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      Effectiveness of a Novel HIV Self-Testing Service with Online Real-Time Counseling Support (HIVST-Online) in Increasing HIV Testing Rate and Repeated HIV Testing among Men Who Have Sex with Men in Hong Kong: Results of a Pilot Implementation Project

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          Abstract

          HIV self-testing (HIVST) with online real-time counseling (HIVST-online) is an evidence-based intervention to increase HIV testing coverage and to ensure linkage to care for men who have sex with men (MSM). A community-based organization (CBO) recruited 122 MSM who had ever used HIVST-online (ever-users) and another 228 new-users from multiple sources and promoted HIVST-online. A free oral fluid-based HIVST kit was sent to all the participants by mail. Experienced HIVST administrators implemented HIVST-online by providing real-time instruction, standard-of-care pre-test and post-test counseling via live-chat application. The number of HIVST-online sessions performed was documented by the administrators. The post-test evaluation was conducted 6 months after the pre-test survey. At month 6, 63.1% of ever-users and 40.4% of new-users received HIVST-online. Taking other types of HIV testing into account, 79.4% of ever-users and 58.6% of new-users being followed up at month 6 received any HIV testing during the project period. Ever-users were more likely to receive HIVST-online and any HIV testing as compared to new-users. Four HIVST-online users were screened to be HIV positive and linked to the treatment. The process evaluation of HIVST-online was positive. Implementation of HIVST-online was helpful to improve HIV testing coverage and repeated HIV testing among Chinese MSM. A larger scale implementation should be considered.

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          Most cited references34

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          Antiretroviral Prophylaxis for HIV Prevention in Heterosexual Men and Women

          New England Journal of Medicine, 367(5), 399-410
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            Does tailoring matter? Meta-analytic review of tailored print health behavior change interventions.

            Although there is a large and growing literature on tailored print health behavior change interventions, it is currently not known if or to what extent tailoring works. The current study provides a meta-analytic review of this literature, with a primary focus on the effects of tailoring. A comprehensive search strategy yielded 57 studies that met inclusion criteria. Those studies-which contained a cumulative N = 58,454-were subsequently meta-analyzed. The sample size-weighted mean effect size of the effects of tailoring on health behavior change was found to be r = .074. Variables that were found to significantly moderate the effect included (a) type of comparison condition, (b) health behavior, (c) type of participant population (both type of recruitment and country of sample), (d) type of print material, (e) number of intervention contacts, (f) length of follow-up, (g) number and type of theoretical concepts tailored on, and (h) whether demographics and/or behavior were tailored on. Implications of these results are discussed and future directions for research on tailored health messages and interventions are offered. Copyright 2007 APA
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              High Coverage of ART Associated with Decline in Risk of HIV Acquisition in Rural KwaZulu-Natal, South Africa

              In the battle to control HIV, mass antiretroviral treatment (ART) costs $500 to $900 per person per year. Bor et al. (p. [Related article:] 961 ) calculated the impact of intensifying ART on the life expectancy of people living in rural KwaZulu Natal. The dates of death were collected from a population of about 100,000 people during 2000–2011: Four years before and 8 years after the scaling up of ART. Life expectancy of adults increased by more than 11 years after ART was expanded, and the economic value of the lifetimes gained were calculated to far exceed the cost of treatment. Tanser et al. (p. [Related article:] 966 ) followed nearly 17,000 HIV-uninfected individuals in KwaZulu-Natal over an 8-year period. Holding other HIV risk factors constant, individual HIV acquisition risk declined significantly with increasing ART coverage of HIV-infected people. The risk of acquiring HIV is reduced in rural communities via large-scale delivery of antiretroviral therapy. The landmark HIV Prevention Trials Network (HPTN) 052 trial in HIV-discordant couples demonstrated unequivocally that treatment with antiretroviral therapy (ART) substantially lowers the probability of HIV transmission to the HIV-uninfected partner. However, it has been vigorously debated whether substantial population-level reductions in the rate of new HIV infections could be achieved in "real-world" sub-Saharan African settings where stable, cohabiting couples are often not the norm and where considerable operational challenges exist to the successful and sustainable delivery of treatment and care to large numbers of patients. We used data from one of Africa's largest population-based prospective cohort studies (in rural KwaZulu-Natal, South Africa) to follow up a total of 16,667 individuals who were HIV-uninfected at baseline, observing individual HIV seroconversions over the period 2004 to 2011. Holding other key HIV risk factors constant, individual HIV acquisition risk declined significantly with increasing ART coverage in the surrounding local community. For example, an HIV-uninfected individual living in a community with high ART coverage (30 to 40% of all HIV-infected individuals on ART) was 38% less likely to acquire HIV than someone living in a community where ART coverage was low (<10% of all HIV-infected individuals on ART).
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                Author and article information

                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
                15 January 2021
                January 2021
                : 18
                : 2
                : 729
                Affiliations
                [1 ]JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; pchan@ 123456link.cuhk.edu.hk (P.S.-f.C.); mitk@ 123456cuhk.edu.hk (M.I.)
                [2 ]AIDS Concern, Hong Kong, China; andrew.chidgey@ 123456aidsconcern.org.hk (A.C.); jason.lau@ 123456aidsconcern.org.hk (J.L.)
                Author notes
                [* ]Correspondence: jlau@ 123456cuhk.edu.hk (J.T.F.L.); wangzx@ 123456cuhk.edu.hk (Z.W.)
                Author information
                https://orcid.org/0000-0003-2344-7107
                Article
                ijerph-18-00729
                10.3390/ijerph18020729
                7830557
                33467770
                51b980d6-f2b0-49b6-b03b-fd4cf2c5cb1b
                © 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 ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 25 November 2020
                : 14 January 2021
                Categories
                Article

                Public health
                hiv self-testing,online real-time counseling,pilot implementation,outcome and process evaluation,men who have sex with men

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