المؤلفون: Daniel Clutterbuck, Alan White, Kat Smithson, Ann Sullivan, Philippa C Matthews, Tim E. A. Peto, Gillian Dean, Martin Murchie, Chamut Kifetew, Valerie Delpech, A. G. Buckley, J. Josh, Fiona Burns, Nicola Mackie, Emma Young, Adrian Palfreeman, Ian Cormack, Hannah Skene, Laura Waters, Roy Trevelion, Michael Rayment, Anthony Nardone, Nick Larbalestier, Sara Croxford, Karen Trewinnard, Paul Randell

المصدر: HIV Medicine. 21:1-26

مصطلحات موضوعية: Male, medicine.medical_specialty, Evidence-Based Medicine, business.industry, Health Policy, Human immunodeficiency virus (HIV), HIV Infections, Hiv testing, medicine.disease_cause, United Kingdom, HIV Testing, Early Diagnosis, Infectious Diseases, Family medicine, Practice Guidelines as Topic, medicine, Humans, Female, Pharmacology (medical), Sexual Health, Association (psychology), business, Reproductive health

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::336821c985de25a73bdf0ffeaaf59a8cTest
https://doi.org/10.1111/hiv.13015Test

المؤلفون: Fiona Burns, Sarika Desai, Graham Hart, Gwenda Hughes, Anthony Nardone, Valerie Delpech, ON Gill

المصدر: HIV Medicine. 18:615-622

مصطلحات موضوعية: Adult, Male, Sexually Transmitted Diseases, Bacterial, medicine.medical_specialty, Adolescent, HIV Infections, Men who have sex with men, Cohort Studies, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, medicine, Humans, Pharmacology (medical), 030212 general & internal medicine, Homosexuality, Male, Gynecology, 030505 public health, Unsafe Sex, Proportional hazards model, business.industry, Incidence, Health Policy, Incidence (epidemiology), Hazard ratio, Attendance, virus diseases, Middle Aged, medicine.disease, Confidence interval, Infectious Diseases, England, Attributable risk, Regression Analysis, Syphilis, 0305 other medical science, business, Demography

الوصف: Objectives The aim of the study was to determine HIV incidence among men who have sex with men (MSM) who repeat test for HIV at sexually transmitted infection (STI) clinics in England, and identify associated factors. Methods Annual HIV incidence and 95% confidence interval (CI) were calculated for a national cohort of MSM who tested HIV negative at any STI clinic in England in 2012 and had a follow-up test within 1 year using routinely collected data. Cox regression analyses were performed to identify predictors of HIV acquisition and population attributable risk for HIV infection was calculated for predictors. Results In 2012, 85 500 MSM not known to be HIV positive attended any STI clinic in England, and 31% tested for HIV at least twice within 1 year at the same clinic. HIV incidence was 2.0 per 100 person-years (PY; 95% CI 1.8–2.2) among repeat testers. Incidence was higher among MSM of black ethnicity (3.2 per 100 PY) and those with a bacterial STI diagnosis at the initial attendance (3.2 per 100 PY). MSM with a previous syphilis or gonorrhoea infection were at significantly greater risk of acquiring HIV in the subsequent year [adjusted hazard ratio 4.1 (95% CI 2.0–8.3) and 2.1 (95% CI 1.4–3.2), respectively]. The predictors accounted for 37% of HIV infections. Conclusions Annual HIV incidence among MSM attending STI clinics in England is high. Previous STIs were predictors of HIV acquisition but only accounted for one in five infections. More discriminatory behavioural predictors of HIV acquisition could provide better triaging of HIV prevention services for MSM attending STI clinics.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::79412ecd603961c4e7d1f6f48aacb2cdTest
https://doi.org/10.1111/hiv.12498Test

