Table 1.
Studies included in the review
| Author, Year | Country, region | Year of the study | Setting | Context | HTC strategy | Testing method | Eligible age group | Median or mean age | Proportion female | Number offered testing | Number accepted testing | Acceptance rate | Total testing HIV positive | Yielda | Prevalenceb | Quality of evidence | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
|
|
|
|||||||||||||||||||
| Total | Female | Male | Total | Female | Male | |||||||||||||||
| Ferrand et al. (2010) | Zimbabwe, Harare | 2007 to 2008 | Tertiary hospital, urban | Inpatient | PITC | POC testing | 10 to 18 yrs | 13 yrs IQR:11 to 16 | 0.43 | 215 | 197 | 91.6% | – | – | 50 | 23.3% | 25.4% | No significant association between sex and HIV status (p=0.25) | Moderate | |
| Wanyenze et al. (2010) | Uganda, western | 2005 to 2008 | Tertiary hospital, urban | Inpatient | PITC | POC testing | 15 to 17 yrs | – | 0.47 | 148 | 141 | 95.3% | – | – | 10 | 6.8% | 7.1% | – | – | Moderate |
| Abbas et al. (2010) | Sudan, Khartoum | 2007 to 2008 | Tertiary hospital, urban | Inpatient | PITC | POC testing | 1.5 mo to 14 yrs | 5 yrs | 0.42 | 127 | 106 | 83.5% | – | – | 6 | 4.7% | 5.7% | – | – | Low |
| Kankasa et al. (2009) | Zambia, Lusaka | 2006 to 2007 | Tertiary hospital, urban | Inpatient | PITC | POC testing | 6 to 18 yrs | – | – | 1785 | 1060 | 59.4% | – | – | 248 | 13.9% | 23.4% | – | – | Low |
| Ramirez-Avila et al. (2012) | South Africa, Durban (KwaZulu-Natal) | 2008 to 2009 | Secondary hospital, urban | Outpatient | PITC | POC testing | 12 to 17 yrs | – | 0.55 | 956 | 389 | 40.7% | 49.0% | 30.0% p<0.01 | 62 | 6.5% | 15.9% | 16.0% | 16.0% p=0.99 | Moderate |
| Kranzer et al. (2014) | Zimbabwe, Harare | 2013 | PHC | Outpatient | PITC | POC testing | 6 to 15 yrs | 9 yrs IQR: 7 to 11 | 0.47 | 2151 | 1534 | 71.3% | No significant association between sex and acceptance rate | 82 | 3.8% | 5.3% | No significant association between sex and HIV status | Moderate | ||
| Ferrand et al. (2010) | Zimbabwe, Harare | 2009 | PHC and ANC clinics, peri-urban | Outpatient | PITC (n=506), ANC (n=88) | POC testing | 10 to 18 yrs | APC: 14 yrs ANC: 17 yrs | APC: 0.58 ANC: 1.00 | 594 | 573 | 96.5% | – | – | 75 | 12.6% | 13.1% | For APC, no significant association between sex and HIV status (p=0.35) | Moderate | |
| Mongare et al. (2013) | Kenya | 2009 to 2012 | Primary healthcare facilities | Outpatient | Family-centred HTC | POC testing | 0 to 15 yrs | – | – | 22,688 | 7382 | 32.5% | – | – | 839 | 3.7% | 11.4% | – | – | N/A |
| Kulzer et al. (2012) | Kenya | 2007 to 2009 | Primary healthcare facilities | Outpatient | Family-centred HTC | POC testing | 0 to 15 yrs | – | – | 484 | 276 | 57.0% | – | – | 50 | 10.3% | 18.1% | – | – | Low |
| Were et al. (2006) | Uganda, districts of Tororo and Busia | 2003 to 2004 | Community, urban, rural | Home-based | Family-centred HTC | Laboratory testing, results provided at people's homes | 6 to 10 yrs | – | 0.48 | 604 | 602 | 99.6% | 99.0% | 99.0% | 23 | 3.8% | 3.8% | 4.0% | 4.0% | Low |
| Were et al. (2006) | 11 to 17 yrs | – | 0.48 | 737 | 734 | 99.6% | 99.0% | 99.0% | 12 | 1.6% | 1.6% | 2.0% | 2.0% | Low | ||||||
| Lugada et al. (2010) | Uganda, southeastern | 2005 to 2007 | Community, rural, urban | Home-based | Family-centred HTC | POC testing | 6 to 14 yrs | – | 0.53 | 1779 | 1055 | 59.3% | 58.2% | 60.6% | 24 | 1.3% | 2.3% | 2.7% | 1.8% | Moderate |
| Lugada et al. (2010) | Uganda, southeastern | 2005 to 2007 | PHC | Outpatient | Family-centred HTC | POC testing | 6 to 14 yrs | – | 0.53 | 979 | 96 | 9.8% | 8.6% | 11.1% | 9 | 0.9% | 9.4% | 8.9% | 9.8% | Moderate |
