Improving access to HIV testing is a key priority in scaling up HIV treatment and prevention services. Home-based voluntary counselling and testing (HBT) as an approach to delivering wide-scale HIV testing is explored here

AM Molesworth

AT Choko

B Wolff

C Michelo

DF Stroup

E Lugada

E Tumwesigye

EJ Mills

EL Corbett

F Nuwaha

F Obare

FG Felley

G Rucker

H Maheswaran

I Ganguli

J Negin

J Wachira

JK Matovu

JM Turan

JN Sekandi

K Kranzer

Kalpana Sabapathy

KL Grabbe

KM De Cock

M Freeman

M May

M Sweat

N Angotti

N Menzies

Nathan Ford

O Shisana

P Braitstein

P Cherutich

P Macpherson

R Hayes

Rafael Van den Bergh

RC Vreeman

Richard Hayes

RM Granich

RP Walensky

S Helleringer

S Kimaiyo

Sarah Fidler

Stephanie L. Sansom

T Welz

V Ochieng-Ooko

W Mutale

W Were

WA Were

English

PubMed

Crossref

PLoS Medicine

Uptake of Home-Based Voluntary HIV Testing in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

Improving access to HIV testing is a key priority in scaling up HIV treatment and prevention services. Home-based voluntary counselling and testing (HBT) as an approach to delivering wide-scale HIV testing is explored here. = 0.33). The proportion of individuals previously tested for HIV among those offered a test ranged from 5% to 66%. Studies in which <30% of individuals had been previously tested, local HIV prevalence was <10%, incentives were provided, or HBT was offered to household members of HIV-positive individuals showed higher uptake of testing. No evidence was reported of negative consequences of HBT.Please see later in the article for the Editors' Summar

Sabapathy Kalpana

Van den Bergh Rafael

Fidler Sarah

Hayes Richard

Ford Nathan

Public Library of Science (PLOS)

Introduction: Improving access to HIV testing is a key priority in scaling up HIV treatment and prevention services. Homebased
voluntary counselling and testing (HBT) as an approach to delivering wide-scale HIV testing is explored here.
Methods and Findings: We conducted a systematic review and random-effects meta-analysis of studies published between
1 January 2000 and 24 September 2012 that reported on uptake of HBT in sub-Saharan Africa, to assess the proportion of
individuals accepting HBT and receiving their test result. Our initial search yielded 1,199 articles; 114 were reviewed as fulltext
articles, and 19 publications involving 21 studies (n = 524,867 individuals offered HBT) were included for final review
and meta-analysis. The studies came from five countries: Uganda, Malawi, Kenya, South Africa, and Zambia. The
proportion of people who accepted HBT (n = 474,377) ranged from 58.1% to 99.8%, with a pooled proportion of 83.3% (95%
CI: 80.4%–86.1%). Heterogeneity was high (t
2 = 0.11). Sixteen studies reported on the number of people who received the
result of HBT (n = 432,835). The proportion of individuals receiving their results out of all those offered testing ranged from
24.9% to 99.7%, with a pooled proportion of 76.7% (95% CI: 73.4%–80.0%) (t2 = 0.12). HIV prevalence ranged from 2.9% to
36.5%. New diagnosis of HIV following HBT ranged from 40% to 79% of those testing positive. Forty-eight percent of the
individuals offered testing were men, and they were just as likely to accept HBT as women (pooled odds ratio = 0.84; 95% CI:
0.56–1.26) (t
2 = 0.33). The proportion of individuals previously tested for HIV among those offered a test ranged from 5% to
66%. Studies in which ,30% of individuals had been previously tested, local HIV prevalence was ,10%, incentives were
provided, or HBT was offered to household members of HIV-positive individuals showed higher uptake of testing. No
evidence was reported of negative consequences of HBT.
Conclusions: HBT could substantially increase awareness of HIV status in previously undiagnosed individuals in sub-Saharan
Africa, with over three-quarters of the studies in this review reporting .70% uptake. It could be a valuable tool for
treatment and prevention efforts

Sabapathy, K

Van den Bergh, R

Fidler, S

Hayes, R

Ford, N

Spiral - Imperial College Digital Repository

Sabapathy, Kalpana

Van den Bergh, Rafael

Fidler, Sarah

Hayes, Richard

Ford, Nathan

MSF Field Research

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What is the impact of home-based HIV counseling and testing on the clinical status of newly enrolled adults in a large HIV care program in Western Kenya?

Uptake of home-based voluntary HIV testing in sub-Saharan Africa: a systematic review and meta-analysis

INTRODUCTION: Improving access to HIV testing is a key priority in scaling up HIV treatment and prevention services. Home-based voluntary counselling and testing (HBT) as an approach to delivering wide-scale HIV testing is explored here. METHODS AND FINDINGS: We conducted a systematic review and random-effects meta-analysis of studies published between 1 January 2000 and 24 September 2012 that reported on uptake of HBT in sub-Saharan Africa, to assess the proportion of individuals accepting HBT and receiving their test result. Our initial search yielded 1,199 articles; 114 were reviewed as full-text articles, and 19 publications involving 21 studies (n = 524,867 individuals offered HBT) were included for final review and meta-analysis. The studies came from five countries: Uganda, Malawi, Kenya, South Africa, and Zambia. The proportion of people who accepted HBT (n = 474,377) ranged from 58.1% to 99.8%, with a pooled proportion of 83.3% (95% CI: 80.4%-86.1%). Heterogeneity was high (τ(2) = 0.11). Sixteen studies reported on the number of people who received the result of HBT (n = 432,835). The proportion of individuals receiving their results out of all those offered testing ranged from 24.9% to 99.7%, with a pooled proportion of 76.7% (95% CI: 73.4%-80.0%) (τ(2) = 0.12). HIV prevalence ranged from 2.9% to 36.5%. New diagnosis of HIV following HBT ranged from 40% to 79% of those testing positive. Forty-eight percent of the individuals offered testing were men, and they were just as likely to accept HBT as women (pooled odds ratio = 0.84; 95% CI: 0.56-1.26) (τ(2) = 0.33). The proportion of individuals previously tested for HIV among those offered a test ranged from 5% to 66%. Studies in which 70% uptake. It could be a valuable tool for treatment and prevention efforts

