Reaching 95-95-95 targets: The role of private sector health facilities in closing the HIV detection gap—Kisumu Kenya, 2018

Details

• Alternative Title:
  Int J STD AIDS
• Personal Author:
  Onyango, Dickens ; Mchembere, Walter ; Agaya, Janet ; Wang, Alice ; Cain, Kevin P ; Grobbee, Diederick E ; van der Sande, Marianne AB ; Baker, Brian ; Yuen, Courtney M
• Description:
  Background:
  
  HIV testing efficiency could be improved by focusing on high yield populations and identifying types of health facilities where people with undiagnosed HIV infection are more likely to attend.
  
  Methods:
  
  A retrospective cohort analysis of data collected during an integrated TB/HIV active case-finding intervention in Western Kenya. Data were analyzed from health facilities’ registers on individuals who reported TB-suggestive symptoms between 1 July and 31 December 2018 and who had an HIV test result within one month following symptom screening. We used logistic regression with general estimating equations adjusting for sub-county level data to identify health facility-level predictors of new HIV diagnoses.
  
  Results:
  
  Of 11,376 adults with presumptive TB identified in 143 health facilities, 1038 (9%) tested HIV positive. The median HIV positivity per health facility was 6% (IQR = 2–15%). Patients with TB symptoms were over three times as likely to have a new HIV diagnosis in private not-for-profit facilities compared to those in government facilities (adjusted odds ratio (aOR) 3.40; 95% CI = 1.96–5.90). Patients tested in hospitals were over two times as likely to have a new HIV diagnosis as those tested in smaller facilities (i.e., health centers and dispensaries) (aOR 2.26; 95% CI = 1.60–3.21).
  
  Conclusion:
  
  Individuals with presumptive TB who attended larger health facilities and private not-for-profit facilities had a higher likelihood of being newly diagnosed with HIV. Strengthening HIV services at these facilities and outreach to populations that use them could help to close the HIV diagnosis gap.
  
  
• Subjects:
  Adult Health Facilities HIV Infections Humans Kenya Private Sector Retrospective Studies Tuberculosis
• Keywords:
  Facilities Health HIV HIV Antibody Hospitals Positivity Private Testing
• Source:
  Int J STD AIDS. 33(5):485-491
• Pubmed ID:
  35225096
• Pubmed Central ID:
  PMC11406363
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/ ; U01 GH002133/GH/CGH CDC HHSUnited States/ ; PEPFAR/PEPFARUnited States/
• Volume:
  33
• Issue:
  5
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:8682cf558a4949ed0e4457d038c4e943dfe3612c2fde99cbb6e88a8c80fa9b4cadb57a5f44d9dcf3f975cceccde4637f444d28f4f45eed834521c94590d097a2
• Download URL:
  https://stacks.cdc.gov/view/cdc/162423/cdc_162423_DS1.pdf
• File Type:
  [PDF - 271.46 KB ]