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Challenges in measurement of linkage following HIV self‐testing: examples from the STAR Project

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Neuman, Melissa, Taegtmeyer, Miriam ORCID: https://orcid.org/0000-0002-5377-2536, Hatzold, Karin, Johnson, Cheryl C, Weiss, Helen A and Fielding, Katherine (2019) 'Challenges in measurement of linkage following HIV self‐testing: examples from the STAR Project'. Journal of the International AIDS Society, Vol 22, Issue S1, e25238.

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Abstract

Knowledge of HIV status through HIV testing constitutes the
first step towards HIV treatment and prevention services. HIV
self-testing (HIVST), whereby individuals collect their own
specimen, conduct their own test and interpret the results,
allows individuals to learn their HIV status conveniently and
privately, as well as to decide when and where to attend posttest
services. Accurate estimation of the proportion of those
tested who link to additional HIV care, treatment and prevention
services is critical in quantifying the health impact of HIV
testing. As HIVST becomes integrated into testing programmes
worldwide, implementers in diverse settings will
need to measure the effectiveness of their programmes to
ensure self-testers link to onward care and services. This can
be challenging, and community health programmes in many
contexts find it difficult to track referral uptake and equity [1].
We draw upon experience from the Self-Testing in AfRica
(STAR) Initiative in 2015 to 2017 to identify three lessons for
measurement of linkage following HIVST. In STAR, two pragmatic
cluster-randomized trials evaluated the effectiveness of
continuous HIVST distribution over 12 months in increasing
testing coverage and linkage to care in Malawi and Zambia. A
third trial, in Zimbabwe, evaluated the effectiveness of an
incentive to promote linkage following a short, campaign-style
HIVST distribution programme, and included a non-randomized
component assessing the association between HIVST distribution
and antiretroviral therapy (ART) initiations in nearby clinics.
Details are provided elsewhere [2,3]. Each trial incorporated a
household survey and data collection from health facilities to
evaluate changes in HIV testing coverage and linkage to confirmatory
testing, care and prevention (Table 1).

Item Type: Article
Subjects: WA Public Health > WA 30 Socioeconomic factors in public health (General)
WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503 Acquired immunodeficiency syndrome. HIV infections
WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503.1 Diagnosis
Faculty: Department: Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI): https://doi.org/10.1002/jia2.25238
Depositing User: Stacy Murtagh
Date Deposited: 29 Mar 2019 12:02
Last Modified: 29 Mar 2019 12:04
URI: https://archive.lstmed.ac.uk/id/eprint/10531

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