Biometric linkage to care in Home based oral mucosal HIV Testing and Counselling programme
Biometric linkage to care in Home based oral mucosal HIV Testing and Counselling programme
Project
The Ndlovu Community Health Centre in Elandsdoorn will initiate a Home based HIV Counselling and Testing Programme, that complements the already existing programmes in Limpopo province. After an information campaign households will be visited by local teams of counsellors. Household members will be invited to test themselves by a first rapid oral mucosal test under supervision of a counsellor. HIV+ confirmed clients will be adequately referred and recognised through their biometrics in an Electronic Health Management System at the Ndlovu clinic. Households will be located by GPS-coordinates. Failure to seek care will be flagged and follow up contacts created. The programme aims at testing more local residents, more men, and more HIV-positives in an earlier phase of their infection, connecting early diagnosis to early care seeking behaviour and disease management.
Project details
Objectives
The main objectives for this programme are:
• Community outreach testing on an annual basis, with an adequate referral for those who test HIV+
• Close the gap between community testing, early care seeking and early initiation of treatment through an innovative tracking and tracing system
• To address and include more male and to guarantee that newly detected HIV+ persons are looking for treatment as soon after knowing their status.
Community groups
Testing:
80% of the households in 2 communities Elandsdoorn , and Marapong Elandsdoorn (6560), and Marapong (4530) (Total: 11090) tested annually for three years. 80% van 11090 = 8872 eligible people. 75% response of eligible household members (75% van 8872 = 6654 invited for HCT).
Linkage to care:
In this area expected prevalence is 13,4%: 13,4% van 6654 = 892
More than 66% of newly detected HIV+ (66% van 892 = 588) contacted a health care facility within one month of HIV testing. More than 75% of newly detected HIV+ contacted a health care facility (NCC or other facility in the area (2 other clinics and governmental hospital) within three months of HIV testing. 75% van 892 = 669
Background
South Africa has the biggest and most high profile HIV epidemic in the world. In 2012, an estimated 6.1 million people were living with HIV, with 240,000 South Africans dying from AIDS-related illnesses. Although the country now invests more than $1 billion annually to run its HIV and AIDS programmes, HIV prevalence remains high (17.9 percent age group 15-49 years) among the general population. Moutse in Limpopo province, consists of 21 townships covering 98.000 inhabitants in a rural area with farm workers, miners and a high unemployment rate (approx. 54%). Ndlovu Care Group would like to implement the program in two townships: Elandsdoorn (6560 inhabitants), and Marapong (4530 inhabitants).
A major problem is that patients still come very late for treatment, 73% of new HIV patients in Ndlovu clinic had CD4-count of less than 350 on diagnosis. The results of the community testing and the Provider Initiated HIV Counselling and Testing at the clinic shows the importance of community outreach and early screening and diagnosis with an adequate referral to treatment centres which will be followed up correctly.