Table 3

Included articles

ResultReferenceIncluded countriesStudy populationStudy designSample sizeMain findings
HIV testingBarrow and Barrow21 Barbados, Jamaica.At-risk persons living in Barbados or Jamaica.HIV surveillance data.Not reported.There was an increase in testing of 14 403 tests in 2000 to 26 045 in 2010.
Chapin-Bardales et al 23 Puerto Rico.MSM.Cross-sectional surveillance data.352 men aged 18–40+.59% of MSM had received a recent HIV test.
Conserve et al 22 Haiti.Haitian men.Cross-sectional surveillance data.7354 men aged 18–59.65.24% of Haitian men had not been tested for HIV.
Fleming et al 24 Dominican Republic.Male steady partners of female cis-gender sex workers.Sociobehavioural survey and indepth interviews.64 men aged 18 or older.76.6% of steady male partners of cis-gender female sex workers living with HIV had been tested.
Figueroa et al 28 Jamaica.MSM.Cross-sectional survey.201 MSM.57.7% of MSM reported having ever completed an HIV test, of whom 93% of men retrieved their results.
Figueroa et al 27 Jamaica.MSM.Cross-sectional survey.449 MSM.74.7% of MSM who had accepted cash for sex in the past 3 months and 79.9% of MSM who had not accepted cash for sex reported having been tested for HIV.
Ivers et al 26 Haiti.HIV-positive patients.Retrospective chart review.117 patients.84.8% of HIV-positive testers had obtained a diagnosis at their first encounter with a health professional.
Johnson and Cheng25 Dominican Republic, Haiti.Men and women in 18 countries.Cross-sectional surveys.27 975 men (Dominican Republic) and 4958 men (Haiti).11 651 Dominican men and 508 Haitian men reported having been tested.
Logie et al 30 Jamaica.Transgender women.Cross-sectional survey.137 transgender women.103 of 137 transgender women (75.7%) had ever received an HIV test.
Logie et al 29 Jamaica.MSM.Cross-sectional survey.498 MSM.No significant differences between HIV-negative and HIV-positive MSM who had tested for HIV with regard to income, education and sex work.
Late testingBarrow and Barrow21 Barbados, Jamaica.At-risk persons living in Barbados or Jamaica.HIV surveillance data.Not reported.Men were more likely than their female counterparts to be immunocompromised at testing.
Tossas-Milligan et al 31 Puerto Rico.Open cohort of patients with HIV/AIDS.Baseline questionnaire analysis.1582 patients aged 18–79.MSM accounted for 29% of those who were late testers for HIV; older men who injected drugs had increased odds of late testing.
Barriers to testingAdams et al 33 Barbados.Professionals and government representatives from various organisations.Key informant interviews followed by snowball sampling.29 participants (16 men, 13 women) aged 30–68.Same-sex practice stigma, breaches of confidentiality and mistrust of health systems affect testing.
Andrinopoulos et al 35 Jamaica.Incarcerated men in Jamaica.Cross-sectional quantitative survey.298 prison inmates aged 18 years or older.Prison inmates who reported low experiences of HIV stigma were more likely to have tested than those who reported high experiences of stigma.
Barrow and Barrow21 Barbados, Jamaica.At-risk persons living in Barbados or Jamaica.HIV surveillance data.Not reported.Structural barriers impede HIV testing and treatment.
Bourne and Charles34 Jamaica.Non-HIV testers in Jamaica.Detailed questionnaire.1192 participants from a 2004 HIV/AIDS/STD National Knowledge, Attitudes, Beliefs, and Practices (KABP) Survey.87.9% of non-testers living in Jamaica reported that they were not at risk for HIV and 59.7% had no interest in learning their HIV status.
Fleming et al 24 Dominican Republic.Male steady partners of cis-gender female sex workers.Sociobehavioural survey and indepth interviews.64 men aged 18 or older.The anxiety associated with testing and fear of a positive result are barriers to testing.
