Mabuto T, Holzman S, Kubeka G, Hoffmann C J
Aurum Institute, Johannesburg, South Africa.
School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
Public Health Action. 2021 Sep 21;11(3):155-161. doi: 10.5588/pha.21.0016.
Mobile community HIV testing can effectively reach undiagnosed people living with HIV in southern Africa. Variable yield in HIV test positivity has been a challenge with high- and low-yield sites often being closely situated. We sought to test whether easy-to-identify, site-level characteristics were associated with HIV positivity yield in a routine mobile HIV testing program.
We used routine testing program test data augmented with site-level characterization, either of the community or shopping site at which HIV testing was offered. Specifically, we described the local environment and interviewed key informants to gain additional information regarding the availability of HIV and other services in the locale.
We included 122 residential and 26 shopping sites with median HIV-positive test yields of 7.6% and 6.9%, respectively. The range for community sites was from 2 to 55% with high and low yields at geographically proximal sites. Factors related to lower income and marginalization, including informal housing and the absence of name-brand stores in shopping venues, were associated with higher HIV-positive testing yield.
Characterization of sites, particularly identifying factors related to marginalization, lack of services, and poverty, can aid in identifying sites with higher HIV-positive yield.
移动社区艾滋病毒检测能够有效地覆盖南部非洲未被诊断出感染艾滋病毒的人群。艾滋病毒检测阳性率存在差异一直是一个挑战，高产和低产地点往往相距很近。我们试图检验在常规移动艾滋病毒检测项目中，易于识别的地点层面特征是否与艾滋病毒阳性率相关。
我们使用了常规检测项目的测试数据，并增加了地点层面的特征描述，这些特征描述涉及提供艾滋病毒检测的社区或购物场所。具体而言，我们描述了当地环境，并采访了关键信息提供者，以获取有关当地艾滋病毒及其他服务可及性的更多信息。
我们纳入了122个居住地点和26个购物地点，艾滋病毒检测阳性率的中位数分别为7.6%和6.9%。社区地点的阳性率范围为2%至55%，在地理位置相近的地点出现了高产和低产情况。与低收入和边缘化相关的因素，包括非正规住房以及购物场所中没有名牌商店，与较高的艾滋病毒检测阳性率相关。
对地点进行特征描述，特别是识别与边缘化、服务缺乏和贫困相关的因素，有助于识别艾滋病毒阳性率较高的地点。
