality between those tested and those not tested. This result, which is stable across modeling frameworks, has important implications for accurately and equitably addressing the counseling and treatment programs that comprise the international health strategy against AIDS, and that promise to shape the future trajectory of the epidemic in Africa and beyond.
    Demographic Research 07/2009; 21(21):627-646. DOI:10.4054/DemRes.2009.21.21 · 1.20 Impact Factor
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