Effect of organizational models of provider-initiated testing and counseling (PITC) in health facilities on adult HIV testing coverage in sub-Saharan Africa¹

1 Supplemental data for this article can be accessed https://doi.org/10.1080/09540121.2019.1626339.

ABSTRACT

The purpose of this paper is to identify which Provider-Initiated HIV Testing and Counseling (PITC) organizational models are the most efficient to maximize testing coverage. We conducted a systematic literature review to identify published articles that evaluated routine PITC programs implemented in adult health facilities in Sub-Saharan Africa. We considered only articles measuring PITC offer, PITC acceptability and PITC coverage. Adjusted meta-regression models were performed to measure the association between PITC offer, acceptability and coverage with PITC organizational model. A total of 30 articles were included in the meta-analysis. Overall, 85.4% [95%CI: 77.2–93.5] of patients were offered a test, and 87.1% [82.4–91.7] accepted the test resulting in a PITC coverage of 74.3% [66–82.6]. Four types of PITC organizational models were identified: PITC initiated and performed during the consultation (model A), PITC initiated before consultation (model B), PITC referred on-site (model C) and PITC referred off-site (model D). Compared to model A, model B had a similar coverage (aOR: 1.02 [0.82–1.26]). However, coverage was lower for model C (aOR: 0.81 [0.68–0.97]) and model D (aOR: 0.58 [0.44–0.77]). Initiating the testing process before or during medical consultation is recommended for maximizing testing coverage among patients.

KEYWORDS:

• Provider initiated testing and counseling
• HIV testing
• testing cover
• organizational models
• Sub-Saharan Africa

Acknowledgments

We thank Alvine Gomene for the translation of the manuscript. We also thank SIDACTION for the financial support to Maxime Inghels.

Disclosure statement

We declare no conflict of interest.

ORCID

M. Inghels http://orcid.org/0000-0002-9340-2054

A. Desgrees du Lou http://orcid.org/0000-0002-2223-5316

J. Larmarange http://orcid.org/0000-0001-7097-700X

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Notes

1 Supplemental data for this article can be accessed https://doi.org/10.1080/09540121.2019.1626339.

Additional information

Funding

The research was supported by a scholarship from the SIDACTION association.