92. A Pilot Intervention to Improve Sexually Transmitted Infection Testing for Urban Adolescents

McKee, M. Diane; Rubin, Susan E.; Alderman, Elizabeth M.; Fletcher, Jason; Campos, Giselle

doi:10.1016/j.jadohealth.2010.11.139

Cited by 2 publications

(6 citation statements)

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“…There were 38 RCTs that reported on the effect of counseling messages: 14 RCTs on general counseling messages prior to HTS [70][71][72][73][74][75][76][77][78][79][80][81][82][83], 4 RCTs on couples counseling [84][85][86][87], 12 RCTs on message and content framing prior to HTS [33,[88][89][90][91][92][93][94][95][96][97][98], 4 RCTs on motivational counseling messages prior to HTS [99][100][101][102], and 4 RCTs on reduced duration counseling prior to HTS [103][104][105][106].…”

Section: Counsel (Information and Counseling Messages)mentioning

confidence: 99%

Section: Hiv-specific Counseling With and Without Economic Empowermentmentioning

confidence: 99%

“…Fourteen RCTs examined the role of general HIV counseling messages and content prior to HTS [70][71][72][73][74][75][76][77][78][79][80][81][82][83] (Table 1). Eight studies were conducted in the Americas [70][71][72]75,76,[81][82][83], 3 in Africa [73,77,79], 2 in Southeast Asia [74,80], and 1 in Europe [78]. One study focused on general population adults [74], 4 on women [75,77,78,80], 1 on MSM [83], 3 on PWID [70,72,75], and 5 on adolescents [71,73,76,79,81], one of which focused on transgender and non-binary adolescents [81].…”

Section: Hiv-specific Counseling With and Without Economic Empowermentmentioning

confidence: 99%

“…Eight studies were conducted in the Americas [70][71][72]75,76,[81][82][83], 3 in Africa [73,77,79], 2 in Southeast Asia [74,80], and 1 in Europe [78]. One study focused on general population adults [74], 4 on women [75,77,78,80], 1 on MSM [83], 3 on PWID [70,72,75], and 5 on adolescents [71,73,76,79,81], one of which focused on transgender and non-binary adolescents [81].…”

Section: Hiv-specific Counseling With and Without Economic Empowermentmentioning

confidence: 99%

“…Uptake. Among the 14 RCTs reported on HTS uptake following general HIV counseling messages [70][71][72][73][74][75][76][77][78][79][80][81][82][83], a meta-analysis of 7 RCTs [70][71][72]78,79,83,95] showed HIV-specific information and counseling messages prior to testing significantly but not importantly increased HTS uptake compared to standard services (RR: 1.22, 95% CI [1.01, 1.48], p < 0.05; I 2 = 64.6%; RD: 0.05, 95% CI [0.00, 0.10], p < 0.05; I 2 = 76.5%) (Figs 3 and 4 and S7 Appendix) with medium risk of bias. Two RCTs [77,80] reported on HTS uptake following HIV-specific counseling and economic empowerment.…”

Section: Hiv-specific Counseling With and Without Economic Empowermentmentioning

confidence: 99%

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Demand creation for HIV testing services: A systematic review and meta-analysis