| Naik et al. (2012) | South Africa, Sisonke District (KwaZulu-Natal) | 2009 to 2011 | Community, rural | Testing campaign | Home-based HTC | POC testing | 14 to 19 yrs | – | 0.65 | 1011 | 867 | 85.8% | 86.9% | 85.6% | 32 | 3.2% | 3.7% | 5.5% | 0.3% | Moderate |
| Wachira et al. (2014) | Kenya, western | 2009 to 2012 | Community, urban/rural | Testing campaign | Home-based HTC | POC testing | 13 to 18 yrs | 15.3 yrs | 0.50 | 34,607 | 34,410 | 99.4% | No significant association between sex and acceptance rate | 162 | 0.5% | 0.5% | Females had greater odds of testing HIV positive | Low | ||
| Vreeman et al. (2010) | Kenya, western | 2008 | Community, urban | Testing campaign | Home-based HTC | POC testing | 18 mo to 13 yrs | – | 0.48 | 2289 | 1294 | 56.5% | 58.0% | 55.2% | 60 | 2.6% | 4.6% | – | – | Moderate |
| Dalal et al. (2013) | Kenya, Lwak (Nyanza Province), Kibera (Nairobi) | 2008 | Community, urban/rural | Sero-prevalence survey | Home-based HTC | POC testing | <13 yrs | – | 0.49 | 1234 | 1190 | 96.4% | 96.8% | 96.0% | 136 | 11.0% | 11.4% | 12.9% | 10.0% | Moderate |
| 13 to 17 yrs | – | 0.51 | 3731 | 3236 | 86.7% | 86.2% | 87.3% | 113 | 3.0% | 3.5% | 5.1% | 1.82% | Moderate | |||||||
| Angotti et al. (2009) | Malawi, North, Central and South Regions | 2004, 2006 | Community, rural | Sero-prevalence survey | Home-based HTC | Laboratory testing, results provided at people's homes 2004, POC testing 2006 | 15 to 19 yrs | – | 0.49 | 1076 | 1007 | 93.6% | 93.5% | 93.7% | 6 | 0.6% | 0.6% | 1.0% | 0.2% | Moderate |
| Kranzer et al. (2011) | South Africa, Cape Town | 2010 | Community, peri-urban | Sero-prevalence survey | Outreach (Mobile clinic with home-based invitation) | POC testing | 15 to 19 yrs | – | – | 140 | 119 | 85.0% | – | – | 3 | 2.1% | 2.5% | Females had greater odds of testing HIV positive | Moderate | |
| Baisley et al. (2012) | Tanzania, Mwanza Region (Lake zone) | 2007 to 2008 | Community, urban, peri-urban | Sero-prevalence survey | Outreach HTC at central site (opt in) | POC testing | 15 to 19 yrs | – | 0.55 | 1302 | 786 | 60.4% | 61.4% | 59.1% | 7 | 0.5% | 0.9% | 1.4% | 0.3% | Moderate |
| Baisley et al. (2012) | Tanzania, Mwanza Region (Lake zone) | 2007 to 2008 | Community, urban, peri-urban | Sero-prevalence survey | Outreach HTC at central site (opt out) | POC testing | 15 to 19 yrs | – | 0.57 | 1223 | 1103 | 90.2% | 91.1% | 89.0% | 11 | 0.9% | 1.0% | 1.6% | 0.2% | Moderate |
| Isingo et al. (2012) | Tanzania, Kiesa ward (Mwanza Region) | 2003 to 2004 | Community, rural | Sero-prevalence survey | Outreach HTC at a central site | Laboratory testing, return for results in 2003/4 and POC testing in 2006/7 | 15 to 19 yrs | – | 0.50 | 2244 | 223 | 9.9% | 10.8% | 9.1% | 17 | 0.8% | 7.6% | 12.4% | 2.0% | Moderate |
| Chamie et al. (2014) | Uganda | 2012 | Community, rural | Testing campaign | Outreach HTC | POC testing | 10 to 19 yrs | – | – | 1762 | 998 | 56.6% | – | – | 5 | 0.30% | 0.50% | – | – | Low |
| Bandason et al. (2013) | Zimbabwe, Harare | 2010 | Peri-urban | Schools | School-linked HTC | POC testing | 5 to 9 yrs | – | 0.54 | 2273 | 22 | 1.0% | 1.0% | 0.9% | 1 | 0.04% | 4.5% | 7.6% | 0.0% | Low |
| 10 to 11 yrs | – | 0.56 | 1334 | 11 | 0.8% | 0.8% | 0.9% | 1 | 0.1% | 9.0% | 16.6% | 0.0% | Low | |||||||
a
HIV prevalence among all eligible;
b
HIV prevalence among all tested. ANC, antenatal clinic;
APC, acute primary care; HTC, HIV testing and counselling; IQR, interquartile ratio; PITC, provider-initiated testing and counselling; PHC, primary healthcare centre; VCT, voluntary counselling and testing; POC, point of care; N/A, not applicable.