High HIV testing uptake and linkage to care in a novel program of home-based HIV counseling and testing with facilitated referral in KwaZulu-Natal, South Africa
OUTPUT TYPE: Journal Article
PUBLICATION YEAR: 2013
TITLE AUTHOR(S): H.Van Rooyen, R.V.Barnabas, J.M.Baeten, Z.Phakathi, P.Joseph, M.Krows, T.Hong, P.M.Murnane, J.Hughes, C.Celum
KEYWORDS: COUNSELLING, HIV TESTING AND COUNSELLING (HTC), HIV/AIDS, KWAZULU-NATAL PROVINCE
DEPARTMENT: Public Health, Societies and Belonging (HSC)
Print: HSRC Library: shelf number 8151
HANDLE: 20.500.11910/2508
URI: http://hdl.handle.net/20.500.11910/2508
If you would like to obtain a copy of this Research Output, please contact Hanlie Baudin at researchoutputs@hsrc.ac.za.
Abstract
For antiretroviral therapy (ART) to have a population level HIV prevention impact, high levels of HIV testing and effective linkages to HIV care among HIV-infected persons are required. Methods: We piloted home-based counseling and testing (HBCT) with point-of-care CD4 count testing and follow-up visits to facilitate linkage of HIV-infected persons to local HIV clinics and uptake of ART in rural KwaZulu-Natal, South Africa. Lay counselor follow-up visits at months one, three and six evaluated the primary outcome of linkage to care. Plasma viral load was measured at baseline and month six. 671 adults were tested for HIV (91% coverage) and 201 (30%) were HIV-infected, of which 73 (36%) were new diagnoses. By month three, 90% of HIV-infected persons not on ART at baseline had visited an HIV clinic and 80% of those eligible for ART at baseline by South African guidelines (CD4?200 cells/mL at the time of the study) had initiated ART. Among HIV-infected participants who were eligible for ART at baseline, mean viral load decreased by 3.23 log10 copies/mL (p<0.001) and the proportion with viral load suppression increased from 20% to 80% between baseline and month six. In this pilot of HBCT and linkages to care in KwaZulu-Natal, 91% of adults were tested for HIV. Linkage to care was ;90% both among newly-identified HIV-infected persons as well as known HIVinfected persons who were not engaged in care.-
Related Research Outputs:
- Using participatory mapping to inform a community-randomized trial of HIV counseling and testing
- Efficacy of a lay health worker led group antiretroviral medication adherence training among non-adherent HIV-positive patients in KwaZulu-Natal, South Africa: results from a randomized trial
- "It's important to take your medication everyday okay?": an evaluation of counselling by lay counsellors for ARV adherence support in the Western Cape, South Africa
- Uthando Lwethu ('our love'): a protocol for a couples-based intervention to increase testing for HIV: a randomized controlled trial in rural KwaZulu-Natal, South Africa
- Initiation of antiretroviral therapy and viral suppression after home HIV testing and counselling in KwaZulu-Natal, South Africa, and Mabarara district, Uganda: a prospective, observational intervention study
- Evaluation of the HIV lay counselling and testing profession in South Africa
- "Men don't want things to be seen or known about them": a mixed-methods study to locate men in a home based counselling and testing programme in KwaZulu-Natal, South Africa
- Home testing and counselling to reduce HIV incidence in a generalised epidemic setting: a mathematical modelling analysis
- Integrating non-communicable disease (NCD) screening and referral to care into home HIV testing and counseling in rural KwaZulu-Natal, South Africa: burden of disease
- Formative research as a tool to address ethical concerns during a family-based home-based counselling and testing (FBCT) intervention development process in KwaZulu-Natal
- The impact of HIV/AIDS on land issues in Kwazulu-Natal province South Africa: case studies from Muden, Dondotha, Kwadumisa and Kwanyuswa
- Putting HIV/AIDS counselling in South Africa in its place
- Bloodwise? Knowledge and attitudes pertaining to HIV and blood donation in Durban
- HIV/AIDS/STI/TB knowledge, beliefs and practices of traditional healers in KwaZulu-Natal, South Africa
- A controlled study of an HIV/AIDS/STI/TB intervention with traditional healers in KwaZulu-Natal, South Africa
- HIV/AIDS/STI/TB knowledge, attitudes and practices among lay health workers and nurses in KwaZulu-Natal, South Africa
- Financial and economic costs of scaling up the provision of HAART to HIV-infected health care workers in KwaZulu-Natal
- Report on experiences in the Amandlamadoda (menpower) sexual and reproductive project in Umkhanyakude, KwaZulu-Natal
- Photo-voice as an analytical and activist tool in the fight against HIV and AIDS stigmatisation in a rural KwaZulu-Natal school
- Youth voices about sex and AIDS: implications for life skills education through the 'Learning Together' project in KwaZulu-Natal, South Africa