Community-based intervention to increase HIV testing and case detection in people aged 16-32 years in Tanzania, Zimbabwe, and Thailand (NIMH Project Accept, HPTN 043): a randomised study
OUTPUT TYPE: Journal Article
PUBLICATION YEAR: 2011
TITLE AUTHOR(S): M.Sweat, S.Morin, D.Celentano, M.Mulawa, B.Singh, J.Mbwambo, S.Kawichai, A.Chingono, G.Khumalo-Sakutukwa, G.Gray, L.Richter, M.Kulich, A.Sadowski, T.Coates, Project Accept Study Team
KEYWORDS: CARE IN THE COMMUNITY, HIV/AIDS, TANZANIA, THAILAND, VOLUNTARY COUNSELING AND TESTING (VCT), ZIMBABWE
DEPARTMENT: Public Health, Societies and Belonging (HSC)
Print: HSRC Library: shelf number 6886
HANDLE: 20.500.11910/3732
URI: http://hdl.handle.net/20.500.11910/3732
If you would like to obtain a copy of this Research Output, please contact Hanlie Baudin at researchoutputs@hsrc.ac.za.
Abstract
In developing countries, most people infected with HIV do not know their infection status. We aimed to assess whether HIV testing could be increased by combination of community mobilisation, mobile community-based voluntary counselling and testing (VCT), and support after testing. Project Accept is underway in ten communities in Tanzania, eight in Zimbabwe, and 14 in Thailand. Communities at each site were paired according to similar demographic and environmental characteristics, and one community from each pair was randomly assigned to receive standard clinic-based VCT (SVCT), and the other community was assigned to receive community-based VCT (CBVCT) plus access to SVCT. Randomisation and assignment of communities to intervention groups was done by the statistics centre by computer; no one was masked to treatment assignment because the interventions were community based. Intervention was provided for about 3 years (2006-09). The primary endpoint of HIV incidence is pending completion of assessments after the intervention. In this interim analysis, we examined the secondary endpoint of uptake in HIV testing, differences in characteristics of clients receiving their fi rst HIV test, and repeat testing. Analyses were limited to clients aged 16-32 years. This study is registered with ClinicalTrials.gov, number NCT00203749. The proportion of clients receiving their first HIV test during the study was higher in CBVCT communities than in SVCT communities in Tanzania (2341 [37%] of 6250 vs 579 [9%] of 6733), Zimbabwe (5437 [51%] of 10 700 vs 602 [5%] of 12 150), and Thailand (7802 [69%] of 11 290 vs 2319 [23%] 10 033). The mean difference in the proportion of clients receiving HIV testing between CBVCT and SVCT communities was 40?2% (95% CI 15-8-64.7; p=0.019) across three community pairs (one per country). HIV prevalence was higher in SVCT communities than in CBVCT communities, but CBVCT detected almost four times more HIV cases than did SVCT across the three study sites (952 vs 264; p=0.003). Repeat HIV testing in CBVCT communities increased in all sites to reach 28% of all those testing for HIV by the end of the intervention period. CBVCT should be considered as a viable intervention to increase detection of HIV infection, especially in regions with restricted access to clinic-based VCT and support services after testing.-
Related Research Outputs:
- Reported physical and sexual abuse in childhood and adult HIV risk behaviour in three African countries: findings from Project Accept (HPTN-043)
- Impact of HIV/AIDS on SADC countries: recommendations to funders
- Southern Africa: a review of the region
- The development, implementation and evaluation of interventions for the care of orphans and vulnerable children in Botswana, South Africa and Zimbabwe: A literature review of evidence-based interventions for home-based child-centred development
- Abstract: Determinants of the use of voluntary counselling and testing services among the sexually active adult population of South Africa
- An audit of HIV/AIDS policies in Botswana, Lesotho, Mozambique, South Africa, Swaziland and Zimbabwe
- The use of implementation research networks on orphans and vulnerable children to encourage research-driven policies: the case of Botswana, South Africa and Zimbabwe
- Declines in HIV prevalence can be associated with changing sexual behaviour in Uganda, urban Kenya, Zimbabwe, and urban Haiti
- HIV risk behaviors in sub-Saharan Africa and northern Thailand: baseline behavioral data from Project Accept
- Project Accept (HPTN 043): a community-based intervention to reduce HIV incidence in populations at risk for HIV in sub-Saharan Africa and Thailand
- Macroeconomic impact of HIV and AIDS on the Zimbabwean economy: a human capital approach
- Exploring coping strategies and life choices made by HIV-discordant couples in long-term relationships: insights from South Africa, Tanzania and the Ukraine: full report
- Situational analysis of orphaned and vulnerable children in eight Zimbabwean districts
- Child and mother indicators of progress towards the MDG: a four country comparison
- Working with community based mobilisers (CBMs) to promote community-based voluntary counseling and testing in rural KwaZulu-Natal, South Africa
- Processes, challenges and supervision of VCT lay counsellor in a community based intervention trial
- Fieldwork processes, challenges and lessons of the recruitment of a qualitative cohort
- HIV/AIDS and sexuality: concerns of youths in rural Zimbabwe
- Chronic cough and its association with TB-HIV co-infection: factors affecting help-seeking behaviour in Harare, Zimbabwe
- Voluntary Counselling and Testing (VCT) site-based brief HIV behavioural risk reduction counselling for HIV negative and HIV positive clients at HIV counselling and testing sites in Mpumalanga, South Africa