Implementation planning for community-based point-of-care HIV testing for infants: Recommendations from community...

Area of Science:

• Public Health
• Diagnostic Medicine
• Community Health

Background:

• Early infant diagnosis (EID) is crucial for identifying HIV infection in infants under 18 months.
• Current hospital-based EID services miss infants not accessing healthcare facilities.
• Community-based point-of-care (POC) HIV testing offers a potential solution to improve testing reach.

Purpose of the Study:

• To assess the feasibility and acceptability of community-based POC HIV testing for HIV-exposed infants in Kenya.
• To identify potential barriers and facilitators for implementing community-based HIV testing strategies.

Main Methods:

• Semi-structured interviews were conducted with 74 community members, including Community Health Workers/Volunteers (CHW/CHV), Traditional Birth Attendants (TBAs), and community leaders.
• Interviews were held at four study sites in Kenya with parents of HIV-exposed infants.
• Feedback was elicited on the acceptability and feasibility of community-based POC HIV testing.

Main Results:

• Community health resources can be leveraged, but increased demand on CHW/CHV is a potential challenge.
• Barriers like confidentiality concerns, disclosure issues, and HIV stigma can be mitigated.
• Strategies include engaging community leaders and providers, community sensitization, and strategic testing locations/timing.

Conclusions:

• Community members believe community-based POC HIV testing is feasible and acceptable with strategic planning.
• This approach can overcome barriers associated with traditional hospital-based early infant diagnosis (EID).
• Successful implementation requires strong community engagement and addressing potential challenges.