title: Uptake of community-based HIV testing during a multi-disease health campaign in rural Uganda.
abstract: BACKGROUND
  The high burden of undiagnosed HIV in sub-Saharan Africa is a major obstacle for HIV prevention and treatment. Multi-disease, community health campaigns (CHCs) offering HIV testing are a successful approach to rapidly increase HIV testing rates and identify undiagnosed HIV. However, a greater understanding of population-level uptake is needed to maximize effectiveness of this approach.
  
  
  METHODS
  After community sensitization and a census, a five-day campaign was performed in May 2012 in a rural Ugandan community. The census enumerated all residents, capturing demographics, household location, and fingerprint biometrics. The CHC included point-of-care screening for HIV, malaria, TB, hypertension and diabetes. Residents who attended vs. did not attend the CHC were compared to determine predictors of participation.
  
  
  RESULTS
  Over 12 days, 18 census workers enumerated 6,343 residents. 501 additional residents were identified at the campaign, for a total community population of 6,844. 4,323 (63%) residents and 556 non-residents attended the campaign. HIV tests were performed in 4,795/4,879 (98.3%) participants; 1,836 (38%) reported no prior HIV testing. Of 2674 adults tested, 257 (10%) were HIV-infected; 125/257 (49%) reported newly diagnosed HIV. In unadjusted analyses, adult resident campaign non-participation was associated with male sex (62% male vs. 67% female participation, p = 0.003), younger median age (27 years in non-participants vs. 32 in participants; p<0.001), and marital status (48% single vs. 71% married/widowed/divorced participation; p<0.001). In multivariate analysis, single adults were significantly less likely to attend the campaign than non-single adults (relative risk [RR]: 0.63 [95% CI: 0.53-0.74]; p<0.001), and adults at home vs. not home during census activities were significantly more likely to attend the campaign (RR: 1.20 [95% CI: 1.13-1.28]; p<0.001).
  
  
  CONCLUSIONS
  CHCs provide a rapid approach to testing a majority of residents for HIV in rural African settings. However, complementary strategies are still needed to engage young, single adults and achieve universal testing.
authors.affiliation: HIV/AIDS Division, Department of Medicine, San Francisco General Hospital, University of California San Francisco, San Francisco, United States of America ; Makerere University-University of California San Francisco (MU-UCSF) Research Collaboration, Uganda ; The Sustainable East Africa Research in Community Health (SEARCH) Consortium.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Chamie
authors.affiliation: Makerere University-University of California San Francisco (MU-UCSF) Research Collaboration, Uganda ; The Sustainable East Africa Research in Community Health (SEARCH) Consortium ; Mulago-Mbarara Joint AIDS Program, Kampala and Mbarara, Uganda.
authors.forename: Dalsone
authors.initials: D
authors.lastname: Kwarisiima
authors.affiliation: HIV/AIDS Division, Department of Medicine, San Francisco General Hospital, University of California San Francisco, San Francisco, United States of America ; Makerere University-University of California San Francisco (MU-UCSF) Research Collaboration, Uganda ; The Sustainable East Africa Research in Community Health (SEARCH) Consortium.
authors.forename: Tamara D
authors.initials: TD
authors.lastname: Clark
authors.affiliation: Makerere University-University of California San Francisco (MU-UCSF) Research Collaboration, Uganda ; The Sustainable East Africa Research in Community Health (SEARCH) Consortium.
authors.forename: Jane
authors.initials: J
authors.lastname: Kabami
authors.affiliation: HIV/AIDS Division, Department of Medicine, San Francisco General Hospital, University of California San Francisco, San Francisco, United States of America ; Makerere University-University of California San Francisco (MU-UCSF) Research Collaboration, Uganda ; The Sustainable East Africa Research in Community Health (SEARCH) Consortium.
authors.forename: Vivek
authors.initials: V
authors.lastname: Jain
authors.affiliation: HIV/AIDS Division, Department of Medicine, San Francisco General Hospital, University of California San Francisco, San Francisco, United States of America ; Makerere University-University of California San Francisco (MU-UCSF) Research Collaboration, Uganda ; The Sustainable East Africa Research in Community Health (SEARCH) Consortium.
authors.forename: Elvin
authors.initials: E
authors.lastname: Geng
authors.affiliation: The Sustainable East Africa Research in Community Health (SEARCH) Consortium ; School of Public Health, University of California, Berkeley, United States of America.
authors.forename: Laura B
authors.initials: LB
authors.lastname: Balzer
authors.affiliation: The Sustainable East Africa Research in Community Health (SEARCH) Consortium ; School of Public Health, University of California, Berkeley, United States of America.
authors.forename: Maya L
authors.initials: ML
authors.lastname: Petersen
authors.affiliation: The Sustainable East Africa Research in Community Health (SEARCH) Consortium ; Gillings School of Global Public Health, University of North Carolina at Chapel Hill, United States of America.
authors.forename: Harsha
authors.initials: H
authors.lastname: Thirumurthy
authors.affiliation: Makerere University-University of California San Francisco (MU-UCSF) Research Collaboration, Uganda ; The Sustainable East Africa Research in Community Health (SEARCH) Consortium ; Center for AIDS Prevention Studies, Department of Medicine, University of California San Francisco, San Francisco, United States of America.
authors.forename: Edwin D
authors.initials: ED
authors.lastname: Charlebois
authors.affiliation: Makerere University-University of California San Francisco (MU-UCSF) Research Collaboration, Uganda ; The Sustainable East Africa Research in Community Health (SEARCH) Consortium ; Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
authors.forename: Moses R
authors.initials: MR
authors.lastname: Kamya
authors.affiliation: HIV/AIDS Division, Department of Medicine, San Francisco General Hospital, University of California San Francisco, San Francisco, United States of America ; Makerere University-University of California San Francisco (MU-UCSF) Research Collaboration, Uganda ; The Sustainable East Africa Research in Community Health (SEARCH) Consortium.
authors.forename: Diane V
authors.initials: DV
authors.lastname: Havlir
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003153:Community Health Services; D015897:Comorbidity; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology*; D006293:Health Promotion; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D019095:Point-of-Care Systems; D012307:Risk Factors; D019035:Rural Health Services; D014454:Uganda / Q000453:epidemiology; D055815:Young Adult