title: Finding HIV in hard to reach populations: mobile HIV testing and geospatial mapping in Umlazi township, Durban, South Africa.
abstract: Mobile, community-based HIV testing may help achieve universal HIV testing in South Africa. We compared the yield, geographic distribution, and demographic characteristics of populations tested by mobile- and clinic-based HIV testing programs deployed by iThembalabantu Clinic in Durban, South Africa. From July to November 2011, 4,701 subjects were tested; HIV prevalence was 35 % among IPHC testers and 10 % among mobile testers (p < 0.001). Mobile testers varied in mean age (22-37 years) and % males (26-67 %). HIV prevalence at mobile sites ranged from 0 to 26 %. Testers traveled further than the clinic closest to their home; mobile testers were more likely to test ≥5 km away from home. Mobile HIV testing can improve testing access and identify testing sites with high HIV prevalence. Individuals often access mobile testing sites farther from home than their nearest clinic. Geospatial techniques can help optimize deployment of mobile units to maximize yield in hard-to-reach populations.
authors: Medical Practice Evaluation Center, Massachusetts General Hospital, 50 Staniford Street, Floor 9, Boston, MA, 02114, USA. ibassett@partners.org.|Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA. ibassett@partners.org.|Harvard Center for AIDS Research, Harvard University, Boston, MA, USA. ibassett@partners.org.|Department of Medicine, Massachusetts General Hospital, Boston, MA, USA. ibassett@partners.org.
authors: Ingrid V
authors: IV
authors: Bassett
authors: Medical Practice Evaluation Center, Massachusetts General Hospital, 50 Staniford Street, Floor 9, Boston, MA, 02114, USA.
authors: Susan
authors: S
authors: Regan
authors: iThembalabantu People's Hope Clinic/AIDS Healthcare Foundation, Durban, South Africa.
authors: Hlengiwe
authors: H
authors: Mbonambi
authors: Harvard Center for Geographic Analysis, Cambridge, MA, USA.
authors: Jeffrey
authors: J
authors: Blossom
authors: Harvard Center for Geographic Analysis, Cambridge, MA, USA.
authors: Stacy
authors: S
authors: Bogan
authors: Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.
authors: Benjamin
authors: B
authors: Bearnot
authors: Medical Practice Evaluation Center, Massachusetts General Hospital, 50 Staniford Street, Floor 9, Boston, MA, 02114, USA.
authors: Marion
authors: M
authors: Robine
authors: Medical Practice Evaluation Center, Massachusetts General Hospital, 50 Staniford Street, Floor 9, Boston, MA, 02114, USA.|Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA.|Harvard Center for AIDS Research, Harvard University, Boston, MA, USA.|Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.|Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA.|Division of Infectious Diseases, Brigham and Women's Hospital, Boston, MA, USA.
authors: Rochelle P
authors: RP
authors: Walensky
authors: iThembalabantu People's Hope Clinic/AIDS Healthcare Foundation, Durban, South Africa.
authors: Bright
authors: B
authors: Mhlongo
authors: Medical Practice Evaluation Center, Massachusetts General Hospital, 50 Staniford Street, Floor 9, Boston, MA, 02114, USA.|Harvard Center for AIDS Research, Harvard University, Boston, MA, USA.|Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.|Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA.
authors: Kenneth A
authors: KA
authors: Freedberg
authors: iThembalabantu People's Hope Clinic/AIDS Healthcare Foundation, Durban, South Africa.
authors: Hilary
authors: H
authors: Thulare
authors: Medical Practice Evaluation Center, Massachusetts General Hospital, 50 Staniford Street, Floor 9, Boston, MA, 02114, USA.|Harvard Center for AIDS Research, Harvard University, Boston, MA, USA.|Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA, USA.|Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA.
authors: Elena
authors: E
authors: Losina
mesh_terms: D000293:Adolescent; D000328:Adult; D000554:Ambulatory Care Facilities / Q000458:organization & administration*; D005191:Family Characteristics; D005260:Female; D005500:Follow-Up Studies; D040362:Geographic Information Systems / Q000706:statistics & numerical data*; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000706:statistics & numerical data*; D008507:Medically Underserved Area; D008875:Middle Aged; D008952:Mobile Health Units; D015397:Program Evaluation; D013019:South Africa / Q000453:epidemiology; D035862:Vulnerable Populations
keywords: Geospatial analysis; HIV mobile testing; South Africa