Author:
Mabuto Tonderai,Setswe Geoffrey,Mshweshwe-Pakela Nolundi,Clark Dave,Day Sarah,Molobetsi Lerato,Pienaar Jacqueline
Abstract
Abstract
Background
Mobile HIV testing approaches are a key to reaching the global targets of halting the HIV epidemic by 2030. Importantly, the number of clients reached through mobile HIV testing approaches, need to remain high to maintain the cost-effectiveness of these approaches. Advances in rapid in-vitro tests such as INSTI® HIV-1/HIV-2 (INSTI) which uses flow-through technologies, offer opportunities to reduce the HIV testing time to about one minute. Using data from a routine mobile HTS programme which piloted the use of the INSTI point-of-care (POC) test, we sought to estimate the effect of using a faster test on client testing volumes and the number of people identified to be living with HIV, in comparison with standard of care HIV rapid tests.
Methods
In November 2019, one out of four mobile HTS teams operating in Ekurhuleni District (South Africa) was randomly selected to pilot the field use of INSTI-POC test as an HIV screening test (i.e., the intervention team). We compared the median number of clients tested for HIV and the number of HIV-positive clients by the intervention team with another mobile HTS team (matched on performance and area of operation) which used the standard of care (SOC) HIV screening test (i.e., SOC team).
Results
From 19 November 2019 to 20 December 2019, the intervention team tested 7,403 clients, and the SOC team tested 2,426 clients. The intervention team tested a median of 442 (IQR: 288–522) clients/day; SOC team tested a median of 97 (IQR: 40–187) clients/day (p<0.0001). The intervention team tested about 180 more males/day compared to the SOC team, and the median number of adolescents and young adults tested/day by the intervention team were almost four times the number tested by the SOC team. The intervention team identified a higher number of HIV-positive clients compared to the SOC team (142 vs. 88), although the proportion of HIV-positive clients was lower in the intervention team due to the higher number of clients tested.
Conclusions
This pilot programme provides evidence of high performance and high reach, for men and young people through the use of faster HIV rapid tests, by trained lay counsellors in mobile HTS units.
Publisher
Springer Science and Business Media LLC
Reference37 articles.
1. World Health Organization. Consolidated guidelines on HIV testing services for a changing epidemic: policy brief 2019. 2019. Available from: https://www.who.int/publications-detail/consolidated-guidelines-on-hiv-testing-services-for-a-changing-epidemic.
2. Mabuto T, Latka MH, Kuwane B, Churchyard GJ, Charalambous S, Hoffmann CJ. Four models of HIV counseling and testing: utilization and test results in South Africa. PLoS One. 2014;9(7):e102267.
3. Bassett IV, Govindasamy D, Erlwanger AS, Hyle EP, Kranzer K, van Schaik N, et al. Mobile HIV screening in Cape Town, South Africa: clinical impact, cost and cost-effectiveness. PloS One. 2014;9(1):e85197. PubMed PMID: 24465503. Pubmed Central PMCID: 3898963.
4. Smith JA, Sharma M, Levin C, Baeten JM, van Rooyen H, Celum C, et al. Cost-effectiveness of community-based strategies to strengthen the continuum of HIV care in rural South Africa: a health economic modelling analysis. Lancet HIV 2015;2(4):e159-68. PubMed PMID: 25844394. Pubmed Central PMCID: 4384819.
5. World Health Organization. Increasing access to HIV testing and counselling 2014. 2019. Available from: https://apps.who.int/iris/bitstream/handle/10665/42757/9241590904.pdf?sequence=1.
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献