HIV, hepatitis B & C, and sexually transmitted infections Innovations in prevention and testing

In this thesis we assessed the acceptability and use of innovative interventions and explored new opportunities for the prevention of HIV, hepatitis B virus (HBV), hepatitis C virus (HCV) infections and sexually transmitted infections (STIs) among key populations. The first part of this thesis focussed on the acceptability, attitudes, beliefs and behavioural intentions towards the use of pre-exposure prophylaxis (PrEP) to prevent an HIV infection among men who have sex with men (MSM) and healthcare professionals in the Netherlands. The insights of these studies help to determine which interventions are needed to effectively implement PrEP nationally. The second part of this thesis focused on opportunities for HIV, HBV, HCV and STI testing, especially among migrant populations. First, we studied access to and use of HIV services pre-and post diagnosis among non-migrants and migrant MSM and heterosexual men/women living with HIV in the Netherlands. Second, we estimated the prevalence of past and present HBV and HCV infection, along with their determinants and awareness of infection status, among different groups of first-generation migrants and Dutch-origin residents of Amsterdam. Third, we evaluated whether integrated tuberculosis, HIV, HBV and HCV screening is effective and acceptable among migrants. Fourth, we studied the usage of HIV/STI self-tests among the general population and sexual risk groups in the Netherlands, and among migrants living in the UK, France and the Netherlands. The results of the second part of this thesis can be used to develop and implement effective testing and screening programmes in the future.