What works - reaching universal HIV testing: lessons from HPTN 071 (PopART) trial in Zambia

Title: What works - reaching universal HIV testing: lessons from HPTN 071 (PopART) trial in Zambia
Authors: Shanaube, K
Schaap, A
Floyd, S
Phiri, M
Griffith, S
Chaila, J
Bock, P
Hayes, R
Fidler, S
Ayles, H
Item Type: Journal Article
Abstract: Objective: To determine the uptake of home-based HIV counselling and testing (HCT) in four HPTN 071 (PopART) trial communities (implementing a ‘full’ combination HIV prevention package that includes universal HIV testing and treatment) in Zambia. We also explore factors associated with uptake of HCT in these communities. Design: HPTN 071 (PopART) is a three-arm community-randomized trial in 12 communities in Zambia and nine communities in South Africa evaluating the impact of a combination HIV prevention package, including universal HIV testing and treatment, on HIV incidence. Methods: Using a door-to-door approach that includes systematically revisiting households, individuals were offered participation in the intervention, and verbal consent was obtained. Data were analysed for the first 18 months of the intervention, December 2013 to June 2015 for individuals 18 years and older. Results: Among 121 130 enumerated household members, 101 102 (83.5%) accepted the intervention. HCT uptake was 72.2% (66 894/92 612), similar by sex but varied across communities. HCT uptake was associated with younger age, sex, community, being symptomatic for TB and sexually transmitted infections and longer time since previous HIV test. Knowledge of HIV status due to the intervention increased by 36% overall and by 66% among HIV positive participants; the highest impact was among 18–24 years old. Conclusion: Overall acceptance of HIV-testing through offering a door-to-door-based combination HIV prevention package was 72.2%. The intervention increased knowledge of HIV status from ∼50 to ∼90%. However, challenges still remain and a one-off intervention is unlikely to be successful but will require repeated visits and multiple strategies.
Issue Date: 17-Jul-2017
Date of Acceptance: 15-Apr-2017
ISSN: 0269-9370
Publisher: Wolters Kluwer Health, Inc.
Start Page: 1555
End Page: 1564
Journal / Book Title: AIDS
Volume: 31
Issue: 11
Copyright Statement: © 2017 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Sponsor/Funder: National Institutes of Health
Funder's Grant Number: PO15001410 (UMIAI068619)
Keywords: Science & Technology
Life Sciences & Biomedicine
Infectious Diseases
home-based HIV counselling and testing
universal HIV testing and immediate treatment
HPTN 071 (PopART) Study Team
06 Biological Sciences
11 Medical And Health Sciences
17 Psychology And Cognitive Sciences
Publication Status: Published
Appears in Collections:Department of Medicine
Faculty of Medicine

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