HIV testing and linkage to services for youth (original) (raw)
Related papers
AIDS (London, England), 2017
Adolescents in Africa have low HIV testing rates. Better understanding of adolescent, provider, and caregiver experiences in high-burden countries such as Kenya could improve adolescent HIV testing programs. We conducted 16 qualitative interviews with HIV-positive and HIV-negative adolescents (13-18 years) and six focus group discussions with Healthcare workers (HCWs) and caregivers of adolescents in Nairobi, Kenya. Semi-structured interviews and focus groups were recorded and transcribed. Analysis employed a modified constant comparative approach to triangulate findings and identify themes influencing testing experiences and practices. All groups identified that supportive interactions during testing were essential to the adolescent's positive testing experience. HCWs were a primary source of support during testing. HCWs who acted respectful and informed helped adolescents accept results, link to care, or return for repeat testing, whereas HCWs who acted dismissive or judgmenta...
Barriers to, and emerging strategies for, HIV testing among adolescents in sub-Saharan Africa
Current Opinion in HIV and AIDS
Purpose of Review HIV/AIDS is one of the leading causes of death among adolescents in sub-Saharan Africa and 40% of new HIV infections worldwide occur in this group. HIV testing and counselling (HTC) is the critical first step to accessing HIV treatment. The prevalence of undiagnosed HIV infection is substantially higher in adolescents compared to in adults. We review barriers to HTC for adolescents and emerging HTC strategies appropriate to adolescents in sub-Saharan Africa. Recent Findings There are substantial individual, health system and legal barriers to HTC among adolescents, and stigma by providers and communities remains an important obstacle. There has been progress made in recent years in developing strategies that address some of these barriers, increase uptake of HTC and yield of HIV. These include targeted approaches focused on provision of HTC among those higher risk of being infected e.g. index-linked HTC and use of screening tools to identify those at risk of HIV. Communitybased HIV testing approaches including HIV self-testing and incentives have also been shown to increase uptake of HTC.
Seeking wider access to HIV testing for adolescents in sub-Saharan Africa
More than 80% of the HIV-infected adolescents live in sub- Saharan Africa. Acquired immune deficiency syndrome (AIDS)- related mortality has increased among adolescents 10–19 y old. The impact is highest in sub-Saharan Africa, where >80% of HIV-infected adolescents live. The World Health Organization has cited inadequate access to HIV testing and counseling (HTC) as a contributing factor to AIDS-related adolescent deaths, most of which occur in sub-Saharan Africa. This review focuses on studies conducted in high adolescent HIV-burden countries targeted by the “All In to End Adolescent AIDS” initiative, and describes barriers to adolescent HTC uptake and coverage. Fear of stigma and family reaction, fear of the impact of a positive diagnosis, perceived risk with respect to sexual exposure, poor attitudes of healthcare providers, and parental consent requirements are identified as major impediments. Most-at-risk adolescents for HIV infection and missed opportunities for testing include, those perinatally infected, those with early sexual debut, high mobility and multiple/older partners, and pregnant and nonpregnant females. Regional analyses show relatively low adolescent testing rates and more restrictive consent requirements for HTC in West and Central Africa as compared to East and southern Africa. Actionable recommendations for widening adolescent access to HTC and therefore timely care include minimizing legal consent barriers, healthcare provider training, parental education and involvement, and expanding testing beyond healthcare facilities.
Plos One, 2012
Objectives: Although youth (12-24 years) in Sub-Saharan Africa have a high HIV risk, many have poor access to HIV testing services and are unaware of their status. Our objective was to evaluate the proportion of adolescents (12-17 years) and young adults (18-24 years) who underwent HIV testing and the prevalence among those tested in an urban adult outpatient clinic with a routine HIV testing program in Durban, South Africa.