المؤلفون: Sewell, J, Daskalopoulou, M, Nakagawa, F, Lampe, FC, Edwards, S, Perry, N, Wilkins, E, O'Connell, R, Jones, M, Collins, S, Speakman, A, Phillips, AN, Rodger, AJ, Johnson, Margaret, McDonnell, Jeff, Aderonke, Adebiyi, Gilson, Richard, Haddow, Lewis, Gilson, Simon, Broussard, Christina, Pralat, Robert, Wayal, Sonali, Fisher, Martin, Pollard, Alex, Fedele, Serge, Kerr, Louise, Heald, Lisa, Hadley, Wendy, Hobbs, Kerry, Williams, Julia, Youssef, Elaney, Richardson, Celia, Groth, Sean, Clowes, Yvonne, Cullie, Jennifer, Murphy, Cynthia, Martin, Christina, George, Valerie, Thompson, Andrew, Anderson, Jane, Mguni, Sifiso, Awosika, Damilola, Scourse, Rosalind, Aderogba, Kazeem, Osborne, Caron, Cross, Sue, Whinney, Jacqueline, Tawana, Cheryl, Lascar, Monica, Maseko, Zandile, Townsend, Gemma, Theodore, Vera, Sagoo, Jas, Miners, Alec, Hart, Graham, Geretti, Anna‐Maria, Burman, Bill, Partridge, Nick, Orton, Kay, Nardone, Anthony, Sullivan, Ann

المساهمون: Daskalopoulou, M [0000-0001-9927-0358], Lampe, FC [0000-0001-6851-5471], Apollo - University of Cambridge Repository

المصدر: HIV Medicine
Sewell, J, Daskalopoulou, M, Nakagawa, F, Lampe, F C, Edwards, S, Perry, N, Wilkins, E, O'Connell, R, Jones, M, Collins, S, Speakman, A, Phillips, A N, Rodger, A J & Antiretrovirals, S T R A A ASTRA S G 2017, ' Accuracy of self-report of HIV viral load among people with HIV on antiretroviral treatment. ', HIV Medicine, vol. 18, no. 7 . https://doi.org/10.1111/hiv.12477Test

مصطلحات موضوعية: 0301 basic medicine, Adult, Male, Pediatrics, medicine.medical_specialty, Sexual transmission, Human immunodeficiency virus (HIV), HIV Infections, accuracy of self-report, CD4 count, medicine.disease_cause, medical record, HIV knowledge, socioeconomic status, 03 medical and health sciences, Young Adult, 0302 clinical medicine, HIV viral load, Surveys and Questionnaires, medicine, Antiretroviral treatment, Humans, Pharmacology (medical), 030212 general & internal medicine, Self report, Depressive symptoms, Original Research, Aged, business.industry, engagement in care, Health Policy, Medical record, Middle Aged, Viral Load, 030112 virology, United Kingdom, CD4 Lymphocyte Count, Infectious Diseases, Cross-Sectional Studies, Anti-Retroviral Agents, accuracy of self‐report, Female, Hiv status, Self Report, business, Viral load

الوصف: OBJECTIVES: The aim of the study was to assess, among people living with HIV, knowledge of their latest HIV viral load (VL) and CD4 count. METHODS: Agreement between self-report and clinic record was assessed among 2771 HIV-diagnosed individuals on antiretroviral treatment (ART) in the UK Antiretrovirals, Sexual Transmission Risk and Attitudes Study (2011-2012). A confidential self-completed questionnaire collected information on demographic, socioeconomic, HIV-related and health-related factors. Participants were asked to self-report their latest VL [undetectable (≤ 50 copies/mL), detectable (> 50 copies/mL) or "don't know"] and CD4 count (< 200, 200-350, 351-500 or > 500 cells/μL, or "don't know"). Latest clinic-recorded VL and CD4 count were documented. RESULTS: Of 2678 participants on ART, 434 (16.2%) did not accurately report whether their VL was undetectable. Of 2334 participants with clinic-recorded VL ≤ 50 copies/mL, 2061 (88.3%) correctly reported undetectable VL; 49 (2.1%) reported detectable VL; 224 (9.6%) did not know their VL. Of 344 participants with clinic-recorded VL > 50 copies/mL, 183 (53.2%) correctly reported detectable VL; 76 (22.1%) reported undetectable VL; 85 (24.7%) did not know their VL. Of 2137 participants who reported undetectable VL, clinic-recorded VL was ≤ 50 copies/mL for 2061 (96.4%) and

