Abstract #386  -  Summary of process of identification of eligible families: Census and Health Screening process and results to find our 400 eligible families
Authors:   Presenting Author:   Mr. Stephen Machokoto - University of Zimbabwe
Additional Authors:  Ms. Rachel Gatsi, Dr. Sally Nyandiya-Bundy, Ms. Norest Beta, Mr. Tinashe Muromo, Dr. Mufuta Tshimanga, Dr. Daniel Montano, Dr. Danuta Kasprzyk,
Aim: Project TALC (Teens and Adults Learning to Communicate), a family intervention, by Rotheram et.al (UCLA) reduces psychosocial consequences of HIV/AIDS, improving coping in US families, with long-term positive effects.
Method / Issue: To adapt Project TALC to Zimbabwe for HIV+ parents, a community-based approach was used with a census to identify families with 12-18 year old children, and adults with HIV via a Health Screening. HIV+ individuals and their children would be accrued into a cohort study to assess the impact of the intervention. After a formative and pilot research phase the intervention trial was launched in 4 urban residential areas.
Results / Comments: All 9,442 housing units (HU) were approached and 8,256 (87%) were enumerated. All household members residing in the HU were listed, with ages, relationship to head of household, employment status, educational level, and school attendance. 14,205 families were enumerated. A mean of 1.7 families resided in each HU, mean family size was 3.8. 4,297 families had a resident parent and biological child age 12-18 years (N=8,509 children). 35% of children age 12-18 do not live with a biologic parent; 11% live with an aunt/uncle, 16% a grandparent or sibling, and 8% an ‘other’ type of household. These children, compared with those living with a biologic parent, are significantly less likely to be in school. Of 4,297 census-eligible families, 3,036 (71%) parents participated in the Health Screening (HS), with 1,823 (60%) agreeing to an HIV test. A 20% HIV prevalence rate was found among tested individuals. 581 parents representing 534 families were identified as HIV+ via self-report of HIV status or a positive lab test during the HS. The HS was viewed positively by community residents but only 60% agreed to HIV testing indicating a reluctance to ‘know your status’. 50% of those agreeing to the HS had previously been tested for HIV and knew their status. Of the 694 persons who self-reported a previous negative HIV test result, 65% (N=447) were retested. Of these, 88% tested HIV-. Of 234 who reported a previous positive HIV test, 15% were retested and all were positive. The HS identified 534 families eligible for the cohort intervention study.
Discussion: Using a community-based door-to-door approach showed individuals were willing to participate in a health screening, including HIV testing. ‘Knowing your status’ is becoming one of the cornerstones of HIV prevention efforts in high impact countries. Community-based testing programs are being implemented in multiple countries. The high numbers of individuals willing to participate in a HS indicates this approach may be worthwhile to consider in Zimbabwe. Testing seems to be linked to service availability, with respondents who refused testing telling our nurses there was no need to ‘know your status’ since they were unsure of service options. Community-based testing programs should ensure linkages to services for HIV+ and HIV- individuals after testing. Next Steps: A Baseline was conducted with 384 families, and all were randomly assigned to intervention or control arms.
Go Back