Diagnostic Technologies in Practice

Grace, Daniel; Steinberg, Malcolm; Kwag, Michael; Chown, Sarah; Doupe, G; Trussler, Terry; Rekart, Michael L.; Gilbert, Mark

doi:10.1177/1049732314549813

Cited by 15 publications

(24 citation statements)

References 30 publications

(41 reference statements)

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“…The men we spoke with argued that more equitable policy would be one more aligned with sound scientific evidence. However, participants tended to speak somewhat more favourably of a 3-month deferral policy, in part because this timeframe matched the typical window period from infection to seroconversion that has become normalized in HIV testing practices [40, 41]. While moves towards a 3-month deferral were viewed as positive by some participants—apparent stepping stones on a road to equity—the majority still considered any policy that maintained a MSM-specific deferral as representing a form of “othering” and being discriminatory.…”

Section: Discussionmentioning

confidence: 99%

Gay and bisexual men’s views on reforming blood donation policy in Canada: a qualitative study

et al. 2019

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Background Researchers and activists have long called for changes to blood donation policies to end what is frequently framed as unjustified bans or deferral periods for men who have sex with men (MSM). Since 2016, in Canada, a man had to be abstinent from all sexual contact (anal or oral sex) with other men for at least 12 months in order to be an eligible blood donor. As of June 3, 2019, this deferral period was reduced to 3 months. Methods To better understand the acceptance of existing deferral policies and possible future policy, we conducted 47 in-depth interviews with a demographically diverse sample of gay, bisexual, queer, and other men who have sex with men (GBM) in Canada’s three largest cities: Vancouver, ( n = 17), Toronto ( n = 15), and Montreal ( n = 15). Interviews were coded in NVivo 11 following an inductive thematic analysis. We focus on men’s preferred policy directions and their opinions about a policy change proposed by Canada’s blood operators: a 3-month deferral for all sexual activity between men. We interviewed GBM approximately one-year before this new deferral policy was approved by Health Canada. Results Most participants were opposed to any deferral period in relation to MSM-specific sexual activity. A fair and safe policy was one that was the “same for everyone” and included screening for several risk factors during the blood donation process with no categorical exclusion of all sexually active MSM. Participants believed that multiple “gender blind” and HIV testing-related strategies could be integrated into the blood donation process. These preferences for a move away from MSM-specific exclusions aligned with their opinions concerning the possible change to a 3-month MSM deferral, for which participants shared three overarching perspectives: (1) step in the right direction ; (2) ambivalence and uncertainty ; and (3) not an improvement. Conclusion A predominant assertion was that a change from a 12-month to a 3-month deferral period would not resolve the fundamental issues of fairness and equity affecting blood screening practices for GBM in Canada. Many participants believed that blood donation policy should be based on more up-to-date scientific evidence concerning risk factor assessment and HIV testing. Electronic supplementary material The online version of this article (10.1186/s12889-019-7123-4) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Gay and bisexual men’s views on reforming blood donation policy in Canada: a qualitative study

et al. 2019

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“…Like US studies, our participants were uninformed about the high transmission potential during AHI. 20–22 Such understanding is critical because some MSM would change their behavior following AHI diagnosis to prevent onward HIV transmission in other studies, 13 and our participants predicted that others would as well.…”

Section: Discussionmentioning

confidence: 71%

“…8,12,20–22 Knowledge of symptoms is crucial because they could motivate AHI testing following high-risk sex. One of the largest studies about AHI found confusion surrounding the various HIV testing window periods.…”

Section: Introductionmentioning

confidence: 99%

Knowledge and preferences concerning acute HIV testing programs among both Peruvian men who have sex with men and transgender women

et al. 2017

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Immediate antiretroviral therapy (ART) for acute HIV infection (AHI) may decrease HIV transmission in high-risk populations. This study evaluated knowledge of AHI and AHI testing program preferences in Lima, Peru through four semi-structured focus groups with high-risk men who have sex with men (MSM) (n = 20) and transgender women (TW) (n = 16). Using content analysis, emergent themes included knowledge of AHI symptoms, AHI transmission potential, and the HIV testing window period, and preferences concerning point of care results. Participants demonstrated low familiarity with the term AHI, but many correctly identified AHI symptoms. However, these symptoms may not motivate testing because they overlap with common viral illnesses and AIDS. Some were aware that infectiousness is highest during AHI, and believe this knowledge would facilitate HIV testing. The shortened window period with AHI testing would encourage testing following high-risk sex. Delayed result notification would not decrease AHI testing demand among MSM, although it might for some TW.

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“…This meta-theme highlights diagnosis as an emotive time, sometimes accompanied by anxiety or confusion generated by negative or indeterminate test results. Testing and uncertainty around result Diagnosis during AHI can be complicated by negative or indeterminate HIV antibody test results leading to confusion [22,29], mistrust of the diagnosis [29], and anxiety precipitated by healthcare providers' (HCP) own uncertainty [30]. In one study, some participants accessed confirmatory testing soon after diagnosis, while others first processed fears and concerns [28].…”

Section: Hiv Diagnosismentioning

confidence: 99%

“…Sexual behaviour change following diagnosis was discussed in seven articles [18,21,23,[29][30][31][32]. Some reported sexual risk reduction to prevent onward transmission, while others demonstrated no behaviour modification as participants adjusted to their diagnosis.…”

Section: Sexual Behaviour Changementioning

confidence: 99%

A systematic review of qualitative research on recently acquired HIV

Nicholls,

Policek,

Volny-Anne

et al. 2023

Aids

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Objective(s): Recently-acquired HIV is a critical time when people may experience debilitating symptoms and is when they are most likely to pass HIV on. Qualitative research offers insights into lived experiences and a deeper understanding of the contextual factors underlying HIV acquisition. We aimed to synthesize qualitative literature on recently-acquired HIV. Design: Systematic review and textual narrative synthesis. Methods: We searched MEDLINE, CINAHL Plus, PsycINFO and Sociology Database. Articles were screened, and two authors completed full text review and data extraction. Quality appraisal was conducted (Critical Appraisal Skills Programme Qualitative Studies Checklist) and certainty of findings graded (GRADE-CERQual). Results: We reviewed 1890 articles (1554 following de-duplication), excluding 1539. Fifteen articles were included and an additional article was included after updating the search. We identified 15 themes, three of which we have high confidence in: recent acquisition of HIV facilitates understanding of circumstances of HIV acquisition; indeterminate HIV tests generate uncertainty and anxiety; and people with recently-acquired HIV are motivated to reduce risk of onward transmission. Conclusions: Our findings highlight the importance of continued research into recently-acquired HIV, as well as the need for support to manage the emotional impact of indeterminate test results and negotiate risk reduction. We found no studies exploring sexual risk in the context of recently-acquired HIV, or use of PrEP or treatment as prevention. The literature is primarily focused on HIV acquisition from an individual and behavioral perspective, neglecting important aspects of lived experience such as immediate ART, stigma, and health and wellbeing.

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Diagnostic Technologies in Practice

Cited by 15 publications

References 30 publications

Gay and bisexual men’s views on reforming blood donation policy in Canada: a qualitative study

Gay and bisexual men’s views on reforming blood donation policy in Canada: a qualitative study

Knowledge and preferences concerning acute HIV testing programs among both Peruvian men who have sex with men and transgender women

A systematic review of qualitative research on recently acquired HIV

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