title: Community-Based HIV and Health Testing for High-Risk Adolescents and Youth.
abstract: Adolescents account for 40% of new HIV infections, and HIV testing strategies to increase uptake of testing are needed. A community-based adolescent and youth HIV and health testing campaign was conducted in seven slum neighborhoods of Port-au-Prince, Haiti, from December 2014 to September 2015. Community health workers provided community sensitization and recruited 10- to 24-year-olds to test for HIV, syphilis, gonorrhea/chlamydia, and to screen for tuberculosis (TB) and pregnancy. HIV-infected individuals were escorted to the GHESKIO HIV clinic for same-day enrollment in care. Among 3425 individuals eligible for testing, 3348 (98%) accepted an HIV test. HIV prevalence was 2.65% (n = 89). Median age was 19 [interquartile range (IQR) 17-20]; 73% were female. HIV prevalence was 0.6-7.4% across slum neighborhoods. All HIV-infected individuals enrolled in care the same day as testing; median CD4 was 529 cells/μL [IQR 363-761]. Syphilis prevalence was 2.60% (65/2536) and gonorrhea/chlamydia prevalence was 6.25% (96/1536). Among 168 (5%) individuals who reported TB symptoms, 7.7% (13/168) had microbiologically confirmed disease. One hundred twenty-nine females (5% of all females) were pregnant. This community-based testing campaign identified an adolescent and youth population with an HIV prevalence six times higher than the estimated national adolescent HIV prevalence (0.4%) in Haiti, including perinatally infected adolescents. This type of community-based campaign for HIV testing within a package of services can serve as a model for other resource-poor settings to identify high-risk adolescents and youth, and curb the global HIV epidemic among adolescents.
authors: 1 Department of Medicine, Center for Global Health, Weill Cornell Medical College , New York, New York.
authors: Lindsey K
authors: LK
authors: Reif
authors: 1 Department of Medicine, Center for Global Health, Weill Cornell Medical College , New York, New York.
authors: Vanessa
authors: V
authors: Rivera
authors: 2 GHESKIO Center , Port-au-Prince, Haiti .
authors: Bianca
authors: B
authors: Louis
authors: 2 GHESKIO Center , Port-au-Prince, Haiti .
authors: Rachel
authors: R
authors: Bertrand
authors: 2 GHESKIO Center , Port-au-Prince, Haiti .
authors: Mireille
authors: M
authors: Peck
authors: 2 GHESKIO Center , Port-au-Prince, Haiti .
authors: Benedict
authors: B
authors: Anglade
authors: 1 Department of Medicine, Center for Global Health, Weill Cornell Medical College , New York, New York.
authors: Grace
authors: G
authors: Seo
authors: 3 ICAP, Department of Pediatrics, Mailman School of Public Health, College of Physicians and Surgeons, Columbia University , New York, New York.|4 Department of Epidemiology, Mailman School of Public Health, Columbia University , New York, New York.