MOAE0103 - Oral Abstract
Integrated community HIV testing campaigns: leveraging HIV infrastructure for non-communicable diseases
Presented by Gabriel Chamie (United States).
G. Chamie1,2, D. Kwarisiima3, T. Clark1,2, J. Kabami2, V. Jain1,2, E. Geng1,2, M. Petersen4, H. Thirumurthy5, M. Kamya6, D.V. Havlir1,2, E. Charlebois2,7, SEARCH Consortium
1University of California, San Francisco, Division of HIV/AIDS, San Francisco General Hospital, San Francisco, United States, 2Makerere University-University of California, San Francisco (MU-UCSF) Research Collaboration, Kampala, Uganda, 3Mulago-Mbarara Teaching Hospitals' Joint AIDS Program (MJAP), Kampala, Uganda, 4School of Public Health, University of California, Berkeley, United States, 5Gillings School of Global Public Health, University of North Carolina, Chapel Hill, United States, 6Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda, 7Center for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco, United States
Background: The high burden of
undiagnosed HIV in sub-Saharan Africa limits treatment and prevention efforts.
Community-based HIV testing campaigns can address this challenge and provide an
untapped opportunity to identify non-communicable diseases (NCDs). We tested
the feasibility and diagnostic yield of integrating NCD and communicable
diseases into a rapid HIV testing and referral campaign for all residents of a
rural Ugandan parish.
Methods: A five-day, multi-disease
campaign, offering diagnostic, preventive, treatment and referral services, was
performed in May 2011. Services included
point-of-care screening for HIV, malaria, TB, hypertension and diabetes.
Finger-prick diagnostics eliminated the need for phlebotomy. HIV-infected
adults met clinic staff and peer counselors on-site; those with CD4≤100/µL
underwent intensive counseling and rapid referral for antiretroviral therapy
(ART). Community participation,
case-finding yield, and linkage to care three months post-campaign were
Results: Of 6,300 residents,
2,323/3,150 (74%) adults and 2,020/3,150 (69%) children participated. An
estimated 95% and 52% of adult female and male residents participated
respectively. Adult HIV prevalence was 7.8%, with 46% of HIV-infected adults
newly diagnosed. Thirty-nine percent of new HIV diagnoses linked to care. In a pilot subgroup with CD4≤100, 83% linked
and started ART within 10 days. Malaria was identified in 10% of children, and
hypertension and diabetes in 28% and 3.5% of adults screened,
respectively. Sixty-five percent of
hypertensives and 23% of diabetics were new diagnoses, of which 43% and 61%
linked to care, respectively. Screening identified suspected TB in 87% of
HIV-infected and 19% of HIV-uninfected adults; 52% percent of HIV-uninfected TB
suspects linked to care.
Conclusions: In an integrated campaign
engaging 74% of adult residents, we identified a high burden of undiagnosed
HIV, hypertension and diabetes. Improving male attendance and optimizing
linkage to care require new approaches.
The campaign demonstrates the feasibility of integrating hypertension,
diabetes and communicable diseases into HIV initiatives.
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