وصف الملف: application/pdf

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::256c1a50dccd329cc4eac7c7440206d3Test
http://europepmc.org/articles/PMC5516233Test

المؤلفون: R Hutt, Nicky Perry, G Stedman-Bryce, Valerie Delpech, Anthony Nardone, A Thornton, S Nicholson, Koh-Jun Ong, Martin Fisher, Adrian Palfreeman, P Wilkinson

المصدر: HIV Medicine. 17:247-254

مصطلحات موضوعية: medicine.medical_specialty, Acus, Pediatrics, 030505 public health, biology, HIV Positivity, business.industry, Health Policy, Human immunodeficiency virus (HIV), Hiv testing, biology.organism_classification, medicine.disease_cause, Test (assessment), 03 medical and health sciences, 0302 clinical medicine, Infectious Diseases, Emergency medicine, General practice, medicine, Pharmacology (medical), 030212 general & internal medicine, Young adult, 0305 other medical science, business, Mass screening

الوصف: Objectives Following national guidelines to expand HIV testing in high-prevalence areas in England, a number of pilot studies were conducted in acute general medical admission units (ACUs) and general practices (GPs) to assess the feasibility and acceptability of testing in these settings. The aim of this study was to estimate the cost per HIV infection diagnosed through routine HIV testing in these settings. Methods Resource use data from four 2009/2010 Department of Health pilot studies (two ACUs; two GPs) were analysed. Data from the pilots were validated and supplemented with information from other sources. We constructed possible scenarios to estimate the cost per test carried out through expanded HIV testing in ACUs and GPs, and the cost per diagnosis. Results In the pilots, cost per test ranged from £8.55 to £13.50, and offer time and patient uptake were 2 minutes and 90% in ACUs, and 5 minutes and 60% in GPs, respectively. In scenario analyses we fixed offer time, diagnostic test cost and uptake rate at 2 minutes, £6 and 80% for ACUs, and 5 minutes, £9.60 and 40% for GPs, respectively. The cost per new HIV diagnosis at a positivity of 2/1000 tests conducted was £3230 in ACUs and £7930 in GPs for tests performed by a Band 3 staff member, and £5940 in ACUs and £18 800 in GPs for tests performed by either hospital consultants or GPs. Conclusions Expanded HIV testing may be more cost-efficient in ACUs than in GPs as a consequence of a shorter offer time, higher patient uptake, higher HIV positivity and lower diagnostic test costs. As cost per new HIV diagnosis reduces at higher HIV positivity, expanded HIV testing should be promoted in high HIV prevalence areas.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::9955d5eea5cda0479471c6b4f766560bTest
https://doi.org/10.1111/hiv.12293Test

المؤلفون: Laura J Brown, Anthony Nardone, LE Guerra, CJ Naidoo, Karen Tan

المصدر: HIV Medicine

مصطلحات موضوعية: Adult, Male, Short Message Service, HIV diagnostic tests, Adolescent, Reminder Systems, education, Psychological intervention, HIV Infections, Logistic regression, law.invention, Men who have sex with men, Odds, 03 medical and health sciences, Sexual and Gender Minorities, Young Adult, 0302 clinical medicine, Randomized controlled trial, law, Medicine, Humans, Pharmacology (medical), 030212 general & internal medicine, Aged, Original Research, Behavior, Text Messaging, 030505 public health, business.industry, Health Policy, public health, Age Factors, Odds ratio, Middle Aged, Confidence interval, Infectious Diseases, Logistic Models, England, randomized controlled trial, Female, Reagent Kits, Diagnostic, behavioural interventions, 0305 other medical science, business, psychological phenomena and processes, Demography

