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Understanding Practical, Robust Implementation and Sustainability of Home-based Comprehensive Sexual Health Care: A

Cornelia Johanna Dorothy Hanneke Goense1,2,3, Thuan-Huong P Doan4, Eneyi E Kpokiri5

  • 1Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, Maastricht, 6200 MD, the Netherlands. c.goense@maastrichtuniversity.nl.

AIDS and Behavior
|July 4, 2024
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Summary

Home-based comprehensive sexual health care (CSH) increases HIV testing uptake among key populations. Offering choices, clear instructions, and tailored dissemination enhances accessibility and willingness to implement CSH.

Keywords:
Comprehensive careHIV testingHome care servicesInterventionKey populationsRealist reviewSTI testingSexual health care

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Area of Science:

  • Public Health
  • Sexual Health
  • Health Services Research

Background:

  • Home-based comprehensive sexual health care (CSH) models are emerging as alternatives to clinic-based services.
  • Understanding the factors influencing the reach, effectiveness, and implementation of these models is crucial for optimizing sexual health outcomes.

Purpose of the Study:

  • To identify elements of home-based CSH that impact key populations under specific circumstances.
  • To systematically assess the reach, effectiveness, adoption, implementation, and maintenance of home-based CSH.

Main Methods:

  • A realist review of peer-reviewed quantitative and qualitative literature (2012-2023) from major databases.
  • Studies focused on home-based CSH including HIV self-sampling/self-testing and additional sexual health services.
  • The PRISM framework was used for systematic assessment.

Main Results:

  • Self-sampling or self-testing for HIV was highly acceptable across key populations.
  • Increased HIV testing was the primary effectiveness outcome.
  • Care providers found home-based CSH acceptable when linkage to care was available.

Conclusions:

  • Home-based CSH can increase sexual health care accessibility and uptake of HIV/STI testing.
  • Tailored dissemination, clear instructions, and client choice enhance successful uptake.
  • Perceived client benefits motivate care providers to implement home-based CSH.