TY - JOUR
T1 - Effectiveness of provider-initiated versus client-initiated HIV testing by different health facility departments in Northern Tanzania
AU - Abdul, Ramadhani
AU - de Wit, Tobias F. Rinke
AU - Martelli, Giulia
AU - Costigan, Kathleen
AU - Katambi, Patrobas
AU - Mllacha, Peter
AU - Pozniak, Anton
AU - Maokola, Werner
AU - Mfinanga, Sayoki
AU - Hermans, Sabine
N1 - Funding Information: This study was funded by Gilead Sciences (USA) and the Diocese of Shinyanga through the Good Samaritan Foundation (Vatican). Funding Information: The Shinyanga and Simiyu Test and Treat program in Tanzania is supported by Gilead Sciences (USA) and the Diocese of Shinyanga through the Good Samaritan Foundation (Vatican). The implementation of the project is by Doctors with Africa CUAMM and the Diocese of Shinyanga within the framework of the Tanzanian Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC) through the National AIDS Control Program (NACP). The scientific evaluation of the project is under the guidance of Principal Investigator Prof Anton Pozniak and is performed by the Amsterdam Institute for Global Health and Development (AIGHD) in collaboration with CUAMM. This research falls under the overall research project ‘Feasibility of universal access to HIV Test and Treat in Shinyanga and Simiyu regions, Tanzania, ethically cleared by NIMR under NIMR/HQ/R.8a/Vol.IX/2711’. The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of any of the institutions mentioned above. We thank all our institutional collaborators, the study participants, the staff at the project clinical sites and laboratories, and the project support staff for their invaluable support to this program in general and the current manuscript in particular. We acknowledge Miss Shraddha Bajaria for her help in reducing the word count. Funding Information: The Shinyanga and Simiyu Test and Treat program in Tanzania is supported by Gilead Sciences (USA) and the Diocese of Shinyanga through the Good Samaritan Foundation (Vatican). The implementation of the project is by Doctors with Africa CUAMM and the Diocese of Shinyanga within the framework of the Tanzanian Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC) through the National AIDS Control Program (NACP). The scientific evaluation of the project is under the guidance of Principal Investigator Prof Anton Pozniak and is performed by the Amsterdam Institute for Global Health and Development (AIGHD) in collaboration with CUAMM. This research falls under the overall research project ‘Feasibility of universal access to HIV Test and Treat in Shinyanga and Simiyu regions, Tanzania, ethically cleared by NIMR under NIMR/HQ/R.8a/Vol.IX/2711’. The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of any of the institutions mentioned above. We thank all our institutional collaborators, the study participants, the staff at the project clinical sites and laboratories, and the project support staff for their invaluable support to this program in general and the current manuscript in particular. We acknowledge Miss Shraddha Bajaria for her help in reducing the word count. Publisher Copyright: © 2023, The Author(s).
PY - 2023/12
Y1 - 2023/12
N2 - Background: HIV prevalence in Tanzania is still high at 4.7% among adults. Regular HIV testing is consistently advocated in the country to increase the level of awareness of HIV status, thus contributing to national HIV prevention. We report findings from three years of implementation of an HIV Test and Treat project utilizing provider-initiated and client-initiated testing and counselling (PITC and CITC). This study compared the effectiveness of PITC versus CITC in HIV case detection by the different departments of health facilities. Method: This retrospective cross-sectional study used health facility-based HIV testing data collected from adults aged 18 years and above between June 2017 – July 2019 in the Shinyanga region, Tanzania. Chi-square and logistic regression analysis were used to assess determinants of yield (HIV positivity). Results: A total of 24,802 HIV tests were performed of which 15,814 (63.8%) were by PITC and 8,987 (36.2%) by CITC. Overall HIV positivity was 5.7%, higher among CITC at 6.6% than PITC at 5.2%. TB and IPD departments had the highest HIV positivity 11.8% and 7.8% respectively. Factors associated with a positive test were testing at a department in the facility compared to CITC, first-time test, and being or having been married compared to being single. Conclusion: Success in identifying HIV + patients was highest among people visiting the clinic for HIV testing (CITC) and first-time testers. With PITC, HIV + patient detection differed between departments, suggesting divergent risk profiles of respective clients and/or divergent HIV alertness of staff. This underscores the importance of increased targeting for PITC to identify HIV + patients.
AB - Background: HIV prevalence in Tanzania is still high at 4.7% among adults. Regular HIV testing is consistently advocated in the country to increase the level of awareness of HIV status, thus contributing to national HIV prevention. We report findings from three years of implementation of an HIV Test and Treat project utilizing provider-initiated and client-initiated testing and counselling (PITC and CITC). This study compared the effectiveness of PITC versus CITC in HIV case detection by the different departments of health facilities. Method: This retrospective cross-sectional study used health facility-based HIV testing data collected from adults aged 18 years and above between June 2017 – July 2019 in the Shinyanga region, Tanzania. Chi-square and logistic regression analysis were used to assess determinants of yield (HIV positivity). Results: A total of 24,802 HIV tests were performed of which 15,814 (63.8%) were by PITC and 8,987 (36.2%) by CITC. Overall HIV positivity was 5.7%, higher among CITC at 6.6% than PITC at 5.2%. TB and IPD departments had the highest HIV positivity 11.8% and 7.8% respectively. Factors associated with a positive test were testing at a department in the facility compared to CITC, first-time test, and being or having been married compared to being single. Conclusion: Success in identifying HIV + patients was highest among people visiting the clinic for HIV testing (CITC) and first-time testers. With PITC, HIV + patient detection differed between departments, suggesting divergent risk profiles of respective clients and/or divergent HIV alertness of staff. This underscores the importance of increased targeting for PITC to identify HIV + patients.
KW - Client initiated Counselling and Testing(CITC)
KW - HIV testing
KW - Provider initiated testing and counselling(PITC)
KW - Tanzania
UR - http://www.scopus.com/inward/record.url?scp=85164202989&partnerID=8YFLogxK
U2 - https://doi.org/10.1186/s12981-023-00541-z
DO - https://doi.org/10.1186/s12981-023-00541-z
M3 - Article
C2 - 37420276
SN - 1742-6405
VL - 20
JO - AIDS research and therapy
JF - AIDS research and therapy
IS - 1
M1 - 44
ER -