Training lay people to conduct HIV testing can be an effective approach to reach high-risk populations and prevent the spread of the infection throughout the world, a study has found.
Lay providers can serve as a critical addition to efforts to help achieve the United Nations' global HIV targets by 2020 and help to cover the "last mile" of HIV services to at-risk populations.
The study -- published in PLOS ONE -- suggests that community-based HIV testing is an effective approach to reach people at risk of HIV who have never been tested or test infrequently.
Key at-risk populations include people who inject drugs, men who have sex with men, female sex workers, and first-time HIV testers.
A cross-sectional survey of 1,230 individuals tested by lay providers found that 74 per cent of clients belonged to at-risk populations, 67 per cent were first-time HIV testers, and 85 per cent preferred lay provider testing to facility-based testing.
Furthermore, lay provider testing yielded a higher HIV positivity rate compared to facility-based testing and resulted in a high ART initiation rate of 91 per cent.
"Innovation in HIV testing is absolutely critical to meet these ambitious targets, and community-based HIV testing offers a promising solution to connect undiagnosed people with the services they need," said Kimberly Green, HIV & TB Director at PATH, a nonprofit global health organisation based in the US.
Lay providers participating in the study belonged to community-based organisations led by at-risk populations in urban areas and to village health worker networks in rural mountainous areas.
Providers used a single rapid diagnostic test in clients' homes, at the offices of community-based organizations, or at any private place preferred by the client.
This approach helped to overcome barriers that had prevented key populations from seeking facility-based testing services, such as a perceived lack of confidentiality, fear of stigma and discrimination, inconvenient service opening times and distance, and long waiting times for test results.
Clients who had an HIV-reactive test were referred to the nearest health facility for HIV confirmatory testing, and those who received a confirmed HIV-positive result were referred to a public or private clinic for enrollment in ART.
Clients with non-reactive test results received counseling to re-test after three or six months and were referred to a local health facility for HIV prevention services.
The study provides new evidence on the effectiveness of HIV testing administered by non-health care workers representing key populations and frontline village health volunteers.
The results also support findings from community-based HIV testing approaches in other regions, including sub-Saharan Africa, that have demonstrated comparatively high rates of HIV testing uptake, high HIV positivity yields, and high success rates in linking people to care.
(This story has not been edited by Business Standard staff and is auto-generated from a syndicated feed.)