E Geoffroy1, E Schell1,2, J Jere3, N Khozomba3. 1. Global AIDS Interfaith Alliance, San Rafael, California, USA. 2. University of California, San Francisco, San Francisco, California, USA. 3. Global AIDS Interfaith Alliance, Limbe, Malawi.
Abstract
Setting: Mulanje District, Malawi. Objective: To examine the effectiveness of door-to-door (DtD) testing in reaching young people and men in a remote, rural area with a high prevalence of human immunodeficiency virus (HIV) infection. Design: This was a retrospective analysis of data collected for a pilot DtD program. HIV testing services (HTS) visited targeted villages for 1-2 weeks. All current residents aged ⩾2 years not known to be HIV-positive were offered testing. Results: Ninety per cent (13 783/15 391) of individuals eligible for testing accepted. Forty-one per cent (n = 5693) of those tested were males and 56% (n = 7752) were aged <20 years. The overall proportion who tested positive was 4% (n = 524), with half as many males as females testing positive (OR 0.49, 95%CI 0.40-0.60, P < 0.001). There was a higher positive yield rate for those aged ⩾20 years (6% for men and 8% for women). Two thirds were first-time testers; males were half as likely as females to have been previously tested (OR 0.43, 95%CI 0.40-0.47, P < 0.001). Conclusion: DtD-HTS can be an effective way to reach populations in remote, rural high-prevalence areas where access to fixed facilities is inadequate. It has the potential to reach young people and men better than facility-based testing or other community strategies, and can identify young HIV-positive children who may have been missed by other methods.
Setting: Mulanje District, Malawi. Objective: To examine the effectiveness of door-to-door (DtD) testing in reaching young people and men in a remote, rural area with a high prevalence of human immunodeficiency virus (HIV) infection. Design: This was a retrospective analysis of data collected for a pilot DtD program. HIV testing services (HTS) visited targeted villages for 1-2 weeks. All current residents aged ⩾2 years not known to be HIV-positive were offered testing. Results: Ninety per cent (13 783/15 391) of individuals eligible for testing accepted. Forty-one per cent (n = 5693) of those tested were males and 56% (n = 7752) were aged <20 years. The overall proportion who tested positive was 4% (n = 524), with half as many males as females testing positive (OR 0.49, 95%CI 0.40-0.60, P < 0.001). There was a higher positive yield rate for those aged ⩾20 years (6% for men and 8% for women). Two thirds were first-time testers; males were half as likely as females to have been previously tested (OR 0.43, 95%CI 0.40-0.47, P < 0.001). Conclusion: DtD-HTS can be an effective way to reach populations in remote, rural high-prevalence areas where access to fixed facilities is inadequate. It has the potential to reach young people and men better than facility-based testing or other community strategies, and can identify young HIV-positive children who may have been missed by other methods.
Entities:
Keywords:
community-based testing; male testing; operational research; testing of young people
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