Logie et al 32 Jamaica.Transgender women over the age of 18.Cross-sectional survey.197 transgender women over the age of 18.Transgender women living in Jamaica who engaged in practices that elevate HIV exposure such as substance use and sex while under the influence of drugs were unlikely to report having had an HIV test.
Strategies and interventions: rapid testing and peer-led testingAlemnji et al 37 Antigua and Barbuda, Bahamas, Barbados, Dominica, Grenada, Jamaica, St Kitts and Nevis, St Lucia, St Vincent and the Grenadines, Suriname, and Trinidad and Tobago.Laboratory managers and directors.Surveys and questionnaire distributed throughout 11 countries.Not reported.8 of 11 countries included had policies in place for HIV rapid testing and all countries were using rapid testing at main laboratory in the country.
Mungrue et al 38 Trinidad and Tobago.Men and women.Retrospective analysis and prospective analysis.14 580 participants.HIV rapid testing had an increase in testing from 1652 in 2008 to 5253 in 2010, of which men tested positive more frequently.
Martin et al 39 Bahamas.Men and women.Cross-sectional survey.252 participants.Participants who expressed a test preference preferred oral fluids testing to fingerprick testing (65.8% vs 34.2%).
Myers et al 43 Antigua, Barbuda.At-risk persons for HIV.Community-based voluntary HIV counselling and testing evaluation.9782 testers, of whom 32% were men.Outreach workers were trained to use a fingerprick rapid testing system that provided test results in 30 min. Of the testers to use the service, 32% were men.
Rodriguez-Diaz and Andrinopoulos44 Jamaica, Puerto Rico.Prison inmates.Comparison of prison programming.4709 inmates (Jamaica), 12 130 (Puerto Rico).The acceptance rate for peer-led HIV testing among inmates was 63%, with a reported HIV prevalence rate of 3.3%.
Zack et al 45 Haiti.Prison inmates.Anonymous survey administration.400+ inmates.64% of inmates who participated in health sessions with the peer health educators were willing to be tested for HIV.
Strategies and interventions: service provider strategiesDuke et al 40 Trinidad and Tobago.Representatives from key national HIV programme services and technical assistance partners.Technical working group designed same-visit HIV testing programme.Multiple HIV programme partners identified by the Ministry of Health.An increase of 22 trained testers in July of 2005 to 2323 testers in 2006 who used the same-visit testing service was reported and included an average of 185 trained testers who used the service per month.
Andrinopoulos et al 46 Jamaica.Incarcerated men in Jamaica.Implementation of HIV testing and treatment programme for prison inmates.1560 prison inmates.HIV testing uptake targeting incarcerated men was acceptable.
Hiner et al 41 Jamaica, Trinidad and Tobago, St Lucia, St Kitts and Nevis, St Vincent and the Grenadines, Suriname, Barbados and the Bahamas, Anguilla, Antigua and Barbuda, Dominica, Grenada, Turks and Caicos.Programme-trained VCT providers.Training of trainers.3489 providers.A training of trainers’ VCT programme trained 3489 individuals in order for them to provide counselling and testing in several Caribbean countries; 80% of the trainers were certified in VCT and were successful in the scaling up of services for VCT.
Orne-Gliemann et al 36 Dominican Republic.Pregnant women and their male partners.Couple-oriented post-test HIV counselling.1943 pregnant women.Couples-oriented counselling was successful in increasing partner HIV testing rates.
Strategies and interventions: novel methodsGiguere et al 47 Puerto Rico.Male and transgender female sex workers.12-week substudy of microbicide and HIV prevention trials.12 male and transgender sex workers.Mixed perspectives were found for HIV self-test use. Participant knowledge of PrEP increased and 9 of 12 indicated interest in using it. All participants reported interest in the likelihood of using a microbicide gel before having receptive anal intercourse.
  • MSM, men who have sex with men; PrEP, pre-exposure prophylaxis; VCT, voluntary counselling and testing.