Increasing Uptake of HIV Testing and Counseling Among the Poorest in Sub-Saharan Countries Through Home-based service provision
Identifieur interne : 000F92 ( Pmc/Curation ); précédent : 000F91; suivant : 000F93Increasing Uptake of HIV Testing and Counseling Among the Poorest in Sub-Saharan Countries Through Home-based service provision
Auteurs : Stéphane HelleringerSource :
- Journal of acquired immune deficiency syndromes (1999) [ 1525-4135 ] ; 2009.
Abstract
Uptake of HIV testing and counseling (HTC) is lower among members of the poorest households in sub-Saharan countries, thereby creating significant inequalities in access to HTC and possibly ARV treatment.
To measure uptake of home-based HTC and estimate HIV prevalence among members of the poorest households in a sub-Saharan population.
Residents of 6 villages of Likoma Island (Malawi) aged 18–35 and their spouses were offered home-based HTC services. Socioeconomic status, HIV testing history and HIV risk factors were assessed. Differences in HTC uptake and HIV infection rates between members of households in the lowest income quartile and the rest of the population were estimated using logistic regression.
Members of households in the lowest income quartile were significantly less likely to have ever used facility-based HTC services than the rest of the population (OR = 0.60, 95% CI: 0.36–0.97). In contrast, they were significantly
HTC uptake was high during a home-based HTC campaign on Likoma Island, particularly among the poorest. Home-based HTC has the potential to significantly reduce existing socioeconomic gradients in HTC uptake, and help mitigate the impact of AIDS on the most vulnerable households.
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DOI: 10.1097/QAI.0b013e31819c1726
PubMed: 19352202
PubMed Central: 3068048
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Increasing Uptake of HIV Testing and Counseling Among the Poorest in Sub-Saharan Countries Through Home-based service provision</title><author><name sortKey="Helleringer, Stephane" sort="Helleringer, Stephane" uniqKey="Helleringer S" first="Stéphane" last="Helleringer">Stéphane Helleringer</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">19352202</idno><idno type="pmc">3068048</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3068048</idno><idno type="RBID">PMC:3068048</idno><idno type="doi">10.1097/QAI.0b013e31819c1726</idno><date when="2009">2009</date><idno type="wicri:Area/Pmc/Corpus">000F93</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000F93</idno><idno type="wicri:Area/Pmc/Curation">000F92</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000F92</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Increasing Uptake of HIV Testing and Counseling Among the Poorest in Sub-Saharan Countries Through Home-based service provision</title><author><name sortKey="Helleringer, Stephane" sort="Helleringer, Stephane" uniqKey="Helleringer S" first="Stéphane" last="Helleringer">Stéphane Helleringer</name></author></analytic><series><title level="j">Journal of acquired immune deficiency syndromes (1999)</title><idno type="ISSN">1525-4135</idno><idno type="eISSN">1944-7884</idno><imprint><date when="2009">2009</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title><p id="P1">Uptake of HIV testing and counseling (HTC) is lower among members of the poorest households in sub-Saharan countries, thereby creating significant inequalities in access to HTC and possibly ARV treatment.</p></sec><sec id="S2"><title>Objectives</title><p id="P2">To measure uptake of home-based HTC and estimate HIV prevalence among members of the poorest households in a sub-Saharan population.</p></sec><sec sec-type="methods" id="S3"><title>Methods</title><p id="P3">Residents of 6 villages of Likoma Island (Malawi) aged 18–35 and their spouses were offered home-based HTC services. Socioeconomic status, HIV testing history and HIV risk factors were assessed. Differences in HTC uptake and HIV infection rates between members of households in the lowest income quartile and the rest of the population were estimated using logistic regression.</p></sec><sec id="S4"><title>Results</title><p id="P4">Members of households in the lowest income quartile were significantly less likely to have ever used facility-based HTC services than the rest of the population (OR = 0.60, 95% CI: 0.36–0.97). In contrast, they were significantly <italic>more likely</italic> to use home-based HTC services provided during the study (aOR = 1.70, 95% CI: 1.04–2.79). Socioeconomic differences in uptake of home-based HTC were not due to underlying differences in socioeconomic characteristics or HIV risk factors. The prevalence of HIV was significantly lower among members of the poorest households tested during home-based HTC than among the rest of the population (aOR=0.37, 95% CI: 0.14–0.96).