Amsterdam 2015
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| Abstract #2092 - Test & repeat | ||||
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Session: 45.6: Test & repeat (Parallel) on Friday @ 09.00-10.30 in C103 Chaired by Vincent Pelletier, Sarah Skeen Authors: Presenting Author: Dr Alastair van Heerden - Human Sciences Research Council, South Africa |
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| Additional Authors: | ||||
| Aim: Throughout many parts of Africa, evidence suggests that men have fewer opportunities and disproportionately poorer access to HIV prevention, care and treatment services than women. Coupled to the fact that men usually delay seeking help for health conditions, when men do seek help at facilities they find the space to be male-unfriendly with awkward operating hours and long waiting times that do not accommodate work obligations. Although community-based HIV counselling and testing (HCT) approaches are gaining credibility as possible alternatives to facility based testing, men are still under-represented by these approaches. This mixed-methods study had two primary aims. The first was to investigate whether an mHealth approach to locating non-resident men would be an acceptable strategy for finding men missed through home-based HCT (HBCT) and encouraging them to test for HIV. The second aim was to obtain deeper understanding from both men and women regarding the reasons why men test less frequently than women through HBCT. | ||||
| Method / Issue: The 554 households enrolled in an initial HBCT study were randomized and visited in this random order in search of 90 men who did not test in the initial study either due to in-eligibility or through choice. These men were identified by the household head as the majority were not present in the home during the visit. The 90 men were then randomised into three arms where they would either receive a voice, text or instant message encouraging them to test. Additionally, focus groups were conducted with ten men and ten women to better understand the barriers that prevent men from participating in HBCT. | ||||
| Results / Comments: Of the households visited, 157 (66.0%) women and 81 (34.0%) men were found to have tested during the initial HBCT visit. Three times as many men (90) reported to have not tested as women (28) for a total of 118 household members not tested during the initial HBCT visit. Response rates for the three mHealth arms varied from a low of 25% with instant message to 81.8% with voice. Overall, four of the ninety (90) men self-reported testing for HIV. Indirect disclosure of HIV status emerged as a major barrier to men testing at home. | ||||
| Discussion: The results of this study suggest the approach to be both feasible and acceptable. Supplementing HBCT with the collection of contact details for all who are not present for further intervention is a promising avenue in need of additional research. Substantial enquiry is still required to understand how to reduce the loss to follow-up and increase the motivation of this cohort of men and women to access HIV testing and treatment services in order to make the approach more effective and efficient. | ||||
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