title: Expanding HIV testing and counselling into communities: Feasibility, acceptability, and effects of an integrated family planning/HTC service delivery model by Village Health Teams in Uganda.
abstract: Improving HIV testing and counselling (HTC) requires a range of strategies. This article reports on HTC service delivery by Village Health Teams (VHTs) in Uganda in the context of a model integrating this new component into pre-existing family planning services. Eight health centres from matched pairs were randomly allocated to intervention or control. After being trained, 36 VHTs reporting to selected facilities in the intervention group started offering HTC along with family planning, while VHTs in the control group provided family planning only. Proficiency testing was conducted as external quality assurance. A survey of all 36 VHTs and 137 family planning clients in the intervention group and 119 clients in the control group and a review of record data were conducted after 10 months. Survey responses by VHTs and their clients in the intervention group demonstrate knowledge of counselling messages and safe testing. External quality assessment results provide additional evidence of competency. Eighty per cent of the family planning clients surveyed in the intervention group received an HIV test during the intervention; 27% of those were first-time testers. More clients had ever tested for HIV in the intervention group compared with the control; clients also retested more often. Findings indicate that this model is feasible and acceptable for expanding quality HTC into communities. This study was registered with ClinicalTrials.gov, number [NCT02244398].
authors.affiliation: FHI 360, 1825 Connecticut Ave NW, Washington, DC 20009, USA abrunie@fhi360.org.
authors.forename: Aurélie
authors.initials: A
authors.lastname: Brunie
authors.affiliation: Clinton Health Access Initiative, Kampala, Uganda.
authors.forename: Patricia
authors.initials: P
authors.lastname: Wamala-Mucheri
authors.affiliation: FHI 360, Kampala, Uganda.
authors.forename: Angela
authors.initials: A
authors.lastname: Akol
authors.affiliation: FHI 360, Durham, NC, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Mercer
authors.affiliation: FHI 360, Durham, NC, USA.
authors.forename: Mario
authors.initials: M
authors.lastname: Chen
mesh_terms: D000328:Adult; D003150:Community Health Workers; D003376:Counseling; D005193:Family Planning Services / Q000706:statistics & numerical data*; D005240:Feasibility Studies; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D011795:Surveys and Questionnaires; D014454:Uganda
keywords: Community health workers; HIV; HIV testing and counselling; Uganda; family planning