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Published on: May 2, 2019
Is home-based HIV testing universally acceptable? Findings from a case-control study nested within the HPTN 071
K Sabapathy1, C Mulubwa2, H Mathema3
1London School of Hygiene and Tropical Medicine, London, UK.
Home-based HIV testing and counselling (HB-HTC) acceptance was linked to prior testing, positive views on HIV care, and perceived sexual risk. Factors like convenience and trust in community providers increased uptake, indicating broad acceptability.
Area of Science:
- Public Health
- Epidemiology
- HIV/AIDS Research
Background:
- The HPTN 071 (PopART) trial investigates universal testing and treatment's impact on community HIV incidence in Zambia and South Africa.
- A nested case-control study examined factors influencing acceptance of home-based HIV testing and counselling (HB-HTC) by community HIV-care providers (CHiPs).
Purpose of the Study:
- To identify factors associated with the acceptance or declination of home-based HIV testing and counselling (HB-HTC) services.
- To understand the drivers of HB-HTC uptake within the context of a community-level HIV prevention trial.
Main Methods:
- A case-control study nested within the HPTN 071 (PopART) trial.
- Analysis of 642 participants (313 cases who declined HB-HTC, 329 controls who accepted HB-HTC), selected via random sampling stratified by gender and community.
- Multivariable logistic regression was used to estimate odds ratios for factors associated with declining HB-HTC.
Main Results:
- Acceptance of HB-HTC was associated with not having been previously tested for HIV, perceiving HTC at home as convenient, and knowing others who accepted HB-HTC.
- Positive attitudes towards HIV services/treatment and self-reported high-risk sexual behavior were linked to higher HB-HTC acceptance.
- Men reporting fear of HIV were more likely to decline HB-HTC, while stigmatizing attitudes were not a significant barrier.
Conclusions:
- Acceptance of HB-HTC is associated with specific individual factors including prior testing history, perceived convenience, social influence, and attitudes towards HIV services.
- The study suggests that HB-HTC delivered by CHiPs achieved broad acceptability across diverse demographic and behavioral subgroups.
- Findings support the integration of HB-HTC into community-based HIV prevention strategies.
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