Offering option of initial HIV care at home increases use of ART

July 19, 2014

LSTM Researchers found that offering adults in Malawi optional home initiation of care following HIV self-testing resulted in a significant increase in the proportion of adults initiating antiretroviral therapy (ART) compared with standard HIV care.

The results are part of a study that was funded by the Wellcome Trust and published in the July 23/30 issue of JAMA, which is HIV/AIDS themed and released early to coincide with the International AIDS Conference taking place in Melbourne, Australia next week.

In 2012 it was estimated that 35 million people worldwide were living with the (HIV). ART not only substantially reduces the risk of HIV transmission but also greatly reduces illness and death, which raises hopes that a high uptake of annual HIV testing and early initiation of ART could improve HIV prevention as well as care.

HIV self-testing, where an individual performs and interprets their own HIV test in private, is a novel approach that has been high acceptability in Malawi and the United States. HIV self-testing can overcome barriers to conventional facility- and community-based testing that lack privacy and convenience.

Dr Peter MacPherson of LSTM and the Malawi-Liverpool-Wellcome Trust Clinical Research Programme, and colleagues, recruited 16,660 adult residents of Blantyre, Malawi, where nearly one in five adults are infected with HIV. Participants received access to HIV self-testing through community volunteers and were randomised to receive either facility-based HIV care, or optional home initiation of HIV care following reporting of a positive HIV self-test result.

During the six months of availability, 58% of all adult participants took an HIV self-test kit. A significantly greater proportion of adults in the home group initiated ART (181/8,194; 2.2%) compared with the facility group (63/8,466; 0.7%). Participants in the home group (6.0%) were also significantly more likely to report a positive HIV self-test result to counsellors than facility group participants (3.3%).

Dr MacPherson said: "These results are extremely encouraging. Our study found that population-level ART initiations were increased by the availability of home initiation of care. We know that early uptake of ART can help prevent HIV infections, as well as dramatically improve health".

"At a time when universal test and treat approaches to controlling the HIV epidemic are being considered, home initiation of HIV care shows high promise as a simple strategy to improve the uptake of ART when HIV self-testing is carried out at home."

Explore further: ACOG issues guidelines for routine HIV testing for women

Related Stories

ACOG issues guidelines for routine HIV testing for women

April 29, 2014

(HealthDay)—Females aged 13 to 64 years should undergo HIV testing at least once in their lifetime, with annual testing thereafter recommended based on risk factors, according to a Committee Opinion published in the May ...

In Africa, STI testing could boost HIV prevention

May 28, 2014

To maximize HIV prevention efforts in South Africa and perhaps the broader region, public health officials should consider testing for other sexually transmitted infections when they test for HIV, according to a new paper ...

Widespread support for rapid HIV testing in dental surgeries

July 15, 2014

More than 80 per cent of oral health patients are willing to receive rapid HIV-testing in dental settings, which could help reduce the spread of the HIV according to a groundbreaking study revealed today at a Sydney University ...

Recommended for you

Targeting HIV in semen to shut down AIDS

August 18, 2015

There may be two new ways to fight AIDS—using a heat shock protein or a small molecule - to attack fibrils in semen associated with the human immunodeficiency virus (HIV) during the initial phases of infection, according ...

Vitamin D status related to immune response to HIV-1

June 15, 2015

Vitamin D plays an important part in the human immune response and deficiency can leave individuals less able to fight infections like HIV-1. Now an international team of researchers has found that high-dose vitamin D supplementation ...

HVTN 505 vaccine induced antibodies nonspecific for HIV

July 30, 2015

A study by researchers at the National Institute of Allergy and Infectious Diseases and Duke University helps explain why the candidate vaccine used in the HVTN 505 clinical trial was not protective against HIV infection ...

Why HIV's cloak has a long tail

June 2, 2015

Virologists at Emory University School of Medicine, Yerkes National Primate Research Center, and Children's Healthcare of Atlanta have uncovered a critical detail explaining how HIV assembles its infectious yet stealthy clothing.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.