BACKGROUND: The World Health Organisation (WHO) estimates that only 12% of men and 10% of women in sub-Saharan Africa have been tested for HIV and know their test results. Home-based counselling and testing (HBCT) offers a novel approach to complement facility-based provider initiated testing and counselling (PITC) and voluntary counselling and testing (VCT) and could greatly increase HIV prevention opportunities. However, there is almost no evidence that large-scale, door-to-door testing is even feasible in settings with both limited resources and significant stigma around HIV and AIDS. OBJECTIVE: To describe our experience with the feasibility and acceptance of home-based HIV counselling and testing (HBCT) in two large, rural, administrative divisions of western Kenya. DESIGN: The USAID-AMPATH Partnership conducted population-based, house-to-house HIV counselling and testing in western Kenya between June 2007 and June 2009. All individuals aged > or = 13 years and all eligible children were offered HBCT. Children were eligible if they were above 13 years of age, and their mother was either HIV-positive or had unknown HIV serostatus, or if their mother was deceased or whose vital status was unknown. SETTING: Kosirai and Turbo Divisions, Rift Valley Province, Kenya. RESULTS: There were 47,066 households approached in 294 villages: 97% of households allowed entry. Of the 138,026 individuals captured, 101,167 individuals were eligible for testing: 89% of adults and 58% of children consented to HIV testing. The prevalence of HIVin these communities was 3.0%: 2.7% in adults and 3.7% among children. Prevalence was highest in the 36-45 year age group and was almost always higher among women and girls. All persons testing HIV-positive were referred to Academic Model Providing Access to Healthcare (AMPATH) for further assessment and care; all consenting persons were counselled on HIV risk-lowering behaviours. CONCLUSION: Home-based HIV counselling and testing was feasible among this rural population in western Kenya, with a majority of the population accepting to get tested. These data suggest that scaling-up of HBCT is possible and may enable large numbers of individuals to know their HIV serostatus in sub-Saharan Africa. More research is needed to describe the cost-effectiveness and clinical impact of this approach.
BACKGROUND: The World Health Organisation (WHO) estimates that only 12% of men and 10% of women in sub-Saharan Africa have been tested for HIV and know their test results. Home-based counselling and testing (HBCT) offers a novel approach to complement facility-based provider initiated testing and counselling (PITC) and voluntary counselling and testing (VCT) and could greatly increase HIV prevention opportunities. However, there is almost no evidence that large-scale, door-to-door testing is even feasible in settings with both limited resources and significant stigma around HIV and AIDS. OBJECTIVE: To describe our experience with the feasibility and acceptance of home-based HIV counselling and testing (HBCT) in two large, rural, administrative divisions of western Kenya. DESIGN: The USAID-AMPATH Partnership conducted population-based, house-to-house HIV counselling and testing in western Kenya between June 2007 and June 2009. All individuals aged > or = 13 years and all eligible children were offered HBCT. Children were eligible if they were above 13 years of age, and their mother was either HIV-positive or had unknown HIV serostatus, or if their mother was deceased or whose vital status was unknown. SETTING: Kosirai and Turbo Divisions, Rift Valley Province, Kenya. RESULTS: There were 47,066 households approached in 294 villages: 97% of households allowed entry. Of the 138,026 individuals captured, 101,167 individuals were eligible for testing: 89% of adults and 58% of children consented to HIV testing. The prevalence of HIVin these communities was 3.0%: 2.7% in adults and 3.7% among children. Prevalence was highest in the 36-45 year age group and was almost always higher among women and girls. All persons testing HIV-positive were referred to Academic Model Providing Access to Healthcare (AMPATH) for further assessment and care; all consenting persons were counselled on HIV risk-lowering behaviours. CONCLUSION: Home-based HIV counselling and testing was feasible among this rural population in western Kenya, with a majority of the population accepting to get tested. These data suggest that scaling-up of HBCT is possible and may enable large numbers of individuals to know their HIV serostatus in sub-Saharan Africa. More research is needed to describe the cost-effectiveness and clinical impact of this approach.
Authors: Rajesh Vedanthan; Jemima H Kamano; Hana Lee; Benjamin Andama; Gerald S Bloomfield; Allison K DeLong; David Edelman; Eric A Finkelstein; Joseph W Hogan; Carol R Horowitz; Simon Manyara; Diana Menya; Violet Naanyu; Sonak D Pastakia; Thomas W Valente; Cleophas C Wanyonyi; Valentin Fuster Journal: Am Heart J Date: 2017-03-23 Impact factor: 4.749
Authors: Larry W Chang; David Serwadda; Thomas C Quinn; Maria J Wawer; Ronald H Gray; Steven J Reynolds Journal: Lancet Infect Dis Date: 2013-01 Impact factor: 25.071
Authors: Becky L Genberg; Hana Lee; Joseph W Hogan; Fatma Some; Juddy Wachira; Xiaotian K Wu; Paula Braitstein Journal: J Acquir Immune Defic Syndr Date: 2018-08-01 Impact factor: 3.731
Authors: Patricia Oluoch; James Orwa; Fillet Lugalia; David Mutinda; Anthony Gichangi; Joseph Oundo; Mohamed Karama; Zipporah Nganga; Jennifer Galbraith Journal: Pan Afr Med J Date: 2017-08-23
Authors: Sonak D Pastakia; Shamim M Ali; Jemima H Kamano; Constantine O Akwanalo; Samson K Ndege; Victor L Buckwalter; Rajesh Vedanthan; Gerald S Bloomfield Journal: Global Health Date: 2013-05-16 Impact factor: 4.185