Community- and facility-based HIV testing interventions in northern Tanzania: Midterm results of Test & Treat Project

Abstract

Test & Treat Project offers universal HIV testing and access to antiretroviral treatment in Northern Tanzania. The current cross-sectional study provides midterm results on HIV testing and counseling activities through community outreaches and facility-based services. A total 255,329 HIV tests were performed: 198,451 (77.7%) during testing campaigns in the villages, 12,592 (4.9%) during special events outreach and 44,286 (17.4%) in the health facilities. Females represented 53.8% (23,809) among those tested in the health facilities, while males were the majority in the community (54.4%, 114,835). Over one third of tests (n = 104,605, 41%) were performed among first-time testers. The overall HIV positivity rate was 1.2%, ranging from 0.7% in the community to 3.8% in the health facilities and decreased over time. Using a multivariable analysis, a positive test result was associated with age ≥ 50 years (PR 1.22, 95% CI 1.11 to 1.34), with female gender (PR 1.61, 95% CI 1.50 to 1.73), being tested in health facilities (PR 5.00, 95% CI 4.65 to 5.36) and for the first time (PR 1.86, 95% CI 1.73 to 2.00). The estimated proportion of PLHIV who knew their status of the project area increased by 28.6% (from 35.7% to 64.3%) and 11.1% (from 57.7% to 68.8%) in the project areas of Shinyanga and Simiyu regions respectively. Reaching the first UNAIDS 90 target by the end of this project seems possible. Future strategies should focus on improving PITC coverage, implementing more targeted testing modalities, together with current universal community-based approach.

Stability in care and risk of loss to follow‐up among clients receiving community health worker‐led differentiated HIV care: Results from a prospective cohort study in northern Tanzania

“…The main activities of the project were the implementation of UTT and a CHW‐led HIV differentiated care model. Outcomes of the community‐based testing component of the project were published by Martelli et al [18], this paper focuses on the outcomes of the latter intervention. Data for this analysis comes from two project sites, Bugisi and Ngokolo health centres, both from the Shinyanga region, where the piloting of the DCM of community‐based ART took place.…”

Effectiveness of provider-initiated versus client-initiated HIV testing by different health facility departments in Northern Tanzania

“…SRRH was only added as a project facility in 2020 and therefore did not receive staff support during the study period. As part of the study, several testing approaches were implemented: community-based testing and facility-based testing [ 13 ]. For this paper, we only report on facility-based testing.…”

Four Decades of HIV: Global Trends, Testing Assays, Treatment, and Challenges

“…The WHO suggests implementing community-based testing because it covers a large population and detects HIV at an early stage compared to other modes of testing [38]. In addition, community-based testing overcomes the barriers between patients and care services [39].…”