McNaghten, A.D., Schilsky, M.A, Farirai, T., et al. Journal of Acquired Immune Deficiency Syndromes (August 2015), E-publication ahead of print.
This study compared three models of HIV testing services (HTS) in outpatient departments (OPDs) in South Africa, Tanzania, and Uganda. The authors conducted client interviews and focus group discussions with participants at 12 OPDs in each country that had been randomized to one of three HTS models: Model A (clients received HTS after clinical consultation); Model B (providers offered and delivered HTS during clinical consultation); and Model C (nurses or lay counselors provided HTS before clinical consultation), and conducted client interviews and focus group discussions. More age-eligible clients were tested in Model C (54.1 percent), followed by Model A (41.7 percent) and Model B (33.9 percent). Of newly identified HIV-positive clients (1,596 in total from the three models), 96.1 percent of those receiving Model A were referred to care, 94.7 percent in Model B, and 94.9 percent in Model C. Additionally, 74.4 percent entered on-site care in Model A, 54.8 percent in Model B, and 55.6 percent in Model C. The authors concluded that Model C, where nurses or counselors provided HTS before clinical consultation, resulted in the highest percentage of client testing for eligible clients. This model was convenient for clients and incurred no additional waiting time; and HTS was provided by specifically trained staff.