Mudanças no âmbito da testagem anti-HIV no Brasil entre 1998 e 2005

França, Ivan; Calazans, Gabriela Junqueira; Zucchi, Eliana Miura

doi:10.1590/s0034-89102008000800011

Cited by 29 publications

(14 citation statements)

References 23 publications

(35 reference statements)

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“…[9–11] Since one quarter of all HIV tests performed in Brazil are conducted at blood centers, these findings further indicate that alternative testing sites are currently under-utilized by large numbers of persons wishing to know their HIV serostatus. [8]…”

Section: Discussionmentioning

confidence: 99%

“…[4–12] Previous studies have shown that many at-risk individuals get tested for HIV for the first time through the blood donation process. [4–8] This test-seeking behavior may pose a threat to the safety of the blood supply through a small but real risk of donation during the HIV window period. [3] The window period is the length of time following infection before the antibody screening test becomes reactive, which may be few days to a several weeks depending on the testing technology being used (e.g., antibodies are typically detected within three weeks after infection, HIV-RNA in seven to eleven days, p24 antigen in three to ten days after HIV-RNA.…”

Section: Introductionmentioning

confidence: 99%

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Blood Donor Test-Seeking Motivation and Prior HIV Testing Experiences in São Paulo, Brazil

et al. 2015

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Background HIV test-seeking behavior among blood donors has been observed worldwide and may pose a threat to the safety of the blood supply. We evaluated current test-seeking motivations and prior alternative HIV testing experiences among blood donors in São Paulo, Brazil. Methods All candidate or potential blood donors were consecutively approached and recruited to participate in the study upon presentation at Fundação Pró-Sangue Hemocentro, the largest blood bank in Brazil. Participants were recruited between August 2012 and May 2013 after they were screened for donor eligibility. Questionnaires were administered through audio computer-assisted self-interview (ACASI). Results Among 11,867 donors, 38% previously tested for HIV apart from blood donation, of whom 47.7% tested at public facilities and 2.7% acknowledged getting tested for HIV as the primary reason for donating. Dissatisfaction with prior alternative testing experience was reported by 2.5% of donors. Current test-seeking motivation was associated with dissatisfaction with prior alternative testing experience and testing at a public alternative facility. The most common reasons for dissatisfaction were too long of a wait to get tested and for results, counseling was too long, lack of privacy, and low confidence in the equipment and accuracy of the test. Conclusion Lack of awareness about the availability of free and confidential public HIV testing services as well as dissatisfaction with past HIV testing and counseling experiences motivate some individuals to test at blood banks. Test-seeking behavior among blood donors may be best addressed by improving alternative testing programs, particularly with respect to time delays, privacy and perceptions about test accuracy. Educational campaigns on safe blood donation and HIV testing for diagnosis, risk counseling and referral to care are also needed for the general public and for health care providers.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Blood Donor Test-Seeking Motivation and Prior HIV Testing Experiences in São Paulo, Brazil

et al. 2015

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“…Truly the greatest challenge to stemming the epidemic continues to be reducing the number of undiagnosed infections in the difficult to reach and most vulnerable populations who test too infrequently 18 . Reducing the number of undiagnosed infections is the first step in expanding care and treatment, viral suppression, and ultimately in preventing subsequent infection to new partners 10 .…”

Section: Discussionmentioning

confidence: 99%

“…Current rates of HIV testing among MSM, however, are not commensurate with their risk. While MSM test at higher rates than heterosexual men, they test less frequently than reproductive age women 18 . In a recently conducted 10 city respondent driven sampling study, just over half of the MSM interviewed had never been tested and close to 50% of those who consented to HIV testing and were seropositive were unaware of their infection 3 .…”

Section: Introductionmentioning

confidence: 95%

Acceptability of self-conducted home-based HIV testing among men who have sex with men in Brazil: data from an on-line survey

Lippman¹,

Périssé

Veloso

et al. 2014

Cad. Saúde Pública

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The Brazilian HIV/AIDS epidemic is concentrated among men who have sex with men (MSM), however HIV testing rates among MSM are not commensurate with their risk. Strategies to expand early diagnosis may include use of self-conducted home-based testing kits, which are now available for purchase in the US. In April 2011 we conducted a survey with Brazilian MSM using Facebook to assess HIV testing preferences and acceptability of home-based testing. Among 356 previously tested, HIV-negative MSM, 47% reported a preference for home-based testing, 27% preferred clinic-based testing, and 26% had no preference. Less frequent testers and those who had considered testing but failed to test were more likely to prefer home-based testing. Close to 90% reported that they would use self-test kits; 62% and 54% said they would use home-based testing to make choices about unprotected sex with regular and new partners, respectively. Concerns included difficulty to understand the tests (32%) and receiving results alone (23%). Overall, home-based testing may appeal to MSM and result in increased testing frequency. Research on feasibility and utilization of self-tests in practice is needed.

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“…In Brazil, this inequality is evidenced, in part, by HIV testing rates. In a home-based study conducted in Brazil in 2005 [39], the social segments in which the HIV testing rate was found to be lowest among men (28%) and among individuals ≥ 45 years of age (21%), whereas that rate was above the national average (of 34%) among women (38%), especially among those in the 25–34 year age bracket (60%). This is primarily attributable to prenatal HIV testing.…”

Section: Discussionmentioning

confidence: 99%

Late entry into HIV care: lessons from Brazil, 2003 to 2006

2012

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BackgroundTo ascertain the population rates and proportion of late entry into HIV care, as well as to determine whether such late entry correlates with individual and contextual factors.MethodsData for the 2003–2006 period in Brazil were obtained from public health records. A case of late entry into HIV care was defined as one in which HIV infection was diagnosed at death, one in which HIV infection was diagnosed after the condition of the patient had already been aggravated by AIDS-related diseases, or one in which the CD4+ T-cell count was ≤ 200 cells/mm3 at the time of diagnosis. We also considered extended and stricter sets of criteria (in which the final criterion was ≤ 350 cells/mm3 and ≤ 100 cells/mm3, respectively). The estimated risk ratio was used in assessing the effects of correlates, and the population rates (per 100,000 population) were calculated on an annual basis.ResultsRecords of 115,369 HIV-infected adults were retrieved, and 43.6% (50,358) met the standard criteria for late entry into care. Diagnosis at death accounted for 29% (14,457) of these cases. Late entry into HIV care (standard criterion) was associated with certain individual factors (sex, age, and transmission category) and contextual factors (region with less economic development/increasing incidence of AIDS, lower local HIV testing rate, and smaller municipal population). Use of the extended criteria increased the proportion of late entry by 34% but did not substantially alter the correlations analyzed. The overall population rate of late entry was 9.9/100,000 population, specific rates being highest for individuals in the 30–59 year age bracket, for men, and for individuals living in regions with greater economic development/higher HIV testing rates, collectively accounting for more than half of the cases observed.ConclusionsAlthough the high proportion of late entry might contribute to spreading the AIDS epidemic in less developed regions, most cases occurred in large cities, with broader availability of HIV testing, and in economically developed regions.

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Mudanças no âmbito da testagem anti-HIV no Brasil entre 1998 e 2005

Cited by 29 publications

References 23 publications

Blood Donor Test-Seeking Motivation and Prior HIV Testing Experiences in São Paulo, Brazil

Blood Donor Test-Seeking Motivation and Prior HIV Testing Experiences in São Paulo, Brazil

Acceptability of self-conducted home-based HIV testing among men who have sex with men in Brazil: data from an on-line survey

Late entry into HIV care: lessons from Brazil, 2003 to 2006

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