High Uptake of Home-Based, District-Wide, HIV Counseling and Testing in Uganda
- 1 November 2010
- journal article
- Published by Mary Ann Liebert Inc in AIDS Patient Care and STDs
- Vol. 24 (11), 735-741
- https://doi.org/10.1089/apc.2010.0096
Abstract
More than 80% of the people infected with HIV in low-income countries of sub-Saharan Africa do not know their HIV serostatus. Innovative measures of increasing access to HIV counseling and testing (HCT) are urgently needed so as to improve care and prevention. We implemented a home-based HCT program in Bushenyi District from September 2004 to March 2007, in Uganda where approximately 90% of people aged older than 14 years had never tested for HIV to gauge whether it was acceptable and increased uptake of HCT. Twenty-nine teams comprising a counselor and a laboratory assistant systematically visited homes offering HCT for all people older than 14 years of age and at-risk children (mother deceased or HIV infected) using a rapid HIV testing three-test algorithm. HIV-infected people received cotrimoxazole prophylaxis, were supplied with long-lasting insecticide-treated bed nets and equipment for treatment of drinking water at home, and were referred for assessment for antiretroviral therapy. The program reached 92,984 (63%) of all the homes in the district. Of these, 32,3621 people were eligible for HCT, and 28,2857 (87%) were present at home and were offered pretest counseling. A total of 264,966 (94%) accepted testing and received their results, of whom 11,359 (4.3%) were HIV-infected. Ninety percent of those testing had never tested before. The cost of testing was $7.83 per previously untested client. Ninety-seven percent of HIV-infected people initiated cotrimoxazole prophylaxis, 74% received bed nets, 70% received water treatment equipment, and 11% began antiretroviral therapy. Forty-four percent of people who were in an HIV-discordant relationship were infected. These results demonstrate that home-based HCT was well-accepted, feasible, and effective in identifying HIV-infected individuals who did not know their HIV status in rural Uganda.Keywords
This publication has 30 references indexed in Scilit:
- Undiagnosed HIV Infection and Couple HIV Discordance Among Household Members of HIV-Infected People Receiving Antiretroviral Therapy in UgandaJAIDS Journal of Acquired Immune Deficiency Syndromes, 2006
- Meta-Analysis of High-Risk Sexual Behavior in Persons Aware and Unaware They are Infected With HIV in the United StatesJAIDS Journal of Acquired Immune Deficiency Syndromes, 2005
- Incidence of HIV Infection in Stable Sexual Partnerships: A Retrospective Cohort Study of 1802 Couples in Mwanza Region, TanzaniaJAIDS Journal of Acquired Immune Deficiency Syndromes, 2002
- Lay people's perceptions of sexually transmitted infections in Uganda.International Journal of STD & AIDS, 1999
- Type of Partnership and Heterosexual Spread of HIV Infection in Rural Uganda: Results from Simulation ModellingInternational Journal of STD & AIDS, 1999
- AnnouncementSexually Transmitted Diseases, 1999
- Rates of HIV-1 transmission within marriage in rural Uganda in relation to the HIV sero-status of the partnersAIDS, 1999
- The social dynamics of HIV transmission as reflected through discordant couples in rural UgandaAIDS, 1995
- Confidential HIV testing and condom promotion in Africa. Impact on HIV and gonorrhea ratesJAMA, 1992
- Effect of serotesting with counselling on condom use and seroconversion among HIV discordant couples in Africa.BMJ, 1992