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


Autoři: Mary Grace Alwano aff001;  Pamela Bachanas aff002;  Lisa Block aff003;  Michelle Roland aff001;  Baraedi Sento aff004;  Stephanie Behel aff002;  Refeletswe Lebelonyane aff005;  Kathleen Wirth aff006;  Faith Ussery aff002;  William Bapati aff004;  Catherine Motswere-Chirwa aff001;  William Abrams aff001;  Gene Ussery aff003;  James A. Miller aff003;  Ebi Bile aff001;  Peter Fonjungo aff002;  Agisanag Kgwadu aff004;  Molly Pretorius Holme aff006;  Lisetta Del Castillo aff001;  Tendani Gaolathe aff007;  Kelebemang Leme aff004;  Nokuthula Majingo aff005;  Shahin Lockman aff006;  Joseph Makhema aff007;  Naomi Bock aff002;  Janet Moore aff002
Působiště autorů: U.S. Centers for Disease Control and Prevention, Division of Global HIV/AIDS, Gaborone, Botswana aff001;  U.S. Centers for Disease Control and Prevention, Division of Global HIV/AIDS, Atlanta, Georgia, United States of America aff002;  Northrop Grumman, Atlanta, Georgia, United States of America aff003;  Tebelopele HIV Counseling and Testing Center, Gaborone, Botswana aff004;  Botswana Ministry of Health and Wellness, Gaborone, Botswana aff005;  Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America aff006;  Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana aff007;  Brigham and Women’s Hospital, Boston, Massachusetts, United States of America aff008
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
doi: 10.1371/journal.pone.0225076

Souhrn

Introduction

Achieving 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.

Methods

BCPP 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.

Results

Of 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.

Conclusions

Even 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.

Klíčová slova:

Community based intervention – HIV diagnosis and management – HIV epidemiology – HIV infections – HIV prevention – Botswana


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Článek vyšel v časopise

PLOS One


2019 Číslo 11