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.

In 2015, a community-wide intervention was launched in the city of Curitiba to evaluate the uptake of multiple HIV testing. A three-stage cluster sampling of 4800 men aged 15-64 years was selected in Curitiba. Logistic regression models were used to establish driving factors of HIV testing over the past 12 months. In the total sample, 49.5% have tested for HIV once in lifetime and 18.7% in the last 12 months. Among MSM, the proportions were much higher: 75.9% and 47.8% respectively. In the multivariate analysis, a significantly higher likelihood of HIV testing was found for young men (15-24 years), men with better educational level, those with more than 6 casual partners, and MSM compared to heterosexual men. The results indicate that the intervention to increase HIV diagnosis has substantially expanded MSM access to HIV testing.

ABSTRACT

The use of natural gums, taken from the exudates and extracts of plants, has been given a strong impulse due to both the many and lucrative possibilities for industrialization and to the excellent international market. A gum or resin of a yellowish color, soluble in water, and which presents a great potential for industrialization, appears on the trunk and branches of the cashew tree; that is known mainly for its nuts that are used as a food ingredient. Cashew gum interacts with water and it has emulsifier, adhesive and stabilizer properties, occurring in the form of pale yellow to reddish ambers. In cold water, it swells into a jelly like mass but dissolves rapidly when heated. The resin/gum secretory ducts that appear along the cashew tree bark were studied using histological procedures and microscopic observations. The gum was studied at its crude state and then chemically treated in order to obtain a kind of gel (microbiofilm).

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 which increases access to and uptake of testing among key populations who are at high risk for HIV infection. OBJECTIVE To describe the development and feasibility of a free, anonymous, Internet-based HIV self-testing (HIVST) strategy designed for men who have sex with men (MSM) in Curitiba, Brazil (E-testing). METHODS The project was developed under the scope of the “A Hora é Agora” (Time is now) program. Individuals aiming to request an HIVST package (2 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, packages 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 with 3,218 provided complete answers to the online questionnaires. Most individuals self-reported being white (77%), young (median age was 25 years, interquartile range 22-31), educated (87.3% complete secondary education or more), and had previously tested for HIV (62.5%). Overall, 2,526 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 reporting to have used E-testing visited the pre-specified 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 MSM population centers in Brazil.