SidaSubSaharaV1, Istex, Curation, bibRecord, 000C54

Effect of home based HIV counselling and testing intervention in rural South Africa: cluster randomised trial

Identifieur interne : 000C54 ( Istex/Curation ); précédent : 000C53; suivant : 000C55

Effect of home based HIV counselling and testing intervention in rural South Africa: cluster randomised trial

Auteurs : Tanya Doherty [Afrique du Sud] ; Hanani Tabana [Afrique du Sud, Suède] ; Debra Jackson [Afrique du Sud] ; Reshma Naik [États-Unis] ; Wanga Zembe [Afrique du Sud] ; Carl Lombard [Afrique du Sud] ; Sonja Swanevelder [Afrique du Sud] ; Matthew P. Fox [États-Unis] ; Anna Thorson [Suède] ; Anna Mia Ekström [Suède] ; Mickey Chopra [États-Unis]

Source :

BMJ : British Medical Journal [ 0959-8138 ] ; 2013-06-13.

RBID : ISTEX:2753CC27BE14A4658CF984F69DBBEE012D1A456F

Descripteurs français

Wicri :
- topic : Collecte de données, Téléphone mobile, Santé publique, Essai, Zone urbaine.

English descriptors

Abstract

Objective To assess the effect of home based HIV counselling and testing on the prevalence of HIV testing and reported behavioural changes in a rural subdistrict of South Africa. Design Cluster randomised controlled trial. Setting 16 communities (clusters) in uMzimkhulu subdistrict, KwaZulu-Natal province, South Africa. Participants 4154 people aged 14 years or more who participated in a community survey. Intervention Lay counsellors conducted door to door outreach and offered home based HIV counselling and testing to all consenting adults and adolescents aged 14-17 years with guardian consent. Control clusters received standard care, which consisted of HIV counselling and testing services at local clinics. Main outcome measures Primary outcome measure was prevalence of testing for HIV. Other outcomes were HIV awareness, stigma, sexual behaviour, vulnerability to violence, and access to care. Results Overall, 69% of participants in the home based HIV counselling and testing arm versus 47% in the control arm were tested for HIV during the study period (prevalence ratio 1.54, 95% confidence interval 1.32 to 1.81). More couples in the intervention arm had counselling and testing together than in the control arm (2.24, 1.49 to 3.03). The intervention had broader effects beyond HIV testing, with a 55% reduction in multiple partners (0.45, 0.33 to 0.62) and a stronger effect among those who had an HIV test (0.37, 0.24 to 0.58) and a 45% reduction in casual sexual partners (0.55, 0.42 to 0.73). Conclusions Home based HIV counselling and testing increased the prevalence of HIV testing in a rural setting with high levels of stigma. Benefits also included higher uptake of couple counselling and testing and reduced sexual risk behaviour. Trial registration Current Controlled Trials ISRCTN31271935.

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DOI: 10.1136/bmj.f3481

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<term>Baseline differences</term>
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<term>Unaids report</term>
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<term>World health organization</term>
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<term>Confidence interval</term>
<term>Control areas</term>
<term>Control arms</term>
<term>Control clusters</term>
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<term>Multiple partners</term>
<term>National antenatal sentinel</term>
<term>National community health workers</term>
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<term>Past year</term>
<term>Prevalence</term>
<term>Prevalence ratio</term>
<term>Prevalence ratios</term>
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<term>Randomised clusters</term>
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<term>Sexual behaviour</term>
<term>Sexual partner</term>
<term>Sexual risk behaviour</term>
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<front><div type="abstract">Objective To assess the effect of home based HIV counselling and testing on the prevalence of HIV testing and reported behavioural changes in a rural subdistrict of South Africa. Design Cluster randomised controlled trial. Setting 16 communities (clusters) in uMzimkhulu subdistrict, KwaZulu-Natal province, South Africa. Participants 4154 people aged 14 years or more who participated in a community survey. Intervention Lay counsellors conducted door to door outreach and offered home based HIV counselling and testing to all consenting adults and adolescents aged 14-17 years with guardian consent. Control clusters received standard care, which consisted of HIV counselling and testing services at local clinics. Main outcome measures Primary outcome measure was prevalence of testing for HIV. Other outcomes were HIV awareness, stigma, sexual behaviour, vulnerability to violence, and access to care. Results Overall, 69% of participants in the home based HIV counselling and testing arm versus 47% in the control arm were tested for HIV during the study period (prevalence ratio 1.54, 95% confidence interval 1.32 to 1.81). More couples in the intervention arm had counselling and testing together than in the control arm (2.24, 1.49 to 3.03). The intervention had broader effects beyond HIV testing, with a 55% reduction in multiple partners (0.45, 0.33 to 0.62) and a stronger effect among those who had an HIV test (0.37, 0.24 to 0.58) and a 45% reduction in casual sexual partners (0.55, 0.42 to 0.73). Conclusions Home based HIV counselling and testing increased the prevalence of HIV testing in a rural setting with high levels of stigma. Benefits also included higher uptake of couple counselling and testing and reduced sexual risk behaviour. Trial registration Current Controlled Trials ISRCTN31271935.</div>
</front>
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	Le SIDA en Afrique subsaharienne (serveur d'exploration)
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Le SIDA en Afrique subsaharienne (serveur d'exploration)

Effect of home based HIV counselling and testing intervention in rural South Africa: cluster randomised trial

Effect of home based HIV counselling and testing intervention in rural South Africa: cluster randomised trial

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