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. 2018 Aug 9;15(8):1700. doi: 10.3390/ijerph15081700

Table 1.

Characteristics of included studies (effectiveness). HIV—human immunodeficiency virus; EU/EEA—European Union/European Economic Area; RCT—randomised-controlled trial; RR—relative risk; WHO—World Health Organization; CI—confidence interval; SMS—short message service.

Study Design and Quality Included Studies Population Intervention Results/Outcomes
Should Voluntary Testing for HIV Infection be Offered to all Recently Arrived Migrants to the EU/EEA?
Pottie et al., 2014 [26] Systematic review AMSTAR 9/11 n = 13

  1. Anaya et al. (RCT, n = 251, United States of America).

  2. Coates et al. (cRCT, n = 115,900, Tanzania, Zimbabwe, Thailand, and South Africa).

  3. Lugada et al. (cRCT, n = 7184, Uganda).

  4. Malonza et al. (RCT, n = 1249, Kenya).

  5. Read et al. (RCT, n = 400, Australia).

  6. Spielberg et al. (cRCT, n = 17,007, United States of America).

  7. Sweat et al. (cRCT, n = 57,156, Tanzania, Zimbabwe, and Thailand).

  8. Walensky et al. (RCT, n = 4855, United States of America).

  9. Appiah et al. (cross sectional, n = Not reported Ghana).

  10. Huebner et al. (Controlled before-after study n = NR, United States of America).

  11. Liang et al. (cohort, n = not reported United States of America).

  12. Shrestha et al. (cohort, n = not reported United States of America).

  13. White et al. (cohort, n = not reported, United States of America).

 Individuals at high risk of exposure Facilitated voluntary enrolment; use of a rapid-testing approach (providing results within 24 h); outreach counseling, delivery of results and treatment options. Receipt of HIV test results: Increased likelihood among participants randomized to the rapid approach study arms to receive test results (RR = 2.14, 95% CI 1.08 to 4.24) (n = 3; RCTs).
Repeat HIV testing and test incidence rate: increased HIV repeat testing among those in the intervention arm (RR = 2.28, 95% CI 0.35 to 15.07) (n = 1; cluster RCT).
HIV incidence 36-month period in five countries showed an 11% reduction in estimated incidence in intervention RR = 0.89, 95% CI = 0.63 to 1.24).
Treatment program uptake: OR = 1.7, 95% CI 0.8 to 3.7 for the uptake of perinatal HIV-1 interventions between rapid VCT versus conventional VCT (n = 1)
Kennedy et al., 2013 [27] Systematic Review AMSTAR 5/11 n = 19

  1. Allen et al. (time series, n = 1458, Rwanda).

  2. Allen et al. (non-randomized trial, n = not reported, Rwanda).

  3. Allen et al. (time series, n = 1438, Rwanda).

  4. Bentley et al. (time series, n = 1628, India).

  5. Brou et al. (time series, n = 980, Cote d’Ivoire).

  6. Chamdisarewa et al. (cross sectional, n = 4872, Zimbabwe).

  7. Creek et al. (cross sectional, n = 1456, Botswana).

  8. Desgrees-Du-Lou et al. (cohort, n = 937, Cote d’Ivoire).

  9. Harris et al. (cross sectional, n = not reported, Zambia).

  10. Huerga et al. (cross sectional, n = 409, Kenya).

  11. Khoshnood et al. (RCT, n = 600, China).

  12. Kiene et al. (before–after, n = 245, Uganda).

  13. Moses et al. (cross sectional, n = not reported, Malawi).

  14. Pang et al. (cross sectional, n = 585, China).

  15. Stringer et al. (cRCT, n = 246, Zambia).

  16. Van Rie et al. (nRCT, n = 1238, DRC).

  17. Van’t Hoog et al. (cross sectional, n = 4142, Kenya).

  18. Wiktor et al. (time series, n = 559, Cote d’Ivoire).

  19. Xu et al. (time series, n = 779, Thailand).

 Low- and middle-income countries; health care setting where individuals were seeking health care services other than HIV testing. Individuals, couples, or groups had to receive pre- and post-test counseling about HIV and an HIV test Provider-initiated testing and counseling (PITC) (aligned with the 2007 WHO). The majority of studies were conducted before WHO PITC guidelines were developed, indicating that provider-initiated testing was occurring in many locations prior to global guidance.
All studies included in this review that reported rates of HIV testing uptake showed increases associated with a PITC approach.
Comparing behavior in the three months preceding PITC to behavior in the three months after PITC, the percentage of participants who reported engaging in risky sex decreased and knowing their partner’s HIV status increased for both HIV-positive and HIV-negative participants.
AHRQ 2012 [28] Systematic Review AMSTAR 9/11 n= 42

  1. Amaro et al. (before-after, n = 939, United States of America).

  2. Anglemyer et al. (systematic review, n = 8).

  3. Bedimo et al. (observational, n = 19,424, United States of America).

  4. Brogly et al. (before–after, n = not reported, Canada).

  5. Camoni et la (before–after, n = 487, Italy).

  6. Cohen et al. (RCT, n = 1763, Botswana, Kenya, Malawi, South Africa, Zimbabwe, India, Brazil, Thailand, and United States of America).

  7. Cunningham et al. (cross sectional, n = 300, United States of America).

  8. Data collection on Adverse events of Anti-HIV Drugs (DAD) study group (observational, n = 33,308, North America, Europe, and Australia).

