Implementation of a Community-Based Hybrid HIV Testing Services Program as a Strategy to Saturate Testing Coverage in Western Kenya

Details

• Journal Article:
  J Acquir Immune Defic Syndr
• Personal Author:
  Truong, Hong-Ha M. ; Akama, Eliud ; Guzé, Mary A. ; Otieno, Frankline ; Obunge, Duncan ; Wandera, Esther ; Nsengiyumva, Ntwali Placide ; Obabo, Sammy ; Bushman, Dena ; Kadede, Kevin ; Bukusi, Elizabeth A. ; Oyaro, Patrick ; Cohen, Craig R.
  More +
• Description:
  Background: ; Knowledge of HIV status is the entry point for linkage to prevention, care, and treatment, and the first step towards achieving the UNAIDS 90–90-90 targets. Most countries rely on proxies for estimating testing saturation, including periodic population-based sampling and yield (number positive among those tested). We conducted a community-based “Hybrid” HIV testing services (HTS) program to identify persons unaware of their HIV-positive status. ; Setting: ; Homa Bay County, Kenya; July through September 2016 ; Methods: ; We conducted community mapping, household census, multi-disease community health campaigns (CHCs), and home-based tracking. HIV testing eligibility was based on 2015 national guidelines. The previously-unidentified fraction (PUF) was defined as the proportion of newly-identified persons living with HIV (PLWH) out of all previously-identified and newly-identified PLWH. ; Results: ; The Hybrid HTS program reached 28,885 persons in total: 25,340 residents and 3,545 non-residents. There were 19,288 persons reached through CHCs and tracking. Of 11,316 individuals eligible for HIV testing, 9,463 (83%) accepted testing, including 1,230 (13%) first-time testers. There were 115 newly-identified PLWH out of 1,589 total HIV-positive persons, representing a 7.2% PUF. Of 93 newly-identified PLWH at the CHCs, 68% initiated same-day antiretroviral therapy. ; Conclusion: ; The Hybrid HTS program identified persons previously unaware of their HIV-positive status, thereby enabling linkage to care and same-day treatment and reducing onward transmission risk. An approach focused on identifying persons unaware of their HIV-positive status in combination with ascertaining the PUF has the potential to better target testing strategies to identify >90% of PLWH in a community.
• Subjects:
  • Adolescent
  • Adult
  • Aged
  • Anti-HIV Agents
  • Community Health Services
  • Female
  • HIV Infections
  • Humans
  • Male
  • Middle Aged
  More +
• Keywords:
  • HIV testing services
  • antiretroviral therapy
  • community health
  • Kenya
• Source:
  J Acquir Immune Defic Syndr. 82(4):362-367
• DOI:
  http://dx.doi.org/10.1097/QAI.0000000000002160
• Pubmed ID:
  31658179
• Pubmed Central ID:
  PMC7148116
• Document Type:
  Text ; Journal Article
• Funding:
  P30 MH062246/MH/NIMH NIH HHSUnited States/ ; U2G PS001913/PS/NCHHSTP CDC HHSUnited States/
• Genre:
  Journal Article
• Place as Subject:
  Kenya
• Volume:
  82
• Issue:
  4
• Download URL:
  https://stacks.cdc.gov/view/cdc/86647/cdc_86647_DS1.pdf
• File Type:
  [PDF - 600.21 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:1bbe2551071185a172e0382e04e2b6dc45537e881d2fa9bfcebe4c88018d99159aeb7765b1eee93005f6eaa84d0edbdbdf7203dc5a3d7c4305ba0c9065973b22