SynthesisAIDS care2017
Should trained lay providers perform HIV testing? A systematic review to inform World Health Organization guidelines.
Synthesis in AIDS care, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 3 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
28 citing papers in PubMed, 3 syntheses or guidelines pooled it, 44 citations in OpenAlex.
- Pooled it
- Pooled it
- Community health volunteers could help improve access to and use of essential health services by communities in LMICs: an umbrella review.Health policy and planning · 2018Pooled it
- Trial
- Article
- Innovative Diagnostic Approaches and Challenges in the Management of HIV: Bridging Basic Science and Clinical Practice.Life (Basel, Switzerland) · 2025Review
- Measuring the uptake of clinic-based HIV treatment and prevention services following HIV testing and referral at private pharmacies in Kenya.BMC health services research · 2025Article
- Task sharing for point-of-care testing: Review of national health policies and implementation landscape in 19 African countries.PLOS global public health · 2025Article
- Factors associated with accuracy of rapid HIV test performance in the Eastern Cape, South Africa.Southern African journal of HIV medicine · 2025Article
- Article
- Implementing a male-specific ART counselling curriculum: a quality assessment with healthcare workers in Malawi.Journal of the International AIDS Society · 2024Article
- Does a youth intern programme strengthen HIV service delivery in South Africa? An interrupted time-series analysis.Journal of the International AIDS Society · 2023Article
- "They are gaining experience; we are gaining extra hands": a mixed methods study to assess healthcare worker perceptions of a novel strategy to strengthen human resources for HIV in South Africa.BMC health services research · 2023Article
- De-medicalized and decentralized HIV testing: a strategy to test hard-to-reach men who have sex with men in Cameroon.Frontiers in public health · 2023Article
- A community health worker delivered intervention to address hypertension among adults engaged in HIV care in northern Tanzania: Outcomes from a pilot feasibility study.Journal of clinical hypertension (Greenwich, Conn.) · 2022Article
- Don't forget about human factors: Lessons learned from COVID-19 point-of-care testing.Cell reports methods · 2022Review
- Lay testing cadres and point-of-care diagnostic tests for HIV and other diseases: An essential combination in health service delivery.PLoS medicine · 2021Article
- Increasing integrated testing in community settings through interventions for change, including the Spring European Testing Week.BMC infectious diseases · 2021Article
- High prevalence of Cryptococcal antigenemia using a finger-prick lateral flow assay in individuals with advanced HIV disease in Santarém Municipality, Brazilian Amazon Basin.Medical mycology · 2021Article
- Acceptability and feasibility of the CHARISMA counseling intervention to support women's use of pre-exposure prophylaxis: results of a pilot study.BMC women's health · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
Abstract
New strategies for HIV testing services (HTS) are needed to achieve UN 90-90-90 targets, including diagnosis of 90% of people living with HIV. Task-sharing HTS to trained lay providers may alleviate health worker shortages and better reach target groups. We conducted a systematic review of studies evaluating HTS by lay providers using rapid diagnostic tests (RDTs). Peer-reviewed articles were included if they compared HTS using RDTs performed by trained lay providers to HTS by health professionals, or to no intervention. We also reviewed data on end-users' values and preferences around lay providers preforming HTS. Searching was conducted through 10 online databases, reviewing reference lists, and contacting experts. Screening and data abstraction were conducted in duplicate using systematic methods. Of 6113 unique citations identified, 5 studies were included in the effectiveness review and 6 in the values and preferences review. One US-based randomized trial found patients' uptake of HTS doubled with lay providers (57% vs. 27%, percent difference: 30, 95% confidence interval: 27-32, p < 0.001). In Malawi, a pre/post study showed increases in HTS sites and tests after delegation to lay providers. Studies from Cambodia, Malawi, and South Africa comparing testing quality between lay providers and laboratory staff found little discordance and high sensitivity and specificity (≥98%). Values and preferences studies generally found support for lay providers conducting HTS, particularly in non-hypothetical scenarios. Based on evidence supporting using trained lay providers, a WHO expert panel recommended lay providers be allowed to conduct HTS using HIV RDTs. Uptake of this recommendation could expand HIV testing to more people globally.
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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.