Increasing knowledge of HIV status in a country with high HIV testing coverage: Results from the Botswana Combination Prevention Project

Abstract

IntroductionAchieving widespread knowledge of HIV-positive status is a crucial step to reaching universal ART coverage, population level viral suppression, and ultimately epidemic control. We implemented a multi-modality HIV testing approach to identify 90% or greater of HIV-positive persons in the Botswana Combination Prevention Project (BCPP) intervention communities.MethodsBCPP is a cluster-randomized trial designed to evaluate the impact of combination prevention interventions on HIV incidence in 30 communities in Botswana. Community case finding and HIV testing that included home and targeted mobile testing were implemented in the 15 intervention communities. We described processes for identifying HIV-positive persons, uptake of HIV testing by age, gender and venue, characteristics of persons newly diagnosed through BCPP, and coverage of knowledge of status reached at the end of study.ResultsOf the 61,655 eligible adults assessed in home or mobile settings, 13,328 HIV-positive individuals, or 93% of the estimated 14,270 positive people in the communities were identified through BCPP. Knowledge of status increased by 25% over the course of the study with the greatest increases seen among men (37%) as compared to women (19%) and among youth aged 16–24 (77%) as compared to older age groups (21%). Although more men were tested through mobile than through home-based testing, higher rates of newly diagnosed HIV-positive men were found through home than mobile testing.ConclusionsEven when HIV testing coverage is high, additional gains can be made using a multi-modality HIV testing strategy to reach different sub-populations who are being missed by non-targeted program activities. Men and youth can be reached and will engage in community testing when services are brought to places they access routinely.

HIV/AIDS knowledge and attitudes assessment among women of child-bearing age in South Sudan: Findings from a Household Survey

“…Lack of HIV/AIDS knowledge can have serious implications for public health interventions to control infection, promote testing, and engage in treatment and care [ 9 , 10 ]. Despite the efforts to improve HIV/AIDS understanding, there is still stigma and discrimination against people with HIV/AIDS in South Sudan [ 10 ].…”

“…Understanding attitudes toward people with HIV/AIDS is vital to support public health measures to control infection. They promote healthy behaviours such as acceptance of condom use, reduced sexual partners, testing, and engagement in treatment and support seeking [ 9 ]. A better understanding of HIV/AIDS in the community can help to plan targeted interventions, adequately use resources, and redress inequity in society by reaching the most vulnerable groups [ 7 ].…”

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“…Access to testing has also made health education and HIV information activities possible. 1 Capturing subjects for HIV testing involves morality implicit in arguments that sometimes assume stereotyped conceptions about masculinity, producing barriers to access to testing. Sexuality is a universe of possibilities that involve roles, identities, practices, tastes and preferences, and should always be an object of individual Prophylaxis and HIV testing among men Francisco MTR, Fonte VRF, Spindola T, Pinheiro CDP, Costa CMA, Rocha FCS and particular analysis in health care.…”

“…Mathematical estimates suggest that the adoption of goal 90, 90, 90, proposed by the Joint United Nations Program on HIV/AIDS (UNAIDS), will establish the end of the epidemic by the year 2030. 1 The ambitious goal calls for global leaders and civil society to make a commitment to ensure that 90% of people living with HIV have access to diagnosis, which 90% of people diagnosed have access to medication, and that 90% of people with access to medication achieve viral suppression. Brazil, as a UN signatory country, assumed the fulfillment of this goal in 2015 and reiterated in 2016.…”

Finding, treating and retaining persons with HIV in a high HIV prevalence and high treatment coverage country: Results from the Botswana Combination Prevention Project

“…Point-of-care fingerstick testing was conducted according to the Botswana national testing algorithm. Samples from each community were retested in the reference laboratory to provide quality control for the field-based HIV rapid testing [30].…”