Factors Influencing Uptake of Hiv Testing and Counselling Among the Youth in Kintampo South District
2016
Background: HIV/AIDS is a threat to global development and human security, and Sub-Saharan Africa remains the region worst affected. It is estimated that 23.5 million people in this region are living with HIV, with youth accounting for 40% of new HIV infections. However, HIV Testing Counselling uptake among the youth is low. Aim: The objective of this study was to assess the factors influencing uptake of HIV testing and counselling among the youth aged 15-24 years in Kintampo South District. Methodology: A cross-sectional study was conducted among the youth aged 15 to 24 years using pre-tested questionnaire in the Kintampo South District. A simple random sampling technique was used to select the communities and households. Only participants who gave consent to participate in the study were interviewed. Data was collected on demographic characteristics, personal related and health system related factors that influence uptake of HIV testing and counselling among the youth 15-24 years. Results: Nearly half of the youth (49.8%) had never tested for HIV with factors such as lack of confidentiality, lack of privacy, mistrust of the health system, inconvenient facility opening hours, fear of positive results and poor attitude of services providers being cited as barriers to uptake of HIV testing and counselling. Age, educational status, marital status and occupation were some demographic factors found to be significant determinants of HIV testing and counselling among the youth. The single most significant factor that was associated with HIV testing and counselling from the study was the high willingness to test for HIV among the youth of the Kintampo South District. University of Ghana http://ugspace.ug.edu.gh v Conclusion: The findings of the study that nearly half of the youth had never tested for HIV and citing lack of confidentiality, lack of privacy, mistrust of the health system, inconvenient facility opening hours, fear of positive results and poor attitude of services providers as barriers to uptake of HIV testing and counselling has a serious public health implications.
Preferred HIV Testing Modalities Among Adolescent Girls and Young Women in Kenya
Journal of Adolescent Health, 2020
To improve testing coverage, it is imperative to determine adolescent girls and young women (AGYW) preferences about HIV testing modality and where they prefer receiving services. Methods: Participants were enrolled between May 2017 and April 2018 from three sites in Homa Bay County, Nyanza region, western Kenya. We explored two recruitment approaches (homebased vs. mobile-event based) and three HIV testing options (oral self-test, staff-administered, or referral to health facility). Exact logistic regression compared yield of newly diagnosed HIV and high-risk HIV-negatives from the recruitment and testing option strategies. Results: A total of 1,198 participants were enrolled, 1,046 (87.3%) at home and 152 (12.7%) at mobile events. Most participants (928, 77.5%) chose staff-aided testing either at home or at a mobile event; 268 (22.4%) chose self-testing; and only 2 (.2%) chose facility referral. Prevalence of newly diagnosed HIV-positives was 2.7% (32/1,198) and 36.8% (429/1,166) of HIV-negative AGYW were identified as high risk. We identified more newly diagnosed HIV infection among AGYW recruited at mobile events than at home (OR ¼ 3.11; 95% CI: 1.33e6.74; p ¼ .02). High-risk status was related to neither recruitment strategy nor testing modality. Older age was associated with increased odds of selecting an oral self-test (OR ¼ 1.85; 95% CI: 1.06e3.22). Conclusions: More than one-third of AGYW were at elevated risk of HIV infection, and those unaware of their HIV infection were more likely to be identified at a mobile outreach. Though selftesting was not the dominant preferred strategy, self-tests were performed accurately and with high confidence. These findings can help inform efficient identification of undiagnosed HIV infection and high risk for seroconversion among AGYW in similar settings.
Research Team: Babatunde Ahonsi (Nigeria) Nahla Tawab (Egypt) Scott Geibel and Sam Kalibala (Kenya) Jerry Okal (Uganda) Babacar Mane (Senegal) Nathi Sohaba and Julialynne Walker (South Africa) Eric Green (United States). This study, implemented between August 2011 and July 2012, sought to provide a comprehensive, evidence-based picture of the HIV-related issues facing young people across Africa, and the prevailing legal, policy, and programmatic responses. The study was designed to establish a basis for a sharper focus on youth within the response to HIV on the continent. Our researchers conducted country-specific analytical reviews of the relevant literature on factors associated with HIV risk-taking and health-seeking behaviors among young people aged 15–24 in six countries across Africa—Egypt, Kenya, Nigeria, Senegal, South Africa, and Uganda. In addition, qualitative and quantitative analyses enabled an evaluation of the similarities and differences among countries regarding factors associated with young people’s sexual risk behavior, HIV-related health-seeking behavior, and the extent of policy and programmatic involvement.
Journal of Acquired Immune Deficiency Syndromes (1999), 2018
Background: Low HIV testing uptake prevents identification of adolescents living with HIV and linkage to care and treatment. We implemented an innovative service package at health care facilities to improve HIV testing uptake and linkage to care among adolescents aged 10–19 years in Western Kenya. Methods: This quasi-experimental study used preintervention and postintervention data at 139 health care facilities (hospitals, health centers, and dispensaries). The package included health worker capacity building, program performance monitoring tools, adolescent-focused HIV risk screening tool, and adolescent-friendly hours. The study population was divided into early (10–14 years) and late (15–19 years) age cohorts. Implementation began in July 2016, with preintervention data collected during January–March 2016 and postintervention data collected during January–March 2017. Descriptive statistics were used to analyze the numbers of adolescents tested for HIV, testing HIV-positive, and l...