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PLoS One. 2014 Jan 2;9(1):e84317. doi: 10.1371/journal.pone.0084317. eCollection 2014.

Uptake of community-based HIV testing during a multi-disease health campaign in rural Uganda.

Author information

1
HIV/AIDS Division, Department of Medicine, San Francisco General Hospital, University of California San Francisco, San Francisco, United States of America ; Makerere University-University of California San Francisco (MU-UCSF) Research Collaboration, Uganda ; The Sustainable East Africa Research in Community Health (SEARCH) Consortium.
2
Makerere University-University of California San Francisco (MU-UCSF) Research Collaboration, Uganda ; The Sustainable East Africa Research in Community Health (SEARCH) Consortium ; Mulago-Mbarara Joint AIDS Program, Kampala and Mbarara, Uganda.
3
Makerere University-University of California San Francisco (MU-UCSF) Research Collaboration, Uganda ; The Sustainable East Africa Research in Community Health (SEARCH) Consortium.
4
The Sustainable East Africa Research in Community Health (SEARCH) Consortium ; School of Public Health, University of California, Berkeley, United States of America.
5
The Sustainable East Africa Research in Community Health (SEARCH) Consortium ; Gillings School of Global Public Health, University of North Carolina at Chapel Hill, United States of America.
6
Makerere University-University of California San Francisco (MU-UCSF) Research Collaboration, Uganda ; The Sustainable East Africa Research in Community Health (SEARCH) Consortium ; Center for AIDS Prevention Studies, Department of Medicine, University of California San Francisco, San Francisco, United States of America.
7
Makerere University-University of California San Francisco (MU-UCSF) Research Collaboration, Uganda ; The Sustainable East Africa Research in Community Health (SEARCH) Consortium ; Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.

Abstract

BACKGROUND:

The high burden of undiagnosed HIV in sub-Saharan Africa is a major obstacle for HIV prevention and treatment. Multi-disease, community health campaigns (CHCs) offering HIV testing are a successful approach to rapidly increase HIV testing rates and identify undiagnosed HIV. However, a greater understanding of population-level uptake is needed to maximize effectiveness of this approach.

METHODS:

After community sensitization and a census, a five-day campaign was performed in May 2012 in a rural Ugandan community. The census enumerated all residents, capturing demographics, household location, and fingerprint biometrics. The CHC included point-of-care screening for HIV, malaria, TB, hypertension and diabetes. Residents who attended vs. did not attend the CHC were compared to determine predictors of participation.

RESULTS:

Over 12 days, 18 census workers enumerated 6,343 residents. 501 additional residents were identified at the campaign, for a total community population of 6,844. 4,323 (63%) residents and 556 non-residents attended the campaign. HIV tests were performed in 4,795/4,879 (98.3%) participants; 1,836 (38%) reported no prior HIV testing. Of 2674 adults tested, 257 (10%) were HIV-infected; 125/257 (49%) reported newly diagnosed HIV. In unadjusted analyses, adult resident campaign non-participation was associated with male sex (62% male vs. 67% female participation, pā€Š=ā€Š0.003), younger median age (27 years in non-participants vs. 32 in participants; p<0.001), and marital status (48% single vs. 71% married/widowed/divorced participation; p<0.001). In multivariate analysis, single adults were significantly less likely to attend the campaign than non-single adults (relative risk [RR]: 0.63 [95% CI: 0.53-0.74]; p<0.001), and adults at home vs. not home during census activities were significantly more likely to attend the campaign (RR: 1.20 [95% CI: 1.13-1.28]; p<0.001).

CONCLUSIONS:

CHCs provide a rapid approach to testing a majority of residents for HIV in rural African settings. However, complementary strategies are still needed to engage young, single adults and achieve universal testing.

PMID:
24392124
PMCID:
PMC3879307
DOI:
10.1371/journal.pone.0084317
[Indexed for MEDLINE]
Free PMC Article

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