ArticleJournal of the International AIDS Society2017
Expanding HIV testing and linkage to care in southwestern Uganda with community health extension workers.
Article in Journal of the International AIDS Society, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 6 of them syntheses that pooled it.
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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.
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Who cites it
38 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Strategies for improving linkage to HIV care after hospital discharge among adults living with HIV in low- and middle-income countries: a systematic review.BMC public health · 2025Pooled it
- 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
- A Systematic Review of Linkage-to-Care and Antiretroviral Initiation Implementation Strategies in Low- and Middle-Income Countries Across Sub-Saharan Africa.AIDS and behavior · 2022Pooled it
- The costs of scaling up HIV and syphilis testing in low- and middle-income countries: a systematic review.Health policy and planning · 2021Pooled it
- Interventions to Improve Linkage to HIV Care in the Era of "Treat All" in Sub-Saharan Africa: a Systematic Review.Current HIV/AIDS reports · 2019Pooled it
- A Systematic Review of the Current Status of Safer Conception Strategies for HIV Affected Heterosexual Couples in Sub-Saharan Africa.AIDS and behavior · 2018Pooled it
- How informal healthcare providers improve uptake of HIV testing: qualitative results from a randomized controlled trial.AIDS (London, England) · 2022Trial
- Community-based antiretroviral therapy versus standard clinic-based services for HIV in South Africa and Uganda (DO ART): a randomised trial.The Lancet. Global health · 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
- Are Economic Evaluations of Task Shifting Too Narrow in Focus? A Rapid Review.PharmacoEconomics · 2025Review
- Costs and cost-effectiveness of community health worker programs focussed on HIV, TB and malaria infectious diseases in low- and middle-income countries (2015-2024): A scoping literature review.PLOS global public health · 2025Article
- Facilitators and barriers to community-based HIV testing in Guinea: a CFIR-based implementation analysis.Frontiers in public health · 2025Article
- Article
- Cost-outcome analysis of HIV testing and counseling, linkage, and defaulter tracing services in Bukoba, Tanzania.AIDS care · 2024Article
- Experiences and challenges of using community health worker-led mechanism in supporting HIV disclosure among adults living with HIV in heterosexual relationships in the rural Uganda.AIDS research and therapy · 2023Article
- How pregnant women living with HIV and their male partners manage men's HIV self-testing: qualitative analysis of an HIVST secondary distribution process in Kampala, Uganda.Journal of the International AIDS Society · 2023Article
- A community health worker-led program to improve access to gestational diabetes screening in urban slums of Pune, India: Results from a mixed methods study.PLOS global public health · 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
- Evaluation of Community-Based, Mobile HIV-Care, Peer-Delivered Linkage Case Management in Manzini Region, Eswatini.International journal of environmental research and public health · 2022Article
- Costs and cost-effectiveness of HIV counselling and testing modalities in Southern Mozambique.Cost effectiveness and resource allocation : C/E · 2022Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
introductionAchieving the UNAIDS goals of 90-90-90 will require more than doubling the number of people accessing HIV care in Uganda. Community-based programmes for entry into HIV care are effective strategies to expand access to HIV care, but few programmes have been evaluated with a particular focus on scale-up.
methodsIntegrated Community Based Initiatives, a Uganda-based non-governmental organization, designed and implemented a programme of community-based HIV counselling and testing and facilitated linkage to care utilizing community health extension workers (CHEWs) in rural Sheema District, Uganda. CHEWs performed programme activities during 1 October 2015 through 31 March 2016. Outcomes for this evaluation were (1) the number of people tested for HIV, and (2) the proportion of those testing positive who were seen at an ART clinic within three months of their positive test, and (3) the cost of the programme per person newly diagnosed with HIV. Microcosting methods were used to calculate the programme costs. Program scalability factors were evaluated using a published framework.
resultsSixty-two CHEWs attended a five-day training that introduced the biology of HIV, the conduct of confidential HIV testing, HIV prevention messages, and linkage, referral, and reporting requirements. CHEWs received a $30 monthly stipend and a field testing kit that included a bicycle, field bag, umbrella, gumboots, reporting booklet, pens, and HIV testing materials. Trained CHEWs tested 43,696 persons for HIV infection during the six-month programme period. Nine-hundred seventy-four participants (2.2%) were identified as HIV positive, and 623 participants (64%) were linked to HIV care. An estimated 69% of adult residents received testing as part of this campaign. The programme cost $3.02 per person test, $135.70 per positive person identified, and $212.15 per HIV-positive person linked to care.
conclusionsLay community health extension workers (CHEWs) can be rapidly trained to scale-up home-based HIV testing and counselling (HTC) and linkage to care in a high-quality and low-cost manner to large numbers of people in a rural, high burden setting. A combination HIV testing approach, such as adding partner testing to community-based testing, could increase the proportion of HIV-positive persons identified.
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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.