et al. 2023

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Background HIV testing services (HTS) are the first steps in reaching the UNAIDS 95-95-95 goals to achieve and maintain low HIV incidence. Evaluating the effectiveness of different demand creation interventions to increase uptake of efficient and effective HTS is useful to prioritize limited programmatic resources. This review was undertaken to inform World Health Organization (WHO) 2019 HIV testing guidelines and assessed the research question, “Which demand creation strategies are effective for enhancing uptake of HTS?” focused on populations globally. Methods and findings The following electronic databases were searched through September 28, 2021: PubMed, PsycInfo, Cochrane CENTRAL, CINAHL Complete, Web of Science Core Collection, EMBASE, and Global Health Database; we searched IAS and AIDS conferences. We systematically searched for randomized controlled trials (RCTs) that compared any demand creation intervention (incentives, mobilization, counseling, tailoring, and digital interventions) to either a control or other demand creation intervention and reported HTS uptake. We pooled trials to evaluate categories of demand creation interventions using random-effects models for meta-analysis and assessed study quality with Cochrane’s risk of bias 1 tool. This study was funded by the WHO and registered in Prospero with ID CRD42022296947. We screened 10,583 records and 507 conference abstracts, reviewed 952 full texts, and included 124 RCTs for data extraction. The majority of studies were from the African (N = 53) and Americas (N = 54) regions. We found that mobilization (relative risk [RR]: 2.01, 95% confidence interval [CI]: [1.30, 3.09], p < 0.05; risk difference [RD]: 0.29, 95% CI [0.16, 0.43], p < 0.05, N = 4 RCTs), couple-oriented counseling (RR: 1.98, 95% CI [1.02, 3.86], p < 0.05; RD: 0.12, 95% CI [0.03, 0.21], p < 0.05, N = 4 RCTs), peer-led interventions (RR: 1.57, 95% CI [1.15, 2.15], p < 0.05; RD: 0.18, 95% CI [0.06, 0.31], p < 0.05, N = 10 RCTs), motivation-oriented counseling (RR: 1.53, 95% CI [1.07, 2.20], p < 0.05; RD: 0.17, 95% CI [0.00, 0.34], p < 0.05, N = 4 RCTs), short message service (SMS) (RR: 1.53, 95% CI [1.09, 2.16], p < 0.05; RD: 0.11, 95% CI [0.03, 0.19], p < 0.05, N = 5 RCTs), and conditional fixed value incentives (RR: 1.52, 95% CI [1.21, 1.91], p < 0.05; RD: 0.15, 95% CI [0.07, 0.22], p < 0.05, N = 11 RCTs) all significantly and importantly (≥50% relative increase) increased HTS uptake and had medium risk of bias. Lottery-based incentives and audio-based interventions less importantly (25% to 49% increase) but not significantly increased HTS uptake (medium risk of bias). Personal invitation letters and personalized message content significantly but not importantly (<25% increase) increased HTS uptake (medium risk of bias). Reduced duration counseling had comparable performance to standard duration counseling (low risk of bias) and video-based interventions were comparable or better than in-person counseling (medium risk of bias). Heterogeneity of effect among pooled studies was high. This study was limited in that we restricted to randomized trials, which may be systematically less readily available for key populations; additionally, we compare only pooled estimates for interventions with multiple studies rather than single study estimates, and there was evidence of publication bias for several interventions. Conclusions Mobilization, couple- and motivation-oriented counseling, peer-led interventions, conditional fixed value incentives, and SMS are high-impact demand creation interventions and should be prioritized for programmatic consideration. Reduced duration counseling and video-based interventions are an efficient and effective alternative to address staffing shortages. Investment in demand creation activities should prioritize those with undiagnosed HIV or ongoing HIV exposure. Selection of demand creation interventions must consider risks and benefits, context-specific factors, feasibility and sustainability, country ownership, and universal health coverage across disease areas.

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Section: Counsel (Information and Counseling Messages)mentioning

confidence: 99%

Section: Hiv-specific Counseling With and Without Economic Empowermentmentioning

confidence: 99%

Section: Hiv-specific Counseling With and Without Economic Empowermentmentioning

confidence: 99%

Section: Hiv-specific Counseling With and Without Economic Empowermentmentioning

confidence: 99%

Section: Hiv-specific Counseling With and Without Economic Empowermentmentioning

confidence: 99%

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Demand creation for HIV testing services: A systematic review and meta-analysis

et al. 2023

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Screening for genital chlamydia infection

Low

Redmond

Uusküla

et al. 2016

Cochrane Database of Systematic Reviews

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Evidence about the effects of screening on C. trachomatis transmission is of low quality because of directness and risk of bias. There is moderate quality evidence that detection and treatment of chlamydia infection can reduce the risk of PID in women at individual level. There is an absence of RCT evidence about the effects of chlamydia screening in pregnancy.Future RCTs of chlamydia screening interventions should determine the effects of chlamydia screening in pregnancy, of repeated rounds of screening on the incidence of chlamydia-associated PID and chlamydia reinfection in general and high risk populations.

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92. A Pilot Intervention to Improve Sexually Transmitted Infection Testing for Urban Adolescents

Cited by 2 publications

References 0 publications

Demand creation for HIV testing services: A systematic review and meta-analysis

Demand creation for HIV testing services: A systematic review and meta-analysis

Screening for genital chlamydia infection

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