HIV ascertainment through repeat home-based testing in the context of a Treatment as Prevention trial (ANRS 12249 TasP) in rural South Africa
type: Article
abstract: Background The ANRS 12249 TasP cluster-randomised trial evaluates whether HIV testing of all members of a community, followed by immediate antiretroviral treatment (ART) for infected people, will prevent onward sexual transmission and reduce HIV incidence at population level. Ascertaining the HIV status of a high proportion of the population regularly and repeatedly is key to the success of any universal test and treat strategy, as the first step of the HIV cascade. Methods Between March 2012 and March 2014, we implemented three six-monthly rounds of home-based HIV counselling and testing in ten local communities (clusters). At each home visit, individual questionnaires were administered and a rapid HIV test offered to all trial participants. We report early results on rates of HIV ascertainment, defined as undergoing a rapid HIV test or HIV-positive self-report. Results Of 12,911 eligible individuals (resident in the trial area and ≥16 years), 10,007 were successfully contacted at least once. At first contact, HIV status was ascertained for 7,628 (76.2% [95% CI: 75.4-77.1]) individuals. At second contact, among the 5,885 individuals contacted a second time, HIV status was ascertained for 2,829 (85.0% [95% CI: 83.7-86.2]) of the 3,328 tested negative at first contact and for 543 (45.7% [95% CI: 42.9-48.6]) of the 1,188 who refused a rapid test at first contact. Overall, HIV ascertainment rate was 89.0% (5,239/5,885 [95% CI: 88.2-89.8]) among trial participants contacted twice. Conclusions Repeat home-based HIV testing is acceptable and feasible in this rural area. Socio-demographic characteristics, behaviours, attitudes, household characteristics and experience of HIV infection and ART in the household will be explored for their association with HIV ascertainment uptake. This will inform whether this intervention reaches the individuals at higher risk in a rural South African region.
presented at: HIV Research for Prevention
doi: 10.1089/aid.2014.5650.abstract
citation key: larmarangeHIVAscertainmentRepeat2014a
creator: Person
author list: Person
author list: TasP ANRS 12249 Study Group
creator: TasP ANRS 12249 Study Group
is part of: Proceedings
  publisher: poster P52.05
    type: Organization
    locality name: Cape Town
  date: 2014-30-10

Person
given name: Joseph
surname: Larmarange

Person
given name: Joanna
surname: Orne-Gliemann

Person
given name: Eric
surname: Balestre

Person
given name: Collins
surname: Iwuji

Person
given name: Nonhlanhla
surname: Okesola

Person
given name: Marie-Louise
surname: Newell

Person
given name: François
surname: Dabis

Person
given name: France
surname: Lert

TasP ANRS 12249 Study Group
type: Organization