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Published in: Israel Journal of Health Policy Research 1/2020

Open Access 01-12-2020 | Sexually Transmitted Infection | Original research article

Community Vs. hospital HIV testing sites in Jerusalem, Israel - who’s tested and who’s at risk?

Authors: Dor Atias, Hagai Levine, Hila Elinav, Michele Haouzi-Bashan, Yotam Lior, Zohar Mor

Published in: Israel Journal of Health Policy Research | Issue 1/2020

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Abstract

Background

After decades of constant increase in HIV diagnoses among men who have sex with men (MSM), a gradual decrease has been reported in recent years. Timely detection of HIV leads to early treatment and behavioral changes which decrease further transmissions. This cross-sectional study aimed to assess demographic and behavioral characteristics of individuals who were tested for HIV in Jerusalem, Israel.

Methods

This study compared individuals who were tested at Hadassah AIDS Center (HAC) with those tested at the Jerusalem Open House (JOH) - an LGBTQ community center. Participants completed anonymous questionnaires regarding their demographic, HIV-testing history, and sexual behaviors. High-risk sexual behavior (HRSB) was defined as a diagnosis of sexually transmitted disease or condomless anal/vaginal sex during the last year.

Results

Among 863 participants, 104 (12.1%) were tested in HAC and 759 (87.9%) in JOH. Of those, 19 (18.3%) and 227 (29.9%) were HRSB, respectively. Two MSM were tested positive in JOH. JOH received more MSM, HRSB and individuals who were previously tested for HIV, while HAC received more migrants and health-care workers. HRSB-participants were more commonly younger, males, non-Jewish, with lower income, previously tested for HIV, reported more sexual partners, payed for sex or used drugs.