الوصف: Objectives The aim of the study was to determine whether behaviourally informed short message service (SMS) primer and reminder messages could increase the return rate of HIV self-sampling kits ordered online. Methods The study was a 2 × 2 factorial design randomized control trial. A total of 9585 individuals who ordered a self-sampling kit from www.freetesting.hiv different SMS combinations: 1) standard reminders sent days 3 and 7 after dispatch (control); 2) primer sent 1 day after dispatch plus standard reminders; 3) behavioural insights (BI) reminders (no primer); or 4) primer plus BI reminders. The analysis was restricted to individuals who received all messages (n = 8999). We used logistic regression to investigate independent effects of the primer and BI reminders and their interaction. We explored the impact of sociodemographic characteristics on kit return as a secondary analysis. Results Those who received the primer and BI reminders had a return rate 4% higher than that of those who received the standard messages. We found strong evidence of a positive effect of the BI reminders (odds ratio 1.13; 95% confidence interval 1.04-1.23; P = 0.003) but no evidence for an effect of the primer, or for an interaction between the two interventions. Odds of kit return increased with age, with those aged ≥ 65 years being almost 2.5 times more likely to return the kit than those aged 25-34 years. Men who have sex with men were 1.5-4.5 times more likely to return the kit compared with other sexual behaviour and gender identity groups. Non-African black clients were 25% less likely to return the kit compared with other ethnicities. Conclusions Adding BI to reminder messages was successful in improving return rates at no additional cost.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e604435f0c9604e3b3b01b79361be370Test
https://pubmed.ncbi.nlm.nih.gov/29963766Test

المؤلفون: Monica Desai, David Dolling, Anthony Nardone, Mitzy Gafos, Sheena McCormack

المصدر: HIV Medicine. 17:133-142

مصطلحات موضوعية: Gynecology, medicine.medical_specialty, 030505 public health, business.industry, Health Policy, Alternative medicine, Health services research, Odds ratio, Men who have sex with men, Clinical trial, 03 medical and health sciences, Pre-exposure prophylaxis, 0302 clinical medicine, Infectious Diseases, Family medicine, medicine, Pharmacology (medical), Professional association, 030212 general & internal medicine, 0305 other medical science, business, Reproductive health

الوصف: Objectives Pre-exposure prophylaxis (PrEP) has proven biological efficacy in reducing the risk of sexual acquisition of HIV. Healthcare providers' (HCPs) knowledge of and attitudes to PrEP will be key to successful implementation. In England, PrEP is only available to men who have sex with men (MSM) through the open-label randomized PROUD pilot study of immediate or deferred use. Methods In September 2013, a cross-sectional survey of UK HCPs distributed through sexual health clinics (219) and professional societies' email lists (2599) and at a conference (80) asked about knowledge of, attitudes to and practice of PrEP. Results Overall, 328 of 2898 (11%) completed the survey, of whom 160 of 328 (49%) were doctors, 51 (16%) sexual health advisers (SHAs), 44 (14%) nurses and 73 (22%) unspecified. Over a quarter (83 of 311; 27%) were involved in PROUD. Most respondents (260 of 326; 80%) rated their knowledge of PrEP as medium or high. Over half of respondents (166 of 307; 54%) thought PrEP should be available outside of a clinical trial. The main barriers to supporting PrEP availability outside a clinical trial were concerns about current evidence (odds ratio [OR] 0.13), lack of UK-specific guidance (OR 0.35), concerns about adherence (OR 0.38) and risk of sexual or physical coercion for patients to have condomless or higher risk sex (OR 0.42 in multivariate regression). Just over half (147 of 277; 53%) had been asked about PrEP by patients in the past year, including almost half of those working in a clinic not involved in the PROUD study (86 of 202; 43%). Conclusions There is support for PrEP availability outside a clinical trial, but HCPs have residual concerns about its effectiveness and negative consequences, and the absence of UK-specific implementation guidance.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::9fc94be65060dfad69440a37af805177Test
https://doi.org/10.1111/hiv.12285Test

