Community-Based HIV Testing Services in an Urban Setting in Western Kenya: a program implementation

Details

• Alternative Title:
  Lancet HIV
• Personal Author:
  Truong, Hong-Ha M. ; Rain Mocello, A. ; Ouma, David ; Bushman, Dena ; Kadede, Kevin ; Ating’a, Eric ; Obunge, Duncan ; Bukusi, Elizabeth A. ; Odhiambo, Francesca ; Cohen, Craig R.
• Description:
  Background:
  
  Some countries are struggling to reach the UNAIDS testing target, especially among men and youth. To identify persons unaware of their HIV-positive status and achieve testing saturation, we implemented a hybrid HIV testing approach in an urban informal settlement in Western Kenya.
  
  Methods:
  
  The Community Health Initiative (CHI) conducted community mapping, household census, multi-disease community health campaigns (CHCs), and home-based tracking in 2018 in the informal settlement of Obunga, located in Kisumu, Kenya. Health and counseling services were tailored for men and youth to encourage their participation. We calculated the previously unidentified fraction (PUF), which is the proportion of newly identified persons living with HIV (PLWH) out of all previously identified and newly identified PLWH.
  
  Findings:
  
  CHI reached a total of 23,584 persons. Of 12,768 HTS-eligible individuals, 12,407 (97%) accepted testing, including 3,917 (32%) first-time testers. There were 101 newly identified PLWH out of 1,248 total HIV-positive persons, representing an 8·1% PUF. The PUF was higher among men (9·8%) and youth ages 15–24 (15·3%). Ninety-four newly identified persons (93%) initiated same-day treatment.
  
  Interpretation:
  
  The community-based hybrid HIV testing approach was successfully implemented for the first time in an urban setting characterized by a high-risk, impoverished and highly mobile population. CHI identified persons previously unaware of their HIV-positive status, thereby enabling linkage to care and same-day treatment initiation, and reducing onward transmission risk. Innovative approaches that make HIV testing more accessible and acceptable, particularly to men and youth, are critical for achieving testing and treatment saturation.
  
  Funding:
  
  U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) through the U.S. Centers for Disease Control and Prevention (CDC)
  
  
• Keywords:
  Adolescent Adult Child Child, Preschool Community Health Community Health Services Female Health Plan Implementation HIV HIV Infections HIV Testing Humans Infant Kenya Male Mass Screening Men Middle Aged Public Health Surveillance Testing Urban Health Services Urban Population Young Adult Youth

  More +
• Source:
  Lancet HIV. 8(1):e16-e23
• Pubmed ID:
  33166505
• Pubmed Central ID:
  PMC10880946
• Document Type:
  Journal Article
• Funding:
  NU2GGH001947/ImCDC/Intramural CDC HHSUnited States/ ; U2GGH001947/CC/CDC HHSUnited States/
• Place as Subject:
  Kenya
• Volume:
  8
• Issue:
  1
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:00c32b0e09372e9a72b2925ad0d425e2f9f5c445ade9b2907e6d983b18181dea
• Download URL:
  https://stacks.cdc.gov/view/cdc/150308/cdc_150308_DS1.pdf
• File Type:
  [PDF - 686.33 KB ]