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A systematic review and meta-analysis of the evidence for community-based HIV testing on men’s engagement in the HIV care cascade

OBJECTIVE: Men with HIV are less likely than women to know their status, be on antiretroviral therapy, and be virally suppressed. This review examined men’s community-based HIV testing services (CB-HTS) outcomes. DESIGN: Systematic review and meta-analysis. METHODS: We searched seven databases and c...

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Autores principales: Groves, Allison K, Stankard, Petra, Bowler, Sarah L, Jamil, Muhammad S, Gebrekristos, Luwam T, Smith, Patrick D, Quinn, Caitlin, Ba, Ndoungou Salla, Chidarikire, Thato, Nguyen, Van Thi Thuy, Baggaley, Rachel, Johnson, Cheryl
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9660288/
https://www.ncbi.nlm.nih.gov/pubmed/35786140
http://dx.doi.org/10.1177/09564624221111277
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author Groves, Allison K
Stankard, Petra
Bowler, Sarah L
Jamil, Muhammad S
Gebrekristos, Luwam T
Smith, Patrick D
Quinn, Caitlin
Ba, Ndoungou Salla
Chidarikire, Thato
Nguyen, Van Thi Thuy
Baggaley, Rachel
Johnson, Cheryl
author_facet Groves, Allison K
Stankard, Petra
Bowler, Sarah L
Jamil, Muhammad S
Gebrekristos, Luwam T
Smith, Patrick D
Quinn, Caitlin
Ba, Ndoungou Salla
Chidarikire, Thato
Nguyen, Van Thi Thuy
Baggaley, Rachel
Johnson, Cheryl
author_sort Groves, Allison K
collection PubMed
description OBJECTIVE: Men with HIV are less likely than women to know their status, be on antiretroviral therapy, and be virally suppressed. This review examined men’s community-based HIV testing services (CB-HTS) outcomes. DESIGN: Systematic review and meta-analysis. METHODS: We searched seven databases and conference abstracts through July 2018. We estimated pooled proportions and/or risk ratios (for meta-analyses) for each outcome using random effects models. RESULTS: 188 studies met inclusion criteria. Common testing models included targeted outreach (e.g. mobile testing), home-based testing, and testing at stand-alone community sites. Across 25 studies reporting uptake, 81% (CI: 75–86%) of men offered testing accepted it. Uptake was higher among men reached through CB-HTS than facility-based HTS (RR = 1.39; CI: 1.13–1.71). Over 69% (CI: 64–71%) of those tested through CB-HTS were men, across 184 studies. Across studies reporting new HIV-positivity among men (n = 18), 96% were newly diagnosed (CI: 77–100%). Across studies reporting linkage to HIV care (n = 8), 70% (CI: 36–103%) of men were linked to care. Across 57 studies reporting sex-disaggregated data for CB-HTS conducted among key populations, men’s uptake was high (80%; CI: 70–88%) and nearly all were newly diagnosed and linked to care (95%; CI: 94–100%; and 94%; CI: 88–100%, respectively). CONCLUSION: CB-HTS is an important strategy for reaching undiagnosed men with HIV from the general population and key population groups, particularly using targeted outreach models. When compared to facility-based HIV testing services, men tested through CB-HTS are more likely to uptake testing, and nearly all men who tested positive through CB-HTS were newly diagnosed. Linkage to care may be a challenge following CB-HTS, and greater efforts and research are needed to effectively implement testing strategies that facilitate rapid ART initiation and linkage to prevention services.
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spelling pubmed-96602882022-11-15 A systematic review and meta-analysis of the evidence for community-based HIV testing on men’s engagement in the HIV care cascade Groves, Allison K Stankard, Petra Bowler, Sarah L Jamil, Muhammad S Gebrekristos, Luwam T Smith, Patrick D Quinn, Caitlin Ba, Ndoungou Salla Chidarikire, Thato Nguyen, Van Thi Thuy Baggaley, Rachel Johnson, Cheryl Int J STD AIDS Review Articles OBJECTIVE: Men with HIV are less likely than women to know their status, be on antiretroviral therapy, and be virally suppressed. This review examined men’s community-based HIV testing services (CB-HTS) outcomes. DESIGN: Systematic review and meta-analysis. METHODS: We searched seven databases and conference abstracts through July 2018. We estimated pooled proportions and/or risk ratios (for meta-analyses) for each outcome using random effects models. RESULTS: 188 studies met inclusion criteria. Common testing models included targeted outreach (e.g. mobile testing), home-based testing, and testing at stand-alone community sites. Across 25 studies reporting uptake, 81% (CI: 75–86%) of men offered testing accepted it. Uptake was higher among men reached through CB-HTS than facility-based HTS (RR = 1.39; CI: 1.13–1.71). Over 69% (CI: 64–71%) of those tested through CB-HTS were men, across 184 studies. Across studies reporting new HIV-positivity among men (n = 18), 96% were newly diagnosed (CI: 77–100%). Across studies reporting linkage to HIV care (n = 8), 70% (CI: 36–103%) of men were linked to care. Across 57 studies reporting sex-disaggregated data for CB-HTS conducted among key populations, men’s uptake was high (80%; CI: 70–88%) and nearly all were newly diagnosed and linked to care (95%; CI: 94–100%; and 94%; CI: 88–100%, respectively). CONCLUSION: CB-HTS is an important strategy for reaching undiagnosed men with HIV from the general population and key population groups, particularly using targeted outreach models. When compared to facility-based HIV testing services, men tested through CB-HTS are more likely to uptake testing, and nearly all men who tested positive through CB-HTS were newly diagnosed. Linkage to care may be a challenge following CB-HTS, and greater efforts and research are needed to effectively implement testing strategies that facilitate rapid ART initiation and linkage to prevention services. SAGE Publications 2022-07-03 2022-11 /pmc/articles/PMC9660288/ /pubmed/35786140 http://dx.doi.org/10.1177/09564624221111277 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Review Articles
Groves, Allison K
Stankard, Petra
Bowler, Sarah L
Jamil, Muhammad S
Gebrekristos, Luwam T
Smith, Patrick D
Quinn, Caitlin
Ba, Ndoungou Salla
Chidarikire, Thato
Nguyen, Van Thi Thuy
Baggaley, Rachel
Johnson, Cheryl
A systematic review and meta-analysis of the evidence for community-based HIV testing on men’s engagement in the HIV care cascade
title A systematic review and meta-analysis of the evidence for community-based HIV testing on men’s engagement in the HIV care cascade
title_full A systematic review and meta-analysis of the evidence for community-based HIV testing on men’s engagement in the HIV care cascade
title_fullStr A systematic review and meta-analysis of the evidence for community-based HIV testing on men’s engagement in the HIV care cascade
title_full_unstemmed A systematic review and meta-analysis of the evidence for community-based HIV testing on men’s engagement in the HIV care cascade
title_short A systematic review and meta-analysis of the evidence for community-based HIV testing on men’s engagement in the HIV care cascade
title_sort systematic review and meta-analysis of the evidence for community-based hiv testing on men’s engagement in the hiv care cascade
topic Review Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9660288/
https://www.ncbi.nlm.nih.gov/pubmed/35786140
http://dx.doi.org/10.1177/09564624221111277
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