المؤلفون: Palfreeman, Adrian, Sullivan, Ann, Rayment, Michael, Waters, Laura, Buckley, Anna, Burns, Fiona, Clutterbuck, Daniel, Cormack, Ian, Croxford, Sara, Dean, Gillian, Delpech, Valerie, Josh, Jo, Kifetew, Chamut, Larbalestier, Nick, Mackie, Nicola, Matthews, Philippa, Murchie, Martin, Nardone, Anthony, Randell, Paul, Skene, Hannah

المصدر: HIV Medicine; Dec2020 Supplement S6, Vol. 21, p1-26, 26p

مصطلحات موضوعية: HIV infection epidemiology, INFECTIOUS disease transmission, COST effectiveness, HEALTH services accessibility, HIV infections, SEXUAL health, MEDICAL screening, PRENATAL care, ANTIRETROVIRAL agents, DISEASE prevalence

مصطلحات جغرافية: UNITED Kingdom

مستخلص: The article informs about of British Infection Association adult HIV testing guidelines 2020 about in areas of high seroprevalence to increase testing uptake and frequency. Topics include target all individuals living with undiagnosed HIV will need to be offered testing and commenced on antiretroviral therapy (ART); and elimination of human immunodeficiency virus (HIV) transmission in the Great Britain.

المؤلفون: Martina Furegato, Gwenda Hughes, Dana Ogaz, Anthony Nardone, N. Connor, Hamish Mohammed, Holly Mitchell, Sarah C Woodhall

المصدر: HIV medicine. 19(2)

مصطلحات موضوعية: Adult, Male, Sexual health clinic, Time Factors, Adolescent, HIV Infections, Men who have sex with men, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Disease Transmission, Infectious, Medicine, Humans, Mass Screening, Pharmacology (medical), 030212 general & internal medicine, Young adult, Homosexuality, Male, Mass screening, Aged, 030505 public health, business.industry, Health Policy, Incidence (epidemiology), Incidence, Confounding, Hazard ratio, virus diseases, Middle Aged, medicine.disease, Confidence interval, Infectious Diseases, England, 0305 other medical science, business, Demography

الوصف: Objectives In the UK, quarterly HIV testing is recommended for high-risk men who have sex with men (MSM). In this manuscript we determined the risk of being newly diagnosed with HIV in MSM by their HIV testing history, considering both the frequency and periodicity of testing. Methods Data on HIV incidence in MSM attending a sexual health clinic (SHC) in England in 2013-2014 with testing history (previous 2 years) were obtained from GUMCAD, the national sexually transmitted infection (STI) surveillance system in England. HIV testing patterns among MSM were defined using the frequency and periodicity of testing, based on 3 month intervals, in the year preceding the first attendance during the study period. Cox proportional hazards regression was used to determine the association between HIV testing pattern and time to HIV diagnosis with and without adjustment for demographic confounders. Analyses were stratified by risk stratum, with 'high risk' defined as a history of a bacterial STI in the past year. Adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs) are reported. Results Among the 37 702 HIV-negative MSM attending an SHC in 2013-2014, 1105 (3%) were diagnosed with HIV infection within 1 year of their first attendance. The probability of HIV diagnosis was highest in MSM who were tested quarterly compared with those who were not tested in the past year (aHR 2.51; 95% CI 1.33-4.74); this increased 1.8-fold among high-risk MSM (aHR 4.48; 95% CI 0.97-21.17). Conclusions The probability of subsequent HIV diagnosis was greatest in high-risk MSM who were tested most frequently. Quarterly HIV testing increased the likelihood of identifying undiagnosed HIV infection and should remain a continued recommendation for high-risk MSM.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::1095ae002f28c0adf799800a985c7d82Test
https://pubmed.ncbi.nlm.nih.gov/28984407Test

المؤلفون: T Hartney, P Crook, Anthony Nardone, I Kennedy

المصدر: HIV Medicine. 15:251-254

مصطلحات موضوعية: Response rate (survey), Clinical audit, medicine.medical_specialty, business.industry, Project commissioning, Health Policy, Audit, Hiv testing, Infectious Diseases, Nursing, Family medicine, General practice, medicine, Pharmacology (medical), business, Mass screening, Reproductive health

