P012 A process evaluation of an incentivized home-based intervention to test and start (HITS) in rural kwazulu-natal, south africa

Abstract

Methods A comprehensive search of published studies was carried out in six electronic databases followed by a manual search of studies from references of selected papers. Data were extracted using a template. The results were synthesised, and a meta-analysis based on a random-effects model was conducted. Subgroup and sensitivity analyses were undertaken to explore sources of heterogeneity. Results Of 30,273 citations, 14 studies with a total of 97,030 study participants were identified. The pooled CHTC uptake was 31.48% (95%CI: 23.55-40.00) with significant heterogeneity between studies (I 2 =99.98%, p < 0.001). The Egger's and Begg's tests showed there was no evidence of publication bias (p=0.08). However, the sensitivity analysis showed that two studies highly influenced the overall estimate. After omitting these two studies, the pooled estimate for CHTC uptake was 24.05% (95%CI: 16.6 5, 32.34, I 2 =99.86%, p<0.001). The sub-group analysis indicated the pooled CHTC uptake was higher among pregnant women and their partners (OR=1.66, 95%CI: 1.58, 1.84) compared with heterosexual couples in general. Similarly, the uptake was higher when one person in the dyad first tested individually without the knowledge of their partner, and then suggested to their partner that they take CHTC together, compared to an approach of undertaking CHTC together as the first testing option for both people (OR=3.16, 95%CI: 2.69, 3.72). Conclusion The findings confirmed that more than three-quarters of study participants who were in ongoing heterosexual relationships chose not to, or were unable to, undertake CHTC. These findings suggest people are cautious of what could amount to harmful risks when couples test together, particularly if their HIV sero-status is shown to be discordant. Further studies are required to explore how couples intend to use HIV testing services including CHTC. Disclosure No significant relationships.

Home‐Based Intervention to Test and Start (HITS): a community‐randomized controlled trial to increase HIV testing uptake among men in rural South Africa

“…Since HCT was offered right after the participants had listened to EPIC‐HIV, they might have not yet been ready to make immediate action towards HCT. Nevertheless, in the post‐intervention satisfaction surveys, 96% of participants who received EPIC‐HIV 1 found EPIC‐HIV 1 acceptable and motivated them to test, and almost everyone reported being empowered with the information from the app [40,41], suggesting that engagement with EPIC‐HIV 1 would potentially lead to better uptake of home‐based HIV testing or linkage to care in the future.…”

“…Since HCT was offered right after the participants had listened to EPIC-HIV, they might have not yet been ready to make immediate action towards HCT. Nevertheless, in the post-intervention satisfaction surveys, 96% of participants who received EPIC-HIV 1 found EPIC-HIV 1 acceptable and motivated them to test, and almost everyone reported being empowered with the information from the app [40,41], suggesting that engagement with EPIC-HIV 1 would potentially lead to better uptake of home-based HIV testing or linkage to care in the future. The overall population coverage of HIV testing during this single round of testing was relatively low at 21% (with 32% of men away from home at the time of the fieldworker visits and 33% choosing not to participate in the annual populationbased HIV testing), although over several rounds of testing, both the cumulative contact rate and the level of HIV testing would increase.…”

Effect of a male-targeted digital decision support application aimed at increasing linkage to HIV care among men: Findings from the HITS cluster randomized clinical trial in rural South Africa

“…Both males and females were eligible to receive financial incentives but only males were eligible to receive EPIC-HIV. Implementation and acceptance of the HITS intervention were evaluated using a process evaluation through post-intervention satisfaction surveys 43,44 as well as focus group discussion and in-depth interviews among study participants, fieldworkers, and health professionals. The results of the process evaluation are published elsewhere.…”

The impact of a conditional financial incentive on linkage to HIV care: Findings from the HITS cluster randomized clinical trial in rural South Africa

“…Randomization was conducted to ensure balance across the arms using stratified sampling at the community level based on the HIV incidence among young females aged 15-30 years. The implementation and acceptance of the HITS intervention were evaluated using a process evaluation, utilizing post-intervention satisfaction surveys 37 as well as focus group discussion and in-depth interviews among study participants, fieldworkers, and health professionals. Results of the process evaluation have been published elsewhere.…”