HIV Self-Testing and ART Initiation at Home: Promising Results from Blantyre Malawi

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Science Speaks is in Atlanta, Georgia this week and will be live-blogging from the 20th CROI — Conference on Retroviruses and Opportunistic Infections from Sunday to Wednesday, covering breaking developments from investigators on cure research, new antiretroviral agents, hepatitis, tuberculosis and treatment as prevention.

ATLANTA, GA — In an area with 18 percent HIV prevalence, an intervention that brought testing and treatment to residents’ homes produced encouraging data, presented Tuesday at a session on engagement in care at the 20th Conference on Retroviruses and Opportunistic Infections in Atlanta.

Peter MacPherson of the Liverpool School of Tropical Medicine presented the data from a cluster-randomized trial that took place between February and November 2012, in Blantyre, Malawi

The trial provided adult residents of 14 neighborhoods with the opportunity to access HIV self-testing provided by community counselors.  Anyone who self-tested and disclosed positive test results to the counselors was provided with confirmatory testing, TB screening, testing to determine their immune cell count and registration for public antiretroviral treatment services if their immune cell counts were under 350.  In half of the neighborhoods, HIV-infected adults who disclosed were offered home clinical assessments and 2 weeks of HIV treatment.

Fifty-eight percent of adults self-tested overall.  A significantly greater proportion of adult residents in the study arm where home assessment and treatment was offered disclosed their positive results and initiated antiretroviral treatment.  The study authors concluded that home-based self-testing can be an important strategy to identify HIV infected persons in poor communities and proactive strategies like access to home-based care and treatment are important to strengthen the linkage between testing and linkage to care.

 

 

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