18
IRUS Total
Downloads

Uptake of Home-Based Voluntary HIV Testing in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

Title: Uptake of Home-Based Voluntary HIV Testing in Sub-Saharan Africa: A Systematic Review and Meta-Analysis
Authors: Sabapathy, K
Van den Bergh, R
Fidler, S
Hayes, R
Ford, N
Item Type: Journal Article
Abstract: Introduction: Improving access to HIV testing is a key priority in scaling up HIV treatment and prevention services. Homebased voluntary counselling and testing (HBT) as an approach to delivering wide-scale HIV testing is explored here. Methods and Findings: We conducted a systematic review and random-effects meta-analysis of studies published between 1 January 2000 and 24 September 2012 that reported on uptake of HBT in sub-Saharan Africa, to assess the proportion of individuals accepting HBT and receiving their test result. Our initial search yielded 1,199 articles; 114 were reviewed as fulltext articles, and 19 publications involving 21 studies (n = 524,867 individuals offered HBT) were included for final review and meta-analysis. The studies came from five countries: Uganda, Malawi, Kenya, South Africa, and Zambia. The proportion of people who accepted HBT (n = 474,377) ranged from 58.1% to 99.8%, with a pooled proportion of 83.3% (95% CI: 80.4%–86.1%). Heterogeneity was high (t 2 = 0.11). Sixteen studies reported on the number of people who received the result of HBT (n = 432,835). The proportion of individuals receiving their results out of all those offered testing ranged from 24.9% to 99.7%, with a pooled proportion of 76.7% (95% CI: 73.4%–80.0%) (t2 = 0.12). HIV prevalence ranged from 2.9% to 36.5%. New diagnosis of HIV following HBT ranged from 40% to 79% of those testing positive. Forty-eight percent of the individuals offered testing were men, and they were just as likely to accept HBT as women (pooled odds ratio = 0.84; 95% CI: 0.56–1.26) (t 2 = 0.33). The proportion of individuals previously tested for HIV among those offered a test ranged from 5% to 66%. Studies in which ,30% of individuals had been previously tested, local HIV prevalence was ,10%, incentives were provided, or HBT was offered to household members of HIV-positive individuals showed higher uptake of testing. No evidence was reported of negative consequences of HBT. Conclusions: HBT could substantially increase awareness of HIV status in previously undiagnosed individuals in sub-Saharan Africa, with over three-quarters of the studies in this review reporting .70% uptake. It could be a valuable tool for treatment and prevention efforts.
Issue Date: 4-Dec-2012
Date of Acceptance: 24-Oct-2012
URI: http://hdl.handle.net/10044/1/49832
DOI: https://dx.doi.org/10.1371/journal.pmed.1001351
ISSN: 1549-1277
Publisher: Public Library of Science
Journal / Book Title: PLoS Medicine
Volume: 9
Issue: 12
Copyright Statement: © 2012 Sabapathy et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Keywords: Science & Technology
Life Sciences & Biomedicine
Medicine, General & Internal
General & Internal Medicine
MEDICINE, GENERAL & INTERNAL
ANTIRETROVIRAL THERAPY
WESTERN KENYA
HOUSEHOLD MEMBERS
RANDOMIZED-TRIAL
RURAL MALAWI
SOUTH-AFRICA
UGANDA
PREVALENCE
ACCEPTANCE
INFECTION
Africa South of the Sahara
Counseling
Developing Countries
HIV Infections
Home Care Services
Humans
Patient Acceptance of Health Care
11 Medical And Health Sciences
Publication Status: Published
Article Number: ARTN e1001351
Appears in Collections:Department of Medicine (up to 2019)