HIV Testing Rates Improve When Conducted by Lay Providers
A greater percentage of those who are at-risk for HIV can be reached when lay providers perform HIV testing, according to a new study from PATH.
The study was conducted in Vietnam, where it is estimated that one-third of people living with HIV are undiagnosed. The results prove that HIV testing by lay providers can be critical to the country reaching the United Nations’ 90-90-90 global HIV targets by 2020.
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To test the effectiveness of lay providers testing for HIV, the researchers piloted 4 such programs, 2 of which were in urban provinces and 2 of which were in rural mountainous provinces. The study was conducted from October 2015 through September 2017 and had the goal of reaching populations that never or infrequently visit facility-based services for HIV testing.
Acceptability of lay provider testing was defined as the proportion of first-time HIV testers utilizing the service, and effectiveness was measured by HIV positivity and antiretroviral therapy (ART) initiation rates.
Among 1230 participants who had been recruited for face-to-face interviews, 74% were part of at-risk populations.
Most participants (67.0%) reported being first-time HIV testers. The majority of participants (85.8%) said they preferred lay provider testing to facility-based testing; those from urban areas and those who had a university or higher education were more likely to prefer lay provider testing.
Lay provider testing also yielded a higher HIV positivity rate than facility-based testing (4.1% vs 1.6%). The rate was particularly higher among first-time testers (6.8%).
There was also a high ART initiation rate (91.0%).
“We believe that one of the key factors to the success of lay provider HIV testing is that it is offered by people from the community who are trusted by HIV-affected populations,” the researcher concluded.
—Colleen Murphy
Reference:
Vu BN, Green KE, Phan HTT, et al. Lay provider HIV testing: a promising strategy to reach the undiagnosed key populations in Vietnam [published online December 31, 2018]. PLoS ONE. https://doi.org/10.1371/journal.pone.0210063.