An Internet-Based HIV Self-Testing Program to Increase HIV Testing Uptake Among Men Who Have Sex With Men in Brazil: Descriptive Cross-Sectional Analysis

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Background

Approximately 30% of people living with HIV worldwide are estimated to be unaware of their infection. HIV self-testing (HIVST) is a strategy recommended by the World Health Organization to increase access to and uptake of testing among key populations who are at high risk for HIV infection.

Objective

This study aimed to describe the development and feasibility of a free, anonymous, internet-based HIVST strategy designed for men who have sex with men in Curitiba, Brazil (electronic testing [e-testing]).

Methods

The project was developed under the scope of the “A Hora é Agora” (The Time is Now) program. Individuals aiming to request an HIVST package (two tests each) answered an anonymous 5-minute questionnaire regarding inclusion criteria and sexual risk behavior. Eligible individuals could receive one package every 6 months for free. Website analytics, response to online questionnaires, package distribution, and return of test results were monitored via a platform-integrated system.

Results

Between February 2015 and January 2016, the website documented 17,786 unique visitors and 3218 completed online questionnaires. Most individuals self-reported being white (77.0%), young (median age: 25 years, interquartile range: 22-31 years), educated (87.3% completed secondary education or more), and previously tested for HIV (62.5%). Overall, 2526 HIVST packages were delivered; of those, 542 (21.4%) reported a result online or by mail (23 reactive and 11 invalid). During the study period, 37 individuals who reported using e-testing visited the prespecified health facility for confirmatory testing (30 positive, 7 negative).

Conclusions

E-testing proved highly feasible and acceptable in this study, thus supporting scale-up to additional centers for men who have sex with men in Brazil.

Related collections

Most cited references 30

Record: found
Abstract: found
Article: not found

The impact of anticipated HIV stigma on delays in HIV testing behaviors: findings from a community-based sample of men who have sex with men and transgender women in New York City.

Kristi Gamarel, Sarit A. Golub (2013)

Treatment as prevention (TaSP) is a critical component of biomedical interventions to prevent HIV transmission. However, its success is predicated on testing and identifying undiagnosed individuals to ensure linkage and retention in HIV care. Research has examined the impact of HIV-associated stigma on HIV-positive individuals, but little work has explored how anticipated HIV stigma-the expectation of rejection or discrimination against by others in the event of seroconversion-may serve as a barrier to HIV testing behaviors. This study examined the association between anticipated stigma and HIV testing behaviors among a sample of 305 men who have sex with men (MSM) and transgender women living in New York City. Participants' mean age was 33.0; 65.5% were racial/ethnic minority; and 50.2% earned <$20,000 per year. Overall, 32% of participants had not had an HIV test in the past 6 months. Anticipated stigma was negatively associated with risk perception. In multivariate models, anticipated stigma, risk perception, and younger age were significant predictors of HIV testing behaviors. Anti-HIV stigma campaigns targeting HIV-negative individuals may have the potential to significantly impact social norms around HIV testing and other biomedical strategies, such pre-exposure prophylaxis, at a critical moment for the redefinition of HIV prevention.

0 comments Cited 94 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: found

Is Open Access

HIV prevalence among men who have sex with men in Brazil: results of the 2nd national survey using respondent-driven sampling

Ligia Kerr, Carl Kendall, Mark Drew Crosland Guimarães … (2018)

Abstract This paper reports human immuno-deficiency virus (HIV) prevalence in the 2nd National Biological and Behavioral Surveillance Survey (BBSS) among men who have sex with men (MSM) in 12 cities in Brazil using respondent-driven sampling (RDS). Following formative research, RDS was applied in 12 cities in the 5 macroregions of Brazil between June and December 2016 to recruit MSM for BBSS. The target sample size was 350 per city. Five to 6 seeds were initially selected to initiate recruitment and coupons and interviews were managed online. On-site rapid testing was used for HIV screening, and confirmed by a 2nd test. Participants were weighted using Gile estimator. Data from all 12 cities were merged and analyzed with Stata 14.0 complex survey data analysis tools in which each city was treated as its own strata. Missing data for those who did not test were imputed HIV+ if they reported testing positive before and were taking antiretroviral therapy. A total of 4176 men were recruited in the 12 cities. The average time to completion was 10.2 weeks. The longest chain length varied from 8 to 21 waves. The sample size was achieved in all but 2 cities. A total of 3958 of the 4176 respondents agreed to test for HIV (90.2%). For results without imputation, 17.5% (95%CI: 14.7–20.7) of our sample was HIV positive. With imputation, 18.4% (95%CI: 15.4–21.7) were seropositive. HIV prevalence increased beyond expectations from the results of the 2009 survey (12.1%; 95%CI: 10.0–14.5) to 18.4%; CI95%: 15.4 to 21.7 in 2016. This increase accompanies Brazil's focus on the treatment to prevention strategy, and a decrease in support for community-based organizations and community prevention programs.

0 comments Cited 88 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

HIV among MSM in a large middle-income country.