</p></sec><sec id="S5"><title>Conclusions</title><p id="P5">HTC uptake was high during a home-based HTC campaign on Likoma Island, particularly among the poorest. Home-based HTC has the potential to significantly reduce existing socioeconomic gradients in HTC uptake, and help mitigate the impact of AIDS on the most vulnerable households.</p></sec></div></front></TEI><pmc article-type="research-article" xml:lang="EN"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">100892005</journal-id><journal-id journal-id-type="pubmed-jr-id">21821</journal-id><journal-id journal-id-type="nlm-ta">J Acquir Immune Defic Syndr</journal-id><journal-title>Journal of acquired immune deficiency syndromes (1999)</journal-title><issn pub-type="ppub">1525-4135</issn><issn pub-type="epub">1944-7884</issn></journal-meta><article-meta><article-id pub-id-type="pmid">19352202</article-id><article-id pub-id-type="pmc">3068048</article-id><article-id pub-id-type="doi">10.1097/QAI.0b013e31819c1726</article-id><article-id pub-id-type="manuscript">NIHMS273151</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Increasing Uptake of HIV Testing and Counseling Among the Poorest in Sub-Saharan Countries Through Home-based service provision</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Helleringer</surname><given-names>Stéphane</given-names></name><role>Postdoctoral Researcher</role></contrib><aff id="A1">University of Pennsylvania, Population Studies Center, 3718 Locust Walk, Philadelphia, PA 19104-6299, USA</aff></contrib-group><contrib-group><contrib contrib-type="author"><name><surname>Kohler</surname><given-names>Hans-Peter</given-names></name><role>Professor of Sociology</role></contrib><aff id="A2">University of Pennsylvania, Population Studies Center, 3718 Locust Walk, Philadelphia, PA 19104-6299, USA</aff></contrib-group><contrib-group><contrib contrib-type="author"><name><surname>Frimpong</surname><given-names>Jemima A.</given-names></name><role>doctoral student</role></contrib><aff id="A3">Health Care Management, Wharton Business School, Philadelphia, PA 19104 USA</aff></contrib-group><contrib-group><contrib contrib-type="author"><name><surname>Mkandawire</surname><given-names>James</given-names></name><role>MPH student</role></contrib><aff id="A4">University of Malawi College of Medicine, Blantyre, Malawi</aff></contrib-group><author-notes><corresp id="CR1"><email>hellerin@ssc.upenn.edu</email>, <email>hpkohler@pop.upenn.edu</email>.
</corresp></author-notes><pub-date pub-type="nihms-submitted"><day>22</day><month>3</month><year>2011</year></pub-date><pub-date pub-type="ppub"><day>1</day><month>6</month><year>2009</year></pub-date><pub-date pub-type="pmc-release"><day>30</day><month>3</month><year>2011</year></pub-date><volume>51</volume><issue>2</issue><fpage>185</fpage><lpage>193</lpage><abstract><sec id="S1"><title>Background</title><p id="P1">Uptake of HIV testing and counseling (HTC) is lower among members of the poorest households in sub-Saharan countries, thereby creating significant inequalities in access to HTC and possibly ARV treatment.</p></sec><sec id="S2"><title>Objectives</title><p id="P2">To measure uptake of home-based HTC and estimate HIV prevalence among members of the poorest households in a sub-Saharan population.</p></sec><sec sec-type="methods" id="S3"><title>Methods</title><p id="P3">Residents of 6 villages of Likoma Island (Malawi) aged 18–35 and their spouses were offered home-based HTC services. Socioeconomic status, HIV testing history and HIV risk factors were assessed. Differences in HTC uptake and HIV infection rates between members of households in the lowest income quartile and the rest of the population were estimated using logistic regression.</p></sec><sec id="S4"><title>Results</title><p id="P4">Members of households in the lowest income quartile were significantly less likely to have ever used facility-based HTC services than the rest of the population (OR = 0.60, 95% CI: 0.36–0.97). In contrast, they were significantly <italic>more likely</italic> to use home-based HTC services provided during the study (aOR = 1.70, 95% CI: 1.04–2.79). Socioeconomic differences in uptake of home-based HTC were not due to underlying differences in socioeconomic characteristics or HIV risk factors. The prevalence of HIV was significantly lower among members of the poorest households tested during home-based HTC than among the rest of the population (aOR=0.37, 95% CI: 0.14–0.96).</p></sec><sec id="S5"><title>Conclusions</title><p id="P5">HTC uptake was high during a home-based HTC campaign on Likoma Island, particularly among the poorest. Home-based HTC has the potential to significantly reduce existing socioeconomic gradients in HTC uptake, and help mitigate the impact of AIDS on the most vulnerable households.</p></sec></abstract><kwd-group><kwd>HIV testing and counseling</kwd><kwd>HIV prevention</kwd><kwd>ARV treatment</kwd><kwd>poverty and inequality</kwd><kwd>Malawi</kwd><kwd>sub-Saharan Africa</kwd></kwd-group><contract-num rid="HD1">R01 HD044228-04S1
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