Feasibility and Effectiveness of Two Community-Based HIV Testing Models in Rural Swaziland

May 2015 - Structural Prevention

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Parker, L., A., Jobanputra, K., Rusike, L., et al. Tropical Medicine and International Health (March 2015), doi: 10.1111/tmi.12501, e-publication ahead of print.

This study compared the costs of home-based versus mobile-based HIV testing and counseling (HBHTC and MHTC, respectively) and described the populations reached through each method. The authors reviewed HIV test records for 2,034 people tested through MHTC and 7,026 tested through HBHTC. They found that HBHTC was significantly cheaper than MHTC (US$11 per person tested versus $24, respectively). The study showed that the two models reached different populations. HBHTC reached a greater proportion of children and adolescents (<20 years) compared to MHTC (57 percent versus 17 percent) and adolescents (27 percent versus 12 percent). By contrast, MHTC outperformed HBHTC in reaching those aged 20 or older (83 percent versus 43 percent). Among adults, more men were tested by MHTC than HBHTC (42 percent versus 39 percent). Of the adults tested through HBHTC, 34 percent were testing for the first time—significantly higher than for MHTC (22 percent). The study showed no difference in linkage to care between the two testing strategies or between men and women. However, linkage to care was highest for children and older individuals and lower for individuals aged 20–39 years. The authors concluded that both HBHTC and MHTC are feasible and affordable ways to improve HTC coverage in high-prevalence settings, adding that strategies to ensure linkage to care are indispensable.

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