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Social network-based approaches to HIV testing: a systematic review and meta-analysis
Annabelle Choong1,2, Yi Ming Lyu1,2, Cheryl C Johnson3
1Central Clinical School, Monash University, Melbourne, Victoria, Australia.
Journal of the International AIDS Society
|September 10, 2024
Summary
Social network-based approaches (SNAs) effectively increase HIV testing uptake and the number of first-time testers. These methods are also cost-effective and acceptable, supporting their integration into HIV testing services.
Area of Science:
- Public Health
- Epidemiology
- Social Sciences
Background:
- Social network-based approaches (SNAs) leverage social connections to encourage HIV testing.
- These strategies involve 'test promoters' motivating partners and social networks to undergo testing.
Purpose of the Study:
- To systematically review the effectiveness, acceptability, and cost-effectiveness of SNAs for HIV testing.
- To collate evidence across diverse populations and identify implementation considerations.
Main Methods:
- Systematic review of studies comparing SNAs with non-SNAs, from January 2010 to May 2023.
- Random-effects meta-analysis to combine effect estimates, with certainty assessed using the GRADE approach.
- Inclusion of 47 studies, including cost-effectiveness and qualitative research.
Main Results:
- SNAs likely increase HIV testing uptake (RR 2.04, Low certainty) and the proportion of first-time testers (RR 1.49, Moderate certainty).
- SNAs may increase the proportion of individuals testing positive for HIV (RR 1.84, Low certainty) with no reported adverse events.
- SNAs are generally cost-effective and found to be acceptable across various populations.
Conclusions:
- SNAs demonstrate a positive impact on HIV testing outcomes, including uptake, first-time testing, and diagnosis rates.
- While no single ideal model exists, SNAs can be integrated into existing services with context-specific adaptations.
- Effectiveness may vary based on testing modality, promoter type, recruitment duration, and incentives.
