Perceptions of door-to-door HIV counselling and testing in Botswana

Kroeger, Karen; Taylor, Allan W.; Marlow, Heather M.; Fleming, Douglas T.; Beyleveld, Vanessa; Alwano, Mary Grace; Tebogo, Kejelepula, Mabel; Busang, Chilume, Kentsenao; Smith, Dawn K.; Roels, Thierry H.; Kilmarx, Peter H.

doi:10.1080/17290376.2011.9725001

Cited by 10 publications

(26 citation statements)

References 26 publications

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“…In this study, the intervention increased opportunities to engage and influence other family members as adolescents living in households with at least an additional member previously tested by CHiPs had higher odds of accepting HCT; as reported elsewhere (15). …”

Section: Discussionsupporting

confidence: 71%

Community intervention improves knowledge of HIV status of adolescents in Zambia

Shanaube

Schaap

Chaila

et al. 2017

Aids

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Objective:To determine the uptake of home-based HIV counselling and testing (HCT) in four communities of the HPTN 071 (PopART) trial in Zambia among adolescents aged 15–19 years and explore factors associated with HCT uptake.Design:The PopART for youth study is a three-arm community-randomized trial in 12 communities in Zambia and nine communities in South Africa which aims to evaluate the acceptability and uptake of a HIV prevention package, including universal HIV testing and treatment, among young people. The study is nested within the HPTN 071 (PopART) trial.Methods:Using a door-to-door approach that includes systematically revisiting households, all adolescents enumerated were offered participation in the intervention and verbal consent was obtained. Data were analysed from October 2015 to September 2016.Results:Among 15 456 enumerated adolescents, 11 175 (72.3%) accepted the intervention. HCT uptake was 80.6% (8707/10 809) and was similar by sex. Adolescents that knew their HIV-positive status increased almost three-fold, from 75 to 210. Following visits from community HIV care providers, knowledge of HIV status increased from 27.6% (3007/10 884) to 88.5% (9636/10 884). HCT uptake was associated with community, age, duration since previous HIV test; other household members accepting HCT, having an HIV-positive household member, circumcision, and being symptomatic for STIs.Conclusion:Through a home-based approach of offering a combination HIV prevention package, the proportion of adolescents who knew their HIV status increased from ∼28 to 89% among those that accepted the intervention. Delivering a community-level door-to-door combination, HIV prevention package is acceptable to many adolescents and can be effective if done in combination with targeted testing.

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Section: Discussionsupporting

confidence: 71%

Community intervention improves knowledge of HIV status of adolescents in Zambia

Shanaube

Schaap

Chaila

et al. 2017

Aids

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“…We identified twenty-five manuscripts comprised of twenty-two peer-reviewed articles [18, 19, 21, 37–55], two theses/dissertations [56, 57] and one conference abstract [58] (Figure 1). Among these, seventeen studies were single component interventions [19, 21, 37–42, 45, 47, 49, 50, 53, 54, 56–58] and eight were multiple component interventions [18, 43, 44, 46, 48, 51, 52, 55]. We identified cross-sectional (16) [18, 19, 39, 41–46, 49–51, 53–55, 58], longitudinal (6) [21, 37, 47, 48, 52, 57], and longitudinal-quantitative parent studies (3) study designs [38, 40, 56].…”

Section: Resultsmentioning

confidence: 99%

“…We identified cross-sectional (16) [18, 19, 39, 41–46, 49–51, 53–55, 58], longitudinal (6) [21, 37, 47, 48, 52, 57], and longitudinal-quantitative parent studies (3) study designs [38, 40, 56]. Twelve studies [18, 37–41, 44, 47, 49–51, 53] were from high-income countries (HIC: USA, UK, Canada), eight [19, 43, 45, 46, 52, 54, 56, 58] from middle-income countries (MIC: South Africa, India, Botswana), and five [21, 42, 48, 55, 57] from low-income countries (LIC: Haiti, Tanzania, Cambodia, Malawi, Kenya). Overall, 24 studies focused on adults [18, 19, 21, 37–43, 45–58], eight included adolescents (defined as ages 10–19) [21, 37, 44–48, 57], and four included pregnant women [21, 43, 55, 57].…”

Section: Resultsmentioning

confidence: 99%

“…Task-shifting was identified as effective in increasing linkage to care among PLHIV in four studies [42, 43, 45, 54]. The four studies were from Botswana, Haiti, and South Africa.…”

Section: Intervention Specific Themesmentioning

confidence: 99%

“…Community mobile outreach testing and linkage interventions facilitated linkage to care [19, 45, 58]. These three studies were from Botswana and South Africa.…”

Section: Intervention Specific Themesmentioning

confidence: 99%

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Facilitators and barriers in HIV linkage to care interventions

Tso

Best

Beanland

et al. 2016

Aids

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Objective To synthesize qualitative evidence on linkage to care interventions for people living with HIV. Design Systematic literature review. Methods We searched nineteen databases for studies reporting qualitative evidence on linkage interventions. Data extraction and thematic analysis were used to synthesize findings. Quality was assessed using the CASP tool and certainty of evidence was evaluated using the CERQual approach. Results Twenty-five studies from eleven countries focused on adults (24 studies), adolescents (8 studies), and pregnant women (4 studies). Facilitators included community-level factors (i.e. task-shifting, mobile outreach, integrated HIV and primary services, supportive cessation programs for substance users, active referrals, and dedicated case management teams) and individual-level factors (encouragement of peers/family and positive interactions with healthcare providers in transitioning into care). One key barrier for people living with HIV was perceived inability of providers to ensure confidentiality as part of linkage to care interventions. Providers reported difficulties navigating procedures across disparate facilities and having limited resources for linkage to care interventions. Conclusions Our findings extend the literature by highlighting the importance of task-shifting, mobile outreach, and integrated HIV and primary services. Both community and individual level factors may increase the feasibility and acceptability of HIV linkage to care interventions. These findings may inform policies to increase the reach of HIV services available in communities .

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Enhancing Public Health HIV Interventions: A Qualitative Meta-Synthesis and Systematic Review of Studies to Improve Linkage to Care, Adherence, and Retention

et al. 2017

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Although HIV services are expanding, few have reached the scale necessary to support universal viral suppression of individuals living with HIV. The purpose of this systematic review was to summarize the qualitative evidence evaluating public health HIV interventions to enhance linkage to care, antiretroviral drug (ARV) adherence, and retention in care. We searched 19 databases without language restrictions. The review collated data from three separate qualitative evidence reviews addressing each of the three outcomes along the care continuum. 21,738 citations were identified and 24 studies were included in the evidence review. Among low and middle-income countries in Africa, men living with HIV had decreased engagement in interventions compared to women and this lack of engagement among men also influenced the willingness of their partners to engage in services. Four structural issues (poverty, unstable housing, food insecurity, lack of transportation) mediated the feasibility and acceptability of public health HIV interventions. Individuals living with HIV identified unmet mental health needs that interfered with their ability to access HIV services. Persistent social and cultural factors contribute to disparities in HIV outcomes across the continuum of care, shaping the context of service delivery among important subpopulations.

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Perceptions of door-to-door HIV counselling and testing in Botswana

Cited by 10 publications

References 26 publications

Community intervention improves knowledge of HIV status of adolescents in Zambia

Community intervention improves knowledge of HIV status of adolescents in Zambia

Facilitators and barriers in HIV linkage to care interventions

Enhancing Public Health HIV Interventions: A Qualitative Meta-Synthesis and Systematic Review of Studies to Improve Linkage to Care, Adherence, and Retention

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