P5-S7.17 Accepting the good with the bad: “barriers and facilitators of community-based HIV testing services for gay men: a systematic review”
Bibliographic record
Abstract
Background With a global focus on increased HIV testing among high risk groups including men who have sex with men (MSM), many community-based HIV testing services have been established in recent years with the goal of increasing testing opportunities for populations at risk. To better understand the acceptability of community based HIV testing models targeting MSM from the provider and consumer perspective we systematically reviewed published studies. Methods We searched Medline, EMBASE and Cochrane databases from 1980 to October 2010. Studies were included if they described acceptability of community based HIV testing services targeting MSM, including outreach settings (eg, saunas, public events), collected through surveys, in-depth interviews, focus groups, or exit forms. A quantitative descriptive analysis of the barriers and facilitators of community based HIV testing identified by service providers and consumers was conducted. Results We identified 25 papers that met our selection criteria and were included in the review see Abstract P5-S7.17 table 1. Twenty one studies focused on facilitators from the consumers' perspective, with testing convenience, provision of rapid testing, and acceptability/feeling comfortable with settings reported at factors that facilitated seeking HIV testing at community based services. From the provider perspective (six studies) key factors enhancing service acceptability were client friendly protocols, service promotion, offering additional clinical services, and effective protocols for follow-up and referral. Sixteen studies captured barriers to using community based HIV testing services from the consumer perspective and the main issue reported related to readiness to receive results on the same day or in the community-based environment. Providers in six studies reported difficulties in follow-up, testing in outreach settings, cost, providing adequate staff training, managing workload and developing and maintaining referral pathways as key barriers. Abstract P5-S7.17 Table 1 Summary of community HIV testing services (sample size) (n=25) Category Subcategory All services n (%) Location Canada 1 (4.0) Hong Kong 1 (4.0) New Zealand 1 (4.0) Switzerland 1 (4.0) The Netherlands 3 (12.0) UK 3 (12.0) USA 15 (60.0) Target group MSM 15 (60.0) Multiple 7 (28.0) Unclear – CBO clients 3 (12.0) Services type* CBO/community centre 10 (40.0) STD clinic 3 (12.0) Mobile testing facility 1 (4.0) Needle exchange programs 2 (8.0) Venue-based outreach (bar, club, sauna) 9 (36.0) Combination (eg, CBO, outreach, mobile testing facility). 5 (20.0) Rapid testing offered Yes 13 (52.0) No 5 (20.0) Yes– in combination with standard testing 4 (16.0) Unclear 3 (12.0) Study design Case studies 1 (4.0) Clinical audit 1 (4.0) Cross-sectional studies 4 (16.0) Evaluation reports 4 (16.0) Pilot/feasibility studies 4 (16.0) Qualitative studies 10 (40.0) Randomised trails (RCT) 1 (4.0) Data collection methods* Client surveys (including exit forms) 15 (60.0) Focus groups 2 (8.0) In-depth interviews 5 (20.0) Provider surveys 2 (8.0) Qualitative phone interviews 3 (12.0) Study participants Clients 17 (68.0) Providers 4 (16.0) Clients & providers 4 (16.0) * Service types and data collection methods are not mutually exclusive, so % do not add to 100% Conclusion Acceptability from both consumers and service providers is important to ensure an efficient and sustainable service. The experiences of many other services collated in this review will help other organisations address potential barriers and facilitators to the implementation of community-based HIV testing services.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.022 | 0.098 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.009 | 0.009 |
| Bibliometrics | 0.017 | 0.020 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.005 | 0.005 |
| Open science | 0.003 | 0.003 |
| Research integrity | 0.004 | 0.002 |
| Insufficient payload (model declined to judge) | 0.022 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".