Understanding linkage to care with HIV self-test approach in Lusaka, Zambia - A mixed method approach

dc.contributor.authorChipungu, J.
dc.contributor.authorBosomprah, S.
dc.contributor.authorZanolini, A.
dc.contributor.authorThimurthy, H.
dc.contributor.authorChilengi, R.
dc.contributor.authorSharma, A.
dc.contributor.authorHolmes, C.B.
dc.date.accessioned2019-02-06T11:50:44Z
dc.date.available2019-02-06T11:50:44Z
dc.date.issued2017-11
dc.description.abstractIntroduction: HIV self-testing (HIVST) is a novel approach designed to assist in achieving the goal of at least 90% of the population that learn their HIV status. A self-test user with a positive test is required to visit a clinic to link into HIV care, yet little is known about patient preferences for linkage strategies. We examined the intention to link to care amongst potential HIVST users and the suitability of three linkage to care strategies in Lusaka Province, Zambia. Methods: We conducted a representative cross sectional survey of 1,617 individuals aged 16–49 years old in Lusaka Province. Participants were shown a video of the HIVST. Data on intention to link to care and preferred linkage to care strategies—text message, phone call and home visits were collected. Eight focus group discussions were held concurrently with survey respondents to understand their preferences between the three linkage to care strategies. Results: Of 1617 enrolled, 60% were women, 40% were men, with an average age of 27years (IQR = 22, 35). More men than women had at least secondary education (84% vs 77%) and were either employed or self-employed (67% vs. 41%). 85% (95%CI = 83 to 86) of participants said they would link to care within the first week of a positive self-test. Income >2,000 Kwacha (USD 200) per month versus income < 2,000 Kwacha (Adjusted odds ratio (AOR) = 0.59; 95%CI: 0.40 to 0.88; p = 0.009) and never versus prior HIV testers (AOR = 0.54; 95% CI: 0.32 to 0.91; p = 0.020) were associated with reduced odds of intention to link to care. 53% (95%CI = 50 to 55) preferred being prompted to link to care by home visits compared to phone call (30%) or SMS (17%). Conclusion: We found almost nine out of ten potential HIVST users in the general population intend to link to care shortly after a positive test, and preferred home visits or phone calls to facilitate linkage, rather than SMS. Also, higher income earners and those who never tested for HIV were associated with reduced odds of intention to link to care. Policy guidelines and implementation strategies for HIVST should be responsive to patient preferences for linkage to care strategies to achieve the continuum of HIV care. © 2017, Public Library of Science. All rights reserved. This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.en_US
dc.identifier.otherhttps://doi.org/10.1371/journal.pone.0187998
dc.identifier.urihttp://ugspace.ug.edu.gh/handle/123456789/27286
dc.language.isoenen_US
dc.publisherPLoS ONEen_US
dc.subjectHIV self-testen_US
dc.subjectLusakaen_US
dc.subjectZambiaen_US
dc.subjectMixed method approachen_US
dc.titleUnderstanding linkage to care with HIV self-test approach in Lusaka, Zambia - A mixed method approachen_US
dc.typeArticleen_US

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