Chido D Chikwari1,2, Stefanie Dringus3, Rashida A Ferrand1,2. 1. Clinical Research Department, London School of Hygiene and Tropical Medicine, London, United Kingdom. 2. Biomedical Research and Training Institute, Zimbabwe. 3. Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, United Kingdom.
Abstract
PURPOSE OF REVIEW: HIV/AIDS is one of the leading causes of death among adolescents in sub-Saharan Africa and 40% of new HIV infections worldwide occur in this group. HIV testing and counselling (HTC) is the critical first step to accessing HIV treatment. The prevalence of undiagnosed HIV infection is substantially higher in adolescents compared with adults. We review barriers to HTC for adolescents and emerging HTC strategies appropriate to adolescents in sub-Saharan Africa. RECENT FINDINGS: There are substantial individual, health system and legal barriers to HTC among adolescents, and stigma by providers and communities remains an important obstacle. There has been progress made in recent years in developing strategies that address some of these barriers, increase uptake of HTC and yield of HIV. These include targeted approaches focused on provision of HTC among those higher risk of being infected, for example, index-linked HTC and use of screening tools to identify those at risk of HIV. Community-based HIV-testing approaches including HIV self-testing and incentives have also been shown to increase uptake of HTC. SUMMARY: In implementing HTC strategies, consideration must be given to scalability and cost-effectiveness. HTC approaches must be coupled with linkage to appropriate care and prevention services.
PURPOSE OF REVIEW: HIV/AIDS is one of the leading causes of death among adolescents in sub-Saharan Africa and 40% of new HIV infections worldwide occur in this group. HIV testing and counselling (HTC) is the critical first step to accessing HIV treatment. The prevalence of undiagnosed HIV infection is substantially higher in adolescents compared with adults. We review barriers to HTC for adolescents and emerging HTC strategies appropriate to adolescents in sub-Saharan Africa. RECENT FINDINGS: There are substantial individual, health system and legal barriers to HTC among adolescents, and stigma by providers and communities remains an important obstacle. There has been progress made in recent years in developing strategies that address some of these barriers, increase uptake of HTC and yield of HIV. These include targeted approaches focused on provision of HTC among those higher risk of being infected, for example, index-linked HTC and use of screening tools to identify those at risk of HIV. Community-based HIV-testing approaches including HIV self-testing and incentives have also been shown to increase uptake of HTC. SUMMARY: In implementing HTC strategies, consideration must be given to scalability and cost-effectiveness. HTC approaches must be coupled with linkage to appropriate care and prevention services.
Authors: Adrienne Epstein; Jason M Nagata; Kyle T Ganson; Denis Nash; Parya Saberi; Alexander C Tsai; Edwin D Charlebois; Sheri D Weiser Journal: AIDS Behav Date: 2022-09-06
Authors: Pitchaya P Indravudh; Katherine Fielding; Moses K Kumwenda; Rebecca Nzawa; Richard Chilongosi; Nicola Desmond; Rose Nyirenda; Melissa Neuman; Cheryl C Johnson; Rachel Baggaley; Karin Hatzold; Fern Terris-Prestholt; Elizabeth L Corbett Journal: PLoS Med Date: 2021-05-11 Impact factor: 11.069
Authors: Pitchaya P Indravudh; Katherine Fielding; Richard Chilongosi; Rebecca Nzawa; Melissa Neuman; Moses K Kumwenda; Rose Nyirenda; Cheryl C Johnson; Miriam Taegtmeyer; Nicola Desmond; Karin Hatzold; Elizabeth L Corbett Journal: BMJ Glob Health Date: 2021-07