Uptake of Community-Based HIV Testing during a Multi-Disease Health Campaign in Rural UgandaReport as inadecuate




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Background

The high burden of undiagnosed HIV in sub-Saharan Africa is a major obstacle for HIV prevention and treatment. Multi-disease, community health campaigns CHCs offering HIV testing are a successful approach to rapidly increase HIV testing rates and identify undiagnosed HIV. However, a greater understanding of population-level uptake is needed to maximize effectiveness of this approach.

Methods

After community sensitization and a census, a five-day campaign was performed in May 2012 in a rural Ugandan community. The census enumerated all residents, capturing demographics, household location, and fingerprint biometrics. The CHC included point-of-care screening for HIV, malaria, TB, hypertension and diabetes. Residents who attended vs. did not attend the CHC were compared to determine predictors of participation.

Results

Over 12 days, 18 census workers enumerated 6,343 residents. 501 additional residents were identified at the campaign, for a total community population of 6,844. 4,323 63% residents and 556 non-residents attended the campaign. HIV tests were performed in 4,795-4,879 98.3% participants; 1,836 38% reported no prior HIV testing. Of 2674 adults tested, 257 10% were HIV-infected; 125-257 49% reported newly diagnosed HIV. In unadjusted analyses, adult resident campaign non-participation was associated with male sex 62% male vs. 67% female participation, p = 0.003, younger median age 27 years in non-participants vs. 32 in participants; p<0.001, and marital status 48% single vs. 71% married-widowed-divorced participation; p<0.001. In multivariate analysis, single adults were significantly less likely to attend the campaign than non-single adults relative risk RR: 0.63 95% CI: 0.53–0.74; p<0.001, and adults at home vs. not home during census activities were significantly more likely to attend the campaign RR: 1.20 95% CI: 1.13–1.28; p<0.001.

Conclusions

CHCs provide a rapid approach to testing a majority of residents for HIV in rural African settings. However, complementary strategies are still needed to engage young, single adults and achieve universal testing.



Author: Gabriel Chamie , Dalsone Kwarisiima, Tamara D. Clark, Jane Kabami, Vivek Jain, Elvin Geng, Laura B. Balzer, Maya L. Petersen, Har

Source: http://plos.srce.hr/



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