الوصف: Objectives The aim of the study was to examine whether UK HIV testing guidelines which recommend the expansion of HIV testing in high HIV prevalence areas have been implemented in England. Methods An online survey tool was used to conduct an audit of sexual health commissioners in 40 high HIV prevalence areas (diagnosed prevalence > 2 per 1000) between May and June 2012. Responders were asked to provide details of expanded HIV testing programmes that they had commissioned in nontraditional settings and perceived barriers and facilitators involved in introducing expanded testing. Results The response rate was 88% (35 of 40). Against the key audit standards, 31% (11 of 35) of areas had commissioned routine testing of new registrants in general practice, and 14% (five of 35) routine testing of general medical admissions. The majority of responders (80%; 28 of 35) had commissioned some form of expanded testing, often targeted at risk groups. The most common setting for commissioning of testing was the community (51%; 18 of 35), followed by general practice (49%; 17 of 35) and hospital departments (36%; 13 of 35). A minority (11%; four of 35) of responders had commissioned testing in all three settings. Where testing in general practice took place this was typically in a minority of practices (median 10–20%). Most (77%; 27 of 35) expected the rate of HIV testing to increase over the next year, but lack of resources was cited as a barrier to testing by 94% (33 of 35) of responders. Conclusions Not all high HIV prevalence areas in England have fully implemented testing guidelines. Scale-up of existing programmes and continued expansion of testing into new settings will be necessary to achieve this.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::4154398b381f3d0f9db0801a80184650Test
https://doi.org/10.1111/hiv.12099Test

المؤلفون: Anthony Nardone, Melinda Tenant-Flowers, Ann Sullivan, M Pearn, M Sudhanva, Patrick S. Roberts, Jane Anderson, Mark Atkins, Michael Rayment, E Doku, A Thornton, Rachael Jones

المصدر: HIV Medicine. 14:49-52

مصطلحات موضوعية: medicine.medical_specialty, business.industry, Health Policy, Point-of-care testing, Workload, HIV screening, Hiv testing, Abbott Diagnostics, Surgery, Test (assessment), Infectious Diseases, medicine, Oral fluid, Pharmacology (medical), Medical physics, business, Mass screening

الوصف: Objectives UK guidelines recommend routine HIV testing in general clinical settings when the local HIV prevalence is > 0.2%. During pilot programmes evaluating the guidelines, we used laboratory-based testing of oral fluid from patients accepting tests. Samples (n = 3721) were tested manually using the Bio-Rad Genscreen Ultra HIV Ag-Ab test (Bio-Rad Laboratories Ltd, Hemel Hempstead, UK). This was a methodologically robust method, but handling of samples was labour intensive. We performed a validation study to ascertain whether automation of oral fluid HIV testing using the fourth-generation HIV test on the Abbott Architect (Abbott Diagnostics, Maidenhead, UK) platform was possible. Methods Oral fluid was collected from 143 patients (56 known HIV-positive volunteers and 87 others having contemporaneous HIV serological tests) using the Oracol+ device (Malvern Medicals, Worcester, UK). Samples were tested concurrently: manually using the Genscreen Ultra test and automatically on the Abbott Architect. Results For oral fluid, the level of agreement of results between the platforms was 100%. All results agreed with HIV serology. The use of the Oracol+ device produced high-quality samples. Subsequent field use of the test has shown a specificity of 99.97% after nearly 3000 tests. Conclusions Laboratory-based HIV testing of oral fluid requires less training of local staff, with fewer demands on clinical time and space than near-patient testing. It is acceptable to patients. The validation exercise and subsequent clinical experience support automation, with test performance preserved. Automation reduces laboratory workload and speeds up the release of results. Automated oral fluid testing is thus a viable option for large-scale HIV screening programmes.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::0044bac6e22edd5190e01dfd0340a422Test
https://doi.org/10.1111/hiv.12063Test