Ligia R.F.S. Kerr, Rosa S Mota, Carl Kendall … (2013)

To conduct the first national biological and behavioral surveillance survey for HIV among MSM in Brazil. A cross-sectional surveillance study utilizing Respondent Driven Sampling (RDS) in 10 cities, following formative research. Planned sample: 350 MSM reporting sex with another man in the last 12 months, at least 18 years of age, and residing in the city of the study. Conventional RDS recruitment. Results were calculated for each city using RDSAT 5.6. For the national estimate, a new individual weight using a novel method was calculated. The 10 cities were aggregated, treated as strata and analyzed using STATA11.0. Self-reported HIV status and logistic regression was used to impute missing values for serostatus, an important issue for RDSAT. A total of 3859 MSM were interviewed. Sample was diverse, most self-identified as mulatto or black, were social class C or below, and had relatively low levels of education. More than 80% reported more than one partner in the last 6 months. Only 49% had ever tested for HIV. HIV prevalence among MSM ranged from 5.2 to 23.7% in the 10 cities (3.7-16.5% without imputation) and was 14.2% for all cities combined with imputation. The overall prevalence was two and three times higher than that estimated for female sex workers and drug users, respectively, in Brazil. Half of those who tested HIV positive were not aware of their infection. The AIDS epidemic in Brazil is disproportionately concentrated among MSM, as has been found in other countries. Renewed efforts to encourage testing, prevention and treatment are required.

0 comments Cited 76 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

Raquel Brandini De Boni:

Instituto Nacional de Infectologia Evandro ChagasOswaldo Cruz FoundationAv Brasil 4365Rio de Janeiro, 20530-360Brazil55 21 3865 9122raqueldeboni@gmail.com

ORCID: http://orcid.org/0000-0002-2455-5997

Journal

Journal ID (nlm-ta): J Med Internet Res

Journal ID (iso-abbrev): J. Med. Internet Res

Journal ID (publisher-id): JMIR

Title: Journal of Medical Internet Research

Publisher: JMIR Publications (Toronto, Canada )

ISSN (Print): 1439-4456

ISSN (Electronic): 1438-8871

Publication date Collection: August 2019

Publication date (Electronic): 01 August 2019

Volume: 21

Issue: 8

Electronic Location Identifier: e14145

Affiliations

[1 ] Instituto Nacional de Infectologia Evandro Chagas Oswaldo Cruz Foundation Rio de Janeiro Brazil

[2 ] National Department of STI, AIDS, and Viral Hepatitis Ministry of Health Brailia Brazil

[3 ] Escola Nacional de Saúde Pública Oswaldo Cruz Foundation Rio de Janeiro Brazil

[4 ] Secretaria Municipal de Saúde Curitiba Curitiba Brazil

[5 ] Grupo Dignidade Curitiba Brazil

[6 ] Centers for Disease Control and Prevention-Brazil Brasilia Brazil

[7 ] Division of Global HIV & TB Center for Global Health Centers for Disease Control and Prevention Atlanta, GA United States

[8 ] HIV Department World Health Organization Geneva Switzerland

Author notes

Corresponding Author: Raquel Brandini De Boni raqueldeboni@ 123456gmail.com

Author information

Raquel Brandini De Boni http://orcid.org/0000-0002-2455-5997

Valdilea Gonçalves Veloso http://orcid.org/0000-0002-6622-3165

Nilo Martinez Fernandes http://orcid.org/0000-0003-3770-6050

Flavia Lessa http://orcid.org/0000-0003-4200-5734

Renato Girade Corrêa http://orcid.org/0000-0003-3863-6875

Renato De Souza Lima http://orcid.org/0000-0003-4540-1054

Marly Cruz http://orcid.org/0000-0002-4061-474X

Juliane Oliveira http://orcid.org/0000-0002-5277-4281

Simone Muniz Nogueira http://orcid.org/0000-0002-9572-1067

Beto de Jesus http://orcid.org/0000-0001-7432-3388

Toni Reis http://orcid.org/0000-0003-4194-3323

Nena Lentini http://orcid.org/0000-0002-4941-0700

Raquel Lima Miranda http://orcid.org/0000-0003-4471-0429

Trista Bingham http://orcid.org/0000-0002-1949-5133

Cheryl C Johnson http://orcid.org/0000-0001-5499-5523

Aristides Barbosa Junior http://orcid.org/0000-0002-4744-9329

Beatriz Grinsztejn http://orcid.org/0000-0003-3692-5155

Article

Publisher ID: v21i8e14145

DOI: 10.2196/14145

PMC ID: 6694730

PubMed ID: 31373276

SO-VID: f82d1dd5-027a-4e79-b24e-5175d5bbfd6a

Copyright © ©Raquel Brandini De Boni, Valdilea Gonçalves Veloso, Nilo Martinez Fernandes, Flavia Lessa, Renato Girade Corrêa, Renato De Souza Lima, Marly Cruz, Juliane Oliveira, Simone Muniz Nogueira, Beto de Jesus, Toni Reis, Nena Lentini, Raquel Lima Miranda, Trista Bingham, Cheryl C Johnson, Aristides Barbosa Junior, Beatriz Grinsztejn. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 01.08.2019.

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/.as well as this copyright and license information must be included.

History

Date received : 27 March 2019

Date revision requested : 14 June 2019

Date revision received : 25 June 2019

Date accepted : 27 June 2019

Comments

Comment on this article

scite_

Cited by 24

See all cited by

Most referenced authors 823

See all reference authors

Submit your digital health research with an established publisher
- celebrating 25 years of open access