Conclusions

MSM and HRSB-individuals were more likely to be tested in JOH, while migrants and health-care workers in HAC, possibly due to the geographic location, reputation and specific atmosphere. In order to encourage HIV-tests among HRSB and non-Jews, additional interventions should be employed, including outreach activities, extending opening hours and reducing testing costs should be employed.
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Literature
1.
go back to reference Mor Z, Weinstein R, Grotto I, Levin Y, Chemtob D. Thirty years of HIV in Israel: current epidemiology and future challenges. BMJ Open. 2013;3(7):e003078.CrossRef Mor Z, Weinstein R, Grotto I, Levin Y, Chemtob D. Thirty years of HIV in Israel: current epidemiology and future challenges. BMJ Open. 2013;3(7):e003078.CrossRef
2.
go back to reference European Centre for Disease Prevention and Control WROfE. HIV/AIDS surveillance in Europe 2018–2017 data. Copenhagen: WHO Regional Office for Europe. European Centre for Disease Prevention and Control, WHO Regional Office for Europe; 2018. European Centre for Disease Prevention and Control WROfE. HIV/AIDS surveillance in Europe 2018–2017 data. Copenhagen: WHO Regional Office for Europe. European Centre for Disease Prevention and Control, WHO Regional Office for Europe; 2018.
3.
go back to reference Chemtob D. HIV HIV/AIDS in Israel : Periodic Epidemiological Report 1981–2018. Jerusalem: Ministry Of Health; 2019. Chemtob D. HIV HIV/AIDS in Israel : Periodic Epidemiological Report 1981–2018. Jerusalem: Ministry Of Health; 2019.
4.
go back to reference Chemtob D, Mor Z, Harel N, Averick N. HIV infection among men who have sex with men in Israel: a 35-year epidemiological and clinical overview, 1981-2015. BMC Public Health. 2019;19(1):747.CrossRef Chemtob D, Mor Z, Harel N, Averick N. HIV infection among men who have sex with men in Israel: a 35-year epidemiological and clinical overview, 1981-2015. BMC Public Health. 2019;19(1):747.CrossRef
5.
go back to reference Mor Z, Dan M. The HIV epidemic among men who have sex with men--behaviour beats science. EMBO Rep. 2012;13(11):948–53.CrossRef Mor Z, Dan M. The HIV epidemic among men who have sex with men--behaviour beats science. EMBO Rep. 2012;13(11):948–53.CrossRef
7.
go back to reference Bavinton BR, Pinto AN, Phanuphak N, Grinsztejn B, Prestage GP, Zablotska-Manos IB, et al. Viral suppression and HIV transmission in serodiscordant male couples: an international, prospective, observational, cohort study. Lancet HIV. 2018;5(8):e438–e47.CrossRef Bavinton BR, Pinto AN, Phanuphak N, Grinsztejn B, Prestage GP, Zablotska-Manos IB, et al. Viral suppression and HIV transmission in serodiscordant male couples: an international, prospective, observational, cohort study. Lancet HIV. 2018;5(8):e438–e47.CrossRef
8.
go back to reference Rodger AJ, Cambiano V, Bruun T, Vernazza P, Collins S, Degen O, et al. Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive PARTNER taking suppressive antiretroviral therapy (PARTNER): final results of a multicentre, prospective, observational study. Lancet. 2019;393(10189). Rodger AJ, Cambiano V, Bruun T, Vernazza P, Collins S, Degen O, et al. Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive PARTNER taking suppressive antiretroviral therapy (PARTNER): final results of a multicentre, prospective, observational study. Lancet. 2019;393(10189).
9.
go back to reference HIV/AIDS JUNPo, HIV/Aids JUNPo. 90–90-90: an ambitious treatment target to help end the AIDS epidemic. Geneva: Unaids; 2014. HIV/AIDS JUNPo, HIV/Aids JUNPo. 90–90-90: an ambitious treatment target to help end the AIDS epidemic. Geneva: Unaids; 2014.
10.
go back to reference Levi I, Modan B, Blumstein T, Luxenburg O, Yehuda-Cohen T, Shasha B, et al. Characteristics of clients attending confidential versus anonymous testing clinics for human immunodeficiency virus. Isr Med Assoc J. 2001;3(3):184–7.PubMed Levi I, Modan B, Blumstein T, Luxenburg O, Yehuda-Cohen T, Shasha B, et al. Characteristics of clients attending confidential versus anonymous testing clinics for human immunodeficiency virus. Isr Med Assoc J. 2001;3(3):184–7.PubMed
11.
go back to reference Central Bureau of Statistics. Statistical Abstract of Israel 2018- No.69. Jerusalem: Central Bureau of Statistics; 2018. Central Bureau of Statistics. Statistical Abstract of Israel 2018- No.69. Jerusalem: Central Bureau of Statistics; 2018.
12.
go back to reference Prevention CfDCa, Service UPH. Preexposure prophylaxis for the prevention of HIV infection in the United States—2017 update: a clinical practice guideline. CDC: Atlanta; 2018. Prevention CfDCa, Service UPH. Preexposure prophylaxis for the prevention of HIV infection in the United States—2017 update: a clinical practice guideline. CDC: Atlanta; 2018.
13.
go back to reference Yang M, Prestage G, Maycock B, Brown G, de Wit J, McKechnie M, et al. The acceptability of different HIV testing approaches: cross-sectional study among GMSM in Australia. Sex Transm Infect. 2014;90(8):592–5.CrossRef Yang M, Prestage G, Maycock B, Brown G, de Wit J, McKechnie M, et al. The acceptability of different HIV testing approaches: cross-sectional study among GMSM in Australia. Sex Transm Infect. 2014;90(8):592–5.CrossRef
14.
go back to reference Smith LV, Rudy ET, Javanbakht M, Uniyal A, Sy LS, Horton T, et al. Client satisfaction with rapid HIV testing: comparison between an urban sexually transmitted disease clinic and a community-based testing center. AIDS Patient Care STDs. 2006;20(10):693–700.CrossRef Smith LV, Rudy ET, Javanbakht M, Uniyal A, Sy LS, Horton T, et al. Client satisfaction with rapid HIV testing: comparison between an urban sexually transmitted disease clinic and a community-based testing center. AIDS Patient Care STDs. 2006;20(10):693–700.CrossRef
15.
go back to reference Mayer KH, Bradford JB, Makadon HJ, Stall R, Goldhammer H, Landers S. Sexual and gender minority health: what we know and what needs to be done. Am J Public Health. 2008;98(6):989–95.CrossRef Mayer KH, Bradford JB, Makadon HJ, Stall R, Goldhammer H, Landers S. Sexual and gender minority health: what we know and what needs to be done. Am J Public Health. 2008;98(6):989–95.CrossRef
16.
go back to reference Leshin D, Olshtain-Pops K, Moses A, Elinav H. Limited awareness of the effective timing of HIV post-exposure prophylaxis among people with high-risk exposure to HIV. Eur J Clin Microbiol Infect Dis. 2019;38(4):779–84.CrossRef Leshin D, Olshtain-Pops K, Moses A, Elinav H. Limited awareness of the effective timing of HIV post-exposure prophylaxis among people with high-risk exposure to HIV. Eur J Clin Microbiol Infect Dis. 2019;38(4):779–84.CrossRef
17.
go back to reference Majumdar B, Browne G, Roberts J, Carpio B. Effects of cultural sensitivity training on health care provider attitudes and patient outcomes. J Nurs Scholarsh. 2004;36(2):161–6.CrossRef Majumdar B, Browne G, Roberts J, Carpio B. Effects of cultural sensitivity training on health care provider attitudes and patient outcomes. J Nurs Scholarsh. 2004;36(2):161–6.CrossRef
18.
go back to reference Tucker CM, Herman KC, Pedersen TR, Higley B, Montrichard M, Ivery P. Cultural sensitivity in physician-patient relationships: perspectives of an ethnically diverse sample of low-income primary care patients. Med Care. 2003;41(7):859–70.CrossRef Tucker CM, Herman KC, Pedersen TR, Higley B, Montrichard M, Ivery P. Cultural sensitivity in physician-patient relationships: perspectives of an ethnically diverse sample of low-income primary care patients. Med Care. 2003;41(7):859–70.CrossRef
19.
go back to reference Bucharski D, Reutter LI, Ogilvie LD. “you need to know where we're coming from”: Canadian aboriginal women's perspectives on culturally appropriate HIV counseling and testing. Health Care Women Int. 2006;27(8):723–47.CrossRef Bucharski D, Reutter LI, Ogilvie LD. “you need to know where we're coming from”: Canadian aboriginal women's perspectives on culturally appropriate HIV counseling and testing. Health Care Women Int. 2006;27(8):723–47.CrossRef
20.
go back to reference Mor Z, Davidovich U. Same-sex sexual attraction, behavior, and practices of Jewish men in Israel and the association with HIV prevalence. AIDS Care. 2016;28(Sup1):64–7.CrossRef Mor Z, Davidovich U. Same-sex sexual attraction, behavior, and practices of Jewish men in Israel and the association with HIV prevalence. AIDS Care. 2016;28(Sup1):64–7.CrossRef
21.
go back to reference Rich R, Leventhal A, Sheffer R, Mor Z. Heterosexual men who purchase sex and attended an STI clinic in Israel: characteristics and sexual behavior. Isr J Health Policy Res. 2018;7(1):19.CrossRef Rich R, Leventhal A, Sheffer R, Mor Z. Heterosexual men who purchase sex and attended an STI clinic in Israel: characteristics and sexual behavior. Isr J Health Policy Res. 2018;7(1):19.CrossRef
22.
go back to reference Mor Z, Shohat T, Goor Y, Dan M. Risk behaviors and sexually transmitted diseases in gay and heterosexual men attending an STD clinic in Tel Aviv, Israel: a cross-sectional study. Isr Med Assoc J. 2012;14(3):147–51.PubMed Mor Z, Shohat T, Goor Y, Dan M. Risk behaviors and sexually transmitted diseases in gay and heterosexual men attending an STD clinic in Tel Aviv, Israel: a cross-sectional study. Isr Med Assoc J. 2012;14(3):147–51.PubMed