LSHTM Research Online

Nations Programme on HIV/AIDS (2011) How to get to zero: faster.

Uptake of home-based voluntary HIV testing in sub-Saharan Africa: a systematic review and meta-analysis.

<div><h3>Introduction</h3><p>Improving access to HIV testing is a key priority in scaling up HIV treatment and prevention services. Home-based voluntary counselling and testing (HBT) as an approach to delivering wide-scale HIV testing is explored here.</p> <h3>Methods and Findings</h3><p>We conducted a systematic review and random-effects meta-analysis of studies published between 1 January 2000 and 24 September 2012 that reported on uptake of HBT in sub-Saharan Africa, to assess the proportion of individuals accepting HBT and receiving their test result.</p> <p>Our initial search yielded 1,199 articles; 114 were reviewed as full-text articles, and 19 publications involving 21 studies (<em>n</em> = 524,867 individuals offered HBT) were included for final review and meta-analysis. The studies came from five countries: Uganda, Malawi, Kenya, South Africa, and Zambia.</p> <p>The proportion of people who accepted HBT (<em>n</em> = 474,377) ranged from 58.1% to 99.8%, with a pooled proportion of 83.3% (95% CI: 80.4%–86.1%). Heterogeneity was high (τ<sup>2</sup> = 0.11). Sixteen studies reported on the number of people who received the result of HBT (<em>n</em> = 432,835). The proportion of individuals receiving their results out of all those offered testing ranged from 24.9% to 99.7%, with a pooled proportion of 76.7% (95% CI: 73.4%–80.0%) (τ<sup>2</sup> = 0.12). HIV prevalence ranged from 2.9% to 36.5%. New diagnosis of HIV following HBT ranged from 40% to 79% of those testing positive. Forty-eight percent of the individuals offered testing were men, and they were just as likely to accept HBT as women (pooled odds ratio = 0.84; 95% CI: 0.56–1.26) (τ<sup>2</sup> = 0.33). The proportion of individuals previously tested for HIV among those offered a test ranged from 5% to 66%. Studies in which <30% of individuals had been previously tested, local HIV prevalence was <10%, incentives were provided, or HBT was offered to household members of HIV-positive individuals showed higher uptake of testing. No evidence was reported of negative consequences of HBT.</p> <h3>Conclusions</h3><p>HBT could substantially increase awareness of HIV status in previously undiagnosed individuals in sub-Saharan Africa, with over three-quarters of the studies in this review reporting >70% uptake. It could be a valuable tool for treatment and prevention efforts.</p> <p> <em>Please see later in the article for the Editors' Summary</em></p> </div

Kalpana Sabapathy (113708)

Rafael Van den Bergh (113711)

Sarah Fidler (76851)

Richard Hayes (32740)

Nathan Ford (59436)

The Francis Crick Institute

IntroductionImproving access to HIV testing is a key priority in scaling up HIV treatment and prevention services. Home-based voluntary counselling and testing (HBT) as an approach to delivering wide-scale HIV testing is explored here.Methods and findingsWe conducted a systematic review and random-effects meta-analysis of studies published between 1 January 2000 and 24 September 2012 that reported on uptake of HBT in sub-Saharan Africa, to assess the proportion of individuals accepting HBT and receiving their test result. Our initial search yielded 1,199 articles; 114 were reviewed as full-text articles, and 19 publications involving 21 studies (n = 524,867 individuals offered HBT) were included for final review and meta-analysis. The studies came from five countries: Uganda, Malawi, Kenya, South Africa, and Zambia. The proportion of people who accepted HBT (n = 474,377) ranged from 58.1% to 99.8%, with a pooled proportion of 83.3% (95% CI: 80.4%-86.1%). Heterogeneity was high (τ(2) = 0.11). Sixteen studies reported on the number of people who received the result of HBT (n = 432,835). The proportion of individuals receiving their results out of all those offered testing ranged from 24.9% to 99.7%, with a pooled proportion of 76.7% (95% CI: 73.4%-80.0%) (τ(2) = 0.12). HIV prevalence ranged from 2.9% to 36.5%. New diagnosis of HIV following HBT ranged from 40% to 79% of those testing positive. Forty-eight percent of the individuals offered testing were men, and they were just as likely to accept HBT as women (pooled odds ratio = 0.84; 95% CI: 0.56-1.26) (τ(2) = 0.33). The proportion of individuals previously tested for HIV among those offered a test ranged from 5% to 66%. Studies in which ConclusionsHBT could substantially increase awareness of HIV status in previously undiagnosed individuals in sub-Saharan Africa, with over three-quarters of the studies in this review reporting >70% uptake. It could be a valuable tool for treatment and prevention efforts

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Uptake of home-based voluntary HIV testing in sub-Saharan Africa: a systematic review and meta-analysis

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