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Implementation of a Community-Based Hybrid HIV Testing Services Program as a Strategy to Saturate Testing Coverage in Western Kenya
  • Published Date:
    Dec 01 2019
  • Source:
    J Acquir Immune Defic Syndr. 82(4):362-367
  • Language:
Filetype[PDF-600.21 KB]

  • Alternative Title:
    J Acquir Immune Defic Syndr
  • Description:

    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.


    Homa Bay County, Kenya; July through September 2016


    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.


    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.


    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.

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