Observational studyThe lancet. HIV2016
A hybrid mobile approach for population-wide HIV testing in rural east Africa: an observational study.
Observational study in The lancet. HIV, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 114 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Sustainable East Africa Research in Community Health
Secondary Distribution of HIV Self-tests: an Innovative Strategy for Promoting Partner Testing and Reducing HIV Risk
Self-Test Strategies and Linkage Incentives to Improve ART and PrEP Uptake in Men
Who cites it
114 citing papers in PubMed, 2 syntheses or guidelines pooled it, 146 citations in OpenAlex.
- A systematic review and meta-analysis of the evidence for community-based HIV testing on men's engagement in the HIV care cascade.International journal of STD & AIDS · 2022Pooled it
- Models of integration of HIV and noncommunicable disease care in sub-Saharan Africa: lessons learned and evidence gaps.AIDS (London, England) · 2018Pooled it
- Trial
- Closing the gap: did delivery approaches complementary to home-based testing reach men with HIV testing services during and after the HPTN 071 (PopART) trial in Zambia?Journal of the International AIDS Society · 2022Trial
- SEARCH Human Immunodeficiency Virus (HIV) Streamlined Treatment Intervention Reduces Mortality at a Population Level in Men With Low CD4 Counts.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Trial
- Financial incentives and deposit contracts to promote HIV retesting in Uganda: A randomized trial.PLoS medicine · 2021Trial
- Trial
- Planning prompts to promote uptake of HIV services among men: a randomised trial in rural Uganda.BMJ global health · 2020Trial
- Far from MCAR: Obtaining Population-level Estimates of HIV Viral Suppression.Epidemiology (Cambridge, Mass.) · 2020Trial
- Population-level viral suppression among pregnant and postpartum women in a universal test and treat trial.AIDS (London, England) · 2020Trial
- A pilot randomized trial of incentive strategies to promote HIV retesting in rural Uganda.PloS one · 2020Trial
- Effect and cost of two successive home visits to increase HIV testing coverage: a prospective study in Lesotho, Southern Africa.BMC public health · 2019Trial
- HIV Testing and Treatment with the Use of a Community Health Approach in Rural Africa.The New England journal of medicine · 2019Trial
- Hypertension control in integrated HIV and chronic disease clinics in Uganda in the SEARCH study.BMC public health · 2019Trial
- Distance to clinic is a barrier to PrEP uptake and visit attendance in a community in rural Uganda.Journal of the International AIDS Society · 2019Trial
- Understanding the Time Needed to Link to Care and Start ART in Seven HPTN 071 (PopART) Study Communities in Zambia and South Africa.AIDS and behavior · 2019Trial
- Trial
- Mobile, Population-wide, Hybrid HIV Testing Strategy Increases Number of Children Tested in Rural Kenya and Uganda.The Pediatric infectious disease journal · 2018Trial
- Early Adopters of Human Immunodeficiency Virus Preexposure Prophylaxis in a Population-based Combination Prevention Study in Rural Kenya and Uganda.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2018Trial
- Costs of streamlined HIV care delivery in rural Ugandan and Kenyan clinics in the SEARCH Studys.AIDS (London, England) · 2018Trial
54 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
Authors and funding
19 authors at 6 institutions in 3 countries.
Funding
Abstract
backgroundDespite large investments in HIV testing, only an estimated 45% of HIV-infected people in sub-Saharan Africa know their HIV status. Optimum methods for maximising population-level testing remain unknown. We sought to show the effectiveness of a hybrid mobile HIV testing approach at achieving population-wide testing coverage.
methodsWe enumerated adult (≥15 years) residents of 32 communities in Uganda (n=20) and Kenya (n=12) using a door-to-door census. Stable residence was defined as living in the community for at least 6 months in the past year. In each community, we did 2 week multiple-disease community health campaigns (CHCs) that included HIV testing, counselling, and referral to care if HIV infected; people who did not participate in the CHCs were approached for home-based testing (HBT) for 1-2 months within the 1-6 months after the CHC. We measured population HIV testing coverage and predictors of testing via HBT rather than CHC and non-testing.
findingsFrom April 2, 2013, to June 8, 2014, 168,772 adult residents were enumerated in the door-to-door census. HIV testing was achieved in 131,307 (89%) of 146,906 adults with stable residence. 13,043 of 136,033 (9·6%, 95% CI 9·4-9·8) adults with and without stable residence had HIV; median CD4 count was 514 cells per μL (IQR 355-703). Among 131,307 adults with stable residence tested, 56,106 (43%) reported no previous testing. Among 13,043 HIV-infected adults, 4932 (38%) were unaware of their status. Among 105,170 CHC attendees with stable residence 104,635 (99%) accepted HIV testing. Of 131,307 adults with stable residence tested, 104,635 (80%; range 60-93% across communities) tested via CHCs. In multivariable analyses of adults with stable residence, predictors of non-testing included being male (risk ratio [RR] 1·52, 95% CI 1·48-1·56), single marital status (1·70, 1·66-1·75), age 30-39 years (1·58, 1·52-1·65 vs 15-19 years), residence in Kenya (1·46, 1·41-1·50), and migration out of the community for at least 1 month in the past year (1·60, 1·53-1·68). Compared with unemployed people, testing for HIV was more common among farmers (RR 0·73, 95% CI 0·67-0·79) and students (0·73, 0·69-0·77); and compared with people with no education, testing was more common in those with primary education (0·84, 0·80-0·89).
interpretationA hybrid, mobile approach of multiple-disease CHCs followed by HBT allowed for flexibility at the community and individual level to help reach testing coverage goals. Men and mobile populations remain challenges for universal testing.
fundingNational Institutes of Health and President's Emergency Plan for AIDS Relief.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.