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      Preference towards HIV Self-Testing above Other Testing Options in a Sample of Men Who Have Sex with Men from Five European Countries

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          Abstract

          We analyzed men who have sex with men (MSM) from Denmark, Germany, Greece, Portugal and Spain to identify who would choose HIV self-testing as their preferred testing method and assessed their preferred setting to acquire a self-testing kit and to confirm a reactive result. In 2016, we recruited an online sample of 3725 HIV-negative MSM. We used Poisson regression to identify factors associated with choosing self-testing as the preferred testing option. For those choosing it as their preferred option, we assessed the preferred settings to acquire a self-testing kit and to confirm a reactive result. Not being open about one’s sexual behaviors with men was associated with choosing self-testing as the preferred option, except in Greece; older age in Greece and Spain; reporting condomless anal intercourses (CAI) in Germany and Portugal; reporting one previous test in Greece; between 2 and 5 in Spain and with having been tested ≥ 12 months ago in Germany, Portugal and Spain. The internet (32.8%) was the preferred place to acquire a self-testing kit and primary care (34.0%) for confirmation purposes. Self-testing was highly valued, especially among individuals who were not open about their sexual behaviors with men. In certain countries, it was also associated with older age, CAI and being undertested.

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          Most cited references49

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          Antiretroviral Therapy for the Prevention of HIV-1 Transmission.

          An interim analysis of data from the HIV Prevention Trials Network (HPTN) 052 trial showed that antiretroviral therapy (ART) prevented more than 96% of genetically linked infections caused by human immunodeficiency virus type 1 (HIV-1) in serodiscordant couples. ART was then offered to all patients with HIV-1 infection (index participants). The study included more than 5 years of follow-up to assess the durability of such therapy for the prevention of HIV-1 transmission.
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            Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio

            Background Cross-sectional studies with binary outcomes analyzed by logistic regression are frequent in the epidemiological literature. However, the odds ratio can importantly overestimate the prevalence ratio, the measure of choice in these studies. Also, controlling for confounding is not equivalent for the two measures. In this paper we explore alternatives for modeling data of such studies with techniques that directly estimate the prevalence ratio. Methods We compared Cox regression with constant time at risk, Poisson regression and log-binomial regression against the standard Mantel-Haenszel estimators. Models with robust variance estimators in Cox and Poisson regressions and variance corrected by the scale parameter in Poisson regression were also evaluated. Results Three outcomes, from a cross-sectional study carried out in Pelotas, Brazil, with different levels of prevalence were explored: weight-for-age deficit (4%), asthma (31%) and mother in a paid job (52%). Unadjusted Cox/Poisson regression and Poisson regression with scale parameter adjusted by deviance performed worst in terms of interval estimates. Poisson regression with scale parameter adjusted by χ2 showed variable performance depending on the outcome prevalence. Cox/Poisson regression with robust variance, and log-binomial regression performed equally well when the model was correctly specified. Conclusions Cox or Poisson regression with robust variance and log-binomial regression provide correct estimates and are a better alternative for the analysis of cross-sectional studies with binary outcomes than logistic regression, since the prevalence ratio is more interpretable and easier to communicate to non-specialists than the odds ratio. However, precautions are needed to avoid estimation problems in specific situations.
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              Initiation of Antiretroviral Therapy in Early Asymptomatic HIV Infection

              New England Journal of Medicine, 373(9), 795-807
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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                30 April 2021
                May 2021
                : 18
                : 9
                : 4804
                Affiliations
                [1 ]Departamento de Salud Pública y Materno-Infantil, Universidad Complutense de Madrid, 28040 Madrid, Spain; hoyosmiller@ 123456hotmail.com (J.H.); lsordo@ 123456ucm.es (L.S.); josepuli@ 123456ucm.es (J.P.)
                [2 ]Gerencia de Atención Primaria de Valladolid Este, Gerencia Regional de Salud de Castilla y León (SACYL), 47010 Valladolid, Spain
                [3 ]CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain; jguerras@ 123456isciii.es (J.-M.G.); cagusti@ 123456iconcologia.net (C.A.); mbelza@ 123456isciii.es (M.-J.B.)
                [4 ]Centro Nacional de Epidemiología, Instituto de Salud Carlos III, 28029 Madrid, Spain
                [5 ]Escuela Nacional de Sanidad, Instituto de Salud Carlos III, 28029 Madrid, Spain; ma.donat@ 123456isciii.es
                [6 ]Departament de Salut, Centre Estudis Epidemiologics sobre les Infeccions de Transmissio Sexual i Sida de Catalunya (CEEISCAT), Generalitat de Catalunya, 08005 Badalona, Spain
                [7 ]AIDS Hilfe NRW e.V., 10963 Berlin, Germany; matthias@ 123456kuske.de
                [8 ]GAT-Grupo de Ativistas em Tratamentos, 1000-228 Lisboa, Portugal; ricardo.fuertes@ 123456gatportugal.org
                [9 ]Checkpoint Athens, 105 54 Athens, Greece; schanos@ 123456athcheckpoint.gr
                [10 ]AIDS Fondet, 1456 Copenhagen, Denmark; francoisdk@ 123456gmail.com
                Author notes
                [†]

                EURO HIV EDAT Group are listed in Acknowledgments.

                Author information
                https://orcid.org/0000-0003-3772-2771
                https://orcid.org/0000-0003-3441-7771
                https://orcid.org/0000-0001-6708-3291
                https://orcid.org/0000-0002-6323-2779
                https://orcid.org/0000-0003-1760-9472
                https://orcid.org/0000-0001-8487-7384
                Article
                ijerph-18-04804
                10.3390/ijerph18094804
                8125199
                33946300
                1a3a84e8-87a5-4a19-ac1d-9b177b448025
                © 2021 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( https://creativecommons.org/licenses/by/4.0/).

                History
                : 07 March 2021
                : 27 April 2021
                Categories
                Article

                Public health
                early diagnosis,hiv,self-testing,men who have sex with men
                Public health
                early diagnosis, hiv, self-testing, men who have sex with men

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