Impact of a Comprehensive Adolescent-Focused Case Finding Intervention on Uptake of HIV Testing and Linkage to Care Among Adolescents in Western Kenya

Abstract

Background:Low HIV testing uptake prevents identification of adolescents living with HIV and linkage to care and treatment. We implemented an innovative service package at health care facilities to improve HIV testing uptake and linkage to care among adolescents aged 10–19 years in Western Kenya.Methods:This quasi-experimental study used preintervention and postintervention data at 139 health care facilities (hospitals, health centers, and dispensaries). The package included health worker capacity building, program performance monitoring tools, adolescent-focused HIV risk screening tool, and adolescent-friendly hours.The study population was divided into early (10–14 years) and late (15–19 years) age cohorts. Implementation began in July 2016, with preintervention data collected during January–March 2016 and postintervention data collected during January–March 2017. Descriptive statistics were used to analyze the numbers of adolescents tested for HIV, testing HIV-positive, and linked to care services. Preintervention and postintervention demographic and testing data were compared using the Poisson mean test. χ2 testing was used to compare the linkage to care rates.Results:During the preintervention period, 25,520 adolescents were tested, 198 testing HIV-positive (0.8%) compared with 77,644 adolescents tested with 534 testing HIV-positive (0.7%) during the postintervention period (both P-values <0.001). The proportion of HIV-positive adolescents linked to care increased from 61.6% to 94.0% (P < 0.001). The increase in linkage to care was observed among both age cohorts and within each facility type (both P-values <0.001).Conclusions:The adolescent-focused case finding intervention package led to a significant increase in both HIV testing uptake and linkage to care services among adolescents in Western Kenya.

Changes over time in HIV testing and counselling uptake and associated factors among youth in Zambia: a cross-sectional analysis of demographic and health surveys from 2007 to 2018

“…The increasing proportion of HIV tests offered through MC observed in the study reflects an attempt of the Zambian government to reach underserved and hard-to-reach youth. In addition to the latter, other community-based strategies that are specific to youth should be explored given their promising results, such as adolescent-focused case finding implemented in Kenya and home-based HTC [ 48 , 49 ]. HIV self-testing (HST) is also part of interventions in Zambia and has shown some acceptance and the potential to improve access to HIV testing [ 50 – 53 ].…”

Perceived barriers to the uptake of health services among first-year university students in Johannesburg, South Africa

“…Health services become unavailable to students when clinic opening hours coincide with lecture hours, or when clinics are not open during weekends and public holidays. Other studies have shown that the inclusion of extended clinic hours, after-hours, and over weekends, in a comprehensive package of services improves uptake and linkage to care among adolescents [ 9 , 12 , 35 , 37 ]. It is not clear why more females than males in our study perceived the inability to leave/stay away from studies as a potential barrier.…”

“We Need it the Same Day”: A Qualitative Study of Caregivers and Community Members' Perspectives Toward the Use of Point-of-Care Early Infant Diagnosis

“…Health services can be made more accessible to adolescents and more "youth-friendly" by a variety of approaches, including staff training, stigma reduction, adapting opening hours, shortening waiting times, offering psychosocial support, and peer support groups, that improve HIV testing uptake and treatment outcomes among adolescents and that provide services related to sexual and reproductive and mental health (106)(107)(108)(109)(110)(111)(112)(113)(114).…”