Kim, H.B., Haile, B., and Lee, T. Health Economics (August 2016), doi:10.1002/hec.3425.
This study used data from a randomized controlled trial to determine voluntary counseling and testing (VCT) uptake among households exposed to HIV education, home-based VCT, or conditional cash transfers (CCTs) to incentivize clinic-based VCT. The authors developed four experimental groups: 1) home-based HIV education with VCT promotion; 2) home-based HIV education with VCT provided that day or within the following 10 days; 3) home-based HIV education for clinic-based VCT with CCT on receiving test results (to compensate for missed wages and required travel for clinic-based VCT); and 4) a control group. To examine recurrent HIV testing, the authors subsequently randomized the four groups into a group receiving home-based VCT and a clinic-based VCT group using CCT. The results showed that relative to those in the control group, individuals receiving home-based VCT, clinic-based VCT, and education only were 63, 57, and 8 times more likely, respectively, to know their status. Despite similar uptake in HIV testing between home- and clinic-based VCT, those who tested at home were more likely to have a positive test result. Previous history of HIV testing did not decrease the likelihood of future HIV testing uptake. The authors concluded that HIV testing uptake is most effective when HIV education is paired with home- or clinic-based VCT, and that VCT promotion campaigns should be linked to improved VCT access.