Abstract:
BACKGROUND. Testing for HIV in individuals informs them of their HIV status, which in turn enables them to receive prevention, treatment
and care services. HIV services should ideally be accessed before an individual’s immune system is severely damaged, which could also increase
the prevention of new HIV infections. The national HIV testing services (HTS) programmes aim to identify HIV-infected individuals and link
them to prevention, care and treatment services. Community-based (CB) HTS reaches community members who do not have access to such
services at healthcare facilities. The Foundation for Professional Development (FPD) provided CB-HTS in a Mpumalanga district, South Africa,
from 1 October 2016 to 30 September 2017 (Country Operating Plan (COP16)), where 65 691 clients were tested.
OBJECTIVES. To determine which of the FPD CB-HTS modalities used in the Mpumalanga district during COP16 delivered the highest
positivity rate, disaggregated by population segmentation. The accompanying objectives were: to describe the demographic characteristics
of HTS clients in the district and to compare the different positivity rates of FPD CB-HTS modalities in the district.
METHODS. This cross-sectional quantitative study used all the individual, programmatic data collected for all CB-HTS clients in Ehlanzeni
during COP16 as secondary data. Descriptive analysis was employed to describe participants’ characteristics. The χ2 test was used for
comparing variables.
RESULTS. The mean age of clients was 29.3 (95% confidence interval (CI) 29.7 - 29.9) years. Of the clients analysed, 56.4% were females. Of
the clients who were tested for HIV, 14.1% were tested for the first time; 67.7% of those were between 15 and 49 years old. The positivity
rate for each modality was calculated, and it was found that home-based HTS had the best positivity rate (9.1%) in the Mpumalanga district
during COP16.
CONCLUSIONS. This study provides evidence that home-based HTS delivered the best positivity rate in the Mpumalanga district. The results
should be used to replicate the programme in other districts. If similar findings are obtained in other studies, it could inform how future
CB-HTS programmes should be rolled out, which could change future strategic planning and resource allocation for CB-HTS programmes.
