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A Comparison of Home-Based Versus Outreach Event-Based Community HIV Testing in Ugandan Fisherfolk Communities

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Abstract

We compared two community-based HIV testing models among fisherfolk in Lake Victoria, Uganda. From May to July 2015, 1364 fisherfolk residents of one island were offered (and 822 received) home-based testing, and 344 fisherfolk on another island were offered testing during eight community mobilization events (outreach event-based testing). Of 207 home-based testing clients identified as HIV-positive (15% of residents), 82 were newly diagnosed, of whom 31 (38%) linked to care within 3 months. Of 41 who screened positive during event-based testing (12% of those tested), 33 were newly diagnosed, of whom 24 (75%) linked to care within 3 months. Testing costs per capita were similar for home-based ($45.09) and event-based testing ($46.99). Compared to event-based testing, home-based testing uncovered a higher number of new HIV cases but was associated with lower linkage to care. Novel community-based test-and-treat programs are needed to ensure timely linkage to care for newly diagnosed fisherfolk.

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Acknowledgements

We are grateful to Rachel Akoberwa, Isabella Akol, Jak Ategeka, Eva Berinda, Fred Mabonga, David Muwanika, Patricia Pauline Nakagulire, and Umar Ssenoga for conducting interviews; Ruth Kyomuhangi, Abdul Kaweesi Mutagubya, Rashid Muyingo, Olivia Nakaweesa, Cosy Nalubega, and Justine Wateya for conducting HIV testing; and Oscar Kasozi (Mildmay Uganda Data supervisor) and Deogratius Nkugwa (Mildmay Uganda Clinical Officer); and the Village Health Teams on Kavenyanja and Zzinga islands for their contributions to community mobilization and client tracking.

Funding

This study was funded by R21MH098657 and R21MH098657-02S1 from the National Institute of Mental Health (LM Bogart, Principal Investigator).

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Authors and Affiliations

  1. Health Unit, RAND Corporation, 1776 Main Street, P.O. Box 2138, Santa Monica, CA, 90407-2138, USA

    Laura M. Bogart, Glenn J. Wagner, Sebastian Linnemayr & David J. Klein

  2. Division of General Pediatrics, Department of Medicine, Boston Children’s Hospital, Boston, MA, USA

    Laura M. Bogart, Emily Maistrellis, David J. Klein & Riana B. Jumamil

  3. Department of Pediatrics, Harvard Medical School, Boston, MA, USA

    Laura M. Bogart

  4. Mildmay Uganda, Kampala, Uganda

    William Musoke & Barbara Mukasa

  5. Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda

    Rose Naigino & Rhoda K. Wanyenze

  6. Division of General Medicine, Massachusetts General Hospital and Division of Infectious Diseases, Harvard Medical School, Boston, MA, USA

    Ingrid V. Bassett

  7. Baylor College of Medicine and Michael E. DeBakey Department of Veterans Affairs Medical Center, Houstan, TX, USA

    Thomas P. Giordano

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  1. Laura M. Bogart
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  2. Glenn J. Wagner
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  3. William Musoke
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  12. Rhoda K. Wanyenze
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Correspondence to Laura M. Bogart.

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There are no conflicts of interest to disclose.

Ethical Approval

All human subjects procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Bogart, L.M., Wagner, G.J., Musoke, W. et al. A Comparison of Home-Based Versus Outreach Event-Based Community HIV Testing in Ugandan Fisherfolk Communities. AIDS Behav 21, 547–560 (2017). https://doi.org/10.1007/s10461-016-1629-x

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