  9. Das et al. (cohort, n = 12,512, United States of America).

  10. Del Romero et al. (cross sectional, n = 625, Spain).

  11. Donnell (pre-post, n = 3381, Botswana, Kenya, Rwanda, South Africa, Tanzania, Uganda, and Zambia).

  12. Diamond et al. (cross sectional, n = 886, United States of America).

  13. El-Bassel et al. (cRCT, n = 535, NR).

  14. Elford et al. (cross sectional, n = 1687, United Kingdom).

  15. Fideli et al. (case control, n = 109, Zambia).

  16. Fisher et al. (cohort, n = 859, United Kingdom).

  17. Fox et al. (before-after, n = 98, United Kingdom).

  18. Goncalyes Melo et al. (cohort, n = 93, Brazil).

  19. Haukoos et al. (cohort, n = not reported, United States of America).

  20. Hernando et al. (cohort, n = 399, Spain).

  21. HIV-CAUSAL (cohort, n = 62,760, 12 European cohorts).

  22. Kihata et al. (cohort, n = 17,517, North America).

  23. May et al.; Lanoy et al.; Moore et al. (cohort, n = 20,379, Europe and North America).

  24. Miguez-Burbbano et al. (cross sectional, n = 85, United States of America).

  25. Montaner et al. (cohort, n = 5413, Canada).

  26. Morin et al. (cross sectional, n = not reported, United States of America).

  27. Musicco (cohort, n = 436, Italy).

  28. Myers et al. (pre-post, n = not reported, United States of America).

  29. Obel et al., Lohse et al., 2006 (observational, n = 2952, Denmark).

  30. Reynolds et al. (cohort, n = 250, Uganda).

  31. Ribaudo et al. (observational, n = 5056).

  32. Severe et al. (RCT, n = 816, Haiti).

  33. SMART (RCT, n = 477, USA/Europe).

  34. Smit et al.; van Haastrecht et al. (cohort, n = 197, Amsterdam).

  35. Sullivan et al. (cohort, n = 2993, Rwanda and Zambia).

  36. Tun et al.; Vlahov et al. (before-after, n = 190, USA).

  37. Wang et al. (cohort, n = 1927, China).

  38. Weis et al. (corss sectional, n = not reported, United States of America).

  39. When to Start Consortium (cohort, n = 45,691, Europe and North America).

  40. White et al. (cohort, n-6479, United States of America).

  41. Wood et al. (cohort, n = 2051, Canada).

  42. Writing Committee for the CASCADE (Concerted Action on SeroConversion to AIDS and Death in Europe) Collaboration (cohort, n = 9455 Europe, Australia, and Canada).

 Testing for asymptomatic HIV infection in Non-pregnant adults and adolescents. Screening Strategies No randomized trial or observational study compared clinical outcomes between adults and adolescents screened and not screened for HIV infection.
Some modeling studies have estimated the cost-effectiveness of strategies involving repeat screening.
No study directly evaluated the acceptability of universal versus targeted HIV screening. One study found universal, opt-out rapid screening associated with higher likelihood of testing compared with physician-directed, targeted rapid screening (25% vs. 0.8%; relative risk [RR], 30 [95% CI, 26 to 34]).
One study found universal testing associated with a higher median CD4 count and lower likelihood of CD4 count <0.200 × 109 cells/L at the time of diagnosis compared with targeted HIV screening, but these differences were not statistically significant.
Desai et al., 2015 [29] Systematic Review AMSTAR 6/11 n = 17

  1. Bloomfeild et al. (observational, n = 399, United States of America).

  2. Bourne et al. (observational, n = 3551, Australia).

  3. Burton et al. (observational, n = 539, United Kingdom).

  4. Cameron et al. (observational, n = 330, United Kingdom).

  5. Cook et al. (RCT, n = 388, United States of America).

  6. Downing et al. (RCT, n = 94, Australia).

  7. Gotz et al. (RCT, n = 216, The Netherlands).

  8. Gotz et al. (observational, n = 4191, The Netherlands).

  9. Guy et al. (observational, n = 681, Australia).

  10. Harte et al. (observational, n = 301, United Kingdom).

  11. La Montagne (observational, n = 592, United Kingdom).

  12. Malotte et al. (RCT, n = 499, United States of America).

  13. Paneth-Pollak et al. (observational, n = 6220, United States of America).

  14. Sparks et al. (RCT, n = 122, United States of America).

  15. Walker et al. (observtional, n = 1116, Australia).

  16. Xu et al. (RCT, n = 1215, United States of America).

  17. Zou et al. (observational, n = 4179, Australia).

 HIV-negative or unknown status in all countries; Hospitals, sexual health clinics, general practice, community venues, and home sampling/testing Active recall SMS: OR for retesting as compared to the control group ranged between 0.93 (95% CI 0.65 to 1.33) and 5.87 (95% CI 1.16 to 29.83). The pooled OR among the observational studies was 2.19 (95% CI 1.47 to 3.23). A pooled OR for retesting among SMS group is 5.66 (95% CI 1.78 to 17.99) among 126.
Phone calls: phone calls and verbal advice and counseling had higher rates of retesting OR = 2.50 (95% CI 1.3 to 4.8) compared to phone calls only. Groups receiving phone calls and verbal advice had higher rates if retesting OR = 14.0 (95% CI 1.63 to 120.09) compared to phone calls only.