23.
go back to reference Rich RS, Leventhal A, Sheffer R, Mor Z. Risky sexual behavior and sexually transmitted infections among men who have sex with men and purchase sex attending an Israeli sexually transmitted infection clinic. Int J STD AIDS. 2019;956462419830856:236–43.CrossRef Rich RS, Leventhal A, Sheffer R, Mor Z. Risky sexual behavior and sexually transmitted infections among men who have sex with men and purchase sex attending an Israeli sexually transmitted infection clinic. Int J STD AIDS. 2019;956462419830856:236–43.CrossRef
24.
go back to reference Mor Z, Grayeb E, Beany A. Arab men who have sex with men in Israel: knowledge, attitudes and sexual practices. HIV Med. 2016;17(4):298–304.CrossRef Mor Z, Grayeb E, Beany A. Arab men who have sex with men in Israel: knowledge, attitudes and sexual practices. HIV Med. 2016;17(4):298–304.CrossRef
25.
go back to reference Persson KI, Berglund T, Bergström J, Eriksson LE, Tikkanen R, Thorson A, et al. Motivators and barriers for HIV testing among men who have sex with men in Sweden. J Clin Nurs. 2016;25(23-24).CrossRef Persson KI, Berglund T, Bergström J, Eriksson LE, Tikkanen R, Thorson A, et al. Motivators and barriers for HIV testing among men who have sex with men in Sweden. J Clin Nurs. 2016;25(23-24).CrossRef
26.
go back to reference Pharr JR, Lough NL, Ezeanolue EE. Barriers to HIV testing among young men who have sex with men (MSM): experiences from Clark County, Nevada. Glob J Health Sci. 2015;8(7):9–17.CrossRef Pharr JR, Lough NL, Ezeanolue EE. Barriers to HIV testing among young men who have sex with men (MSM): experiences from Clark County, Nevada. Glob J Health Sci. 2015;8(7):9–17.CrossRef
27.
go back to reference Fernández-Balbuena S, de la Fuente L, Hoyos J, Rosales-Statkus ME, Barrio G, Belza MJ, et al. Highly visible street-based HIV rapid testing: is it an attractive option for a previously untested population? A cross-sectional study. Sex Transm Infect. 2014;90(2):112–8.CrossRef Fernández-Balbuena S, de la Fuente L, Hoyos J, Rosales-Statkus ME, Barrio G, Belza MJ, et al. Highly visible street-based HIV rapid testing: is it an attractive option for a previously untested population? A cross-sectional study. Sex Transm Infect. 2014;90(2):112–8.CrossRef
28.
go back to reference Cao B, Gupta S, Wang J, Hightow-Weidman LB, Muessig KE, Tang W, et al. Social media interventions to promote HIV testing, linkage, adherence, and retention: systematic review and meta-analysis. J Med Internet Res. 2017;19(11):e394.CrossRef Cao B, Gupta S, Wang J, Hightow-Weidman LB, Muessig KE, Tang W, et al. Social media interventions to promote HIV testing, linkage, adherence, and retention: systematic review and meta-analysis. J Med Internet Res. 2017;19(11):e394.CrossRef
29.
go back to reference Chen MJ, Scheer S, Nguyen TQ, Kohn RP, Schwarcz SK. HIV Coinfection among persons diagnosed as having sexually transmitted diseases, San Francisco, 2007 to 2014. Sex Transm Dis. 2018;45(8):563–72.CrossRef Chen MJ, Scheer S, Nguyen TQ, Kohn RP, Schwarcz SK. HIV Coinfection among persons diagnosed as having sexually transmitted diseases, San Francisco, 2007 to 2014. Sex Transm Dis. 2018;45(8):563–72.CrossRef
30.
go back to reference Polansky A, Levy I, Mor Z. Risk factors of syphilis co-infection among HIV. AIDS Care. 2019;31(9):1157–61.CrossRef Polansky A, Levy I, Mor Z. Risk factors of syphilis co-infection among HIV. AIDS Care. 2019;31(9):1157–61.CrossRef
31.
go back to reference Braxton J, Davis DW, Emerson B, Flagg EW, Grey J, Grier L, et al. Sexually transmitted disease surveillance 2017. 2018.CrossRef Braxton J, Davis DW, Emerson B, Flagg EW, Grey J, Grier L, et al. Sexually transmitted disease surveillance 2017. 2018.CrossRef
32.
go back to reference Johnson AM, Mercer CH, Erens B, Copas AJ, McManus S, Wellings K, et al. Sexual behaviour in Britain: partnerships, practices, and HIV risk behaviours. Lancet. 2001;358(9296):1835–42.CrossRef Johnson AM, Mercer CH, Erens B, Copas AJ, McManus S, Wellings K, et al. Sexual behaviour in Britain: partnerships, practices, and HIV risk behaviours. Lancet. 2001;358(9296):1835–42.CrossRef
Metadata
Title
Community Vs. hospital HIV testing sites in Jerusalem, Israel - who’s tested and who’s at risk?
Authors
Dor Atias
Hagai Levine
Hila Elinav
Michele Haouzi-Bashan
Yotam Lior
Zohar Mor
Publication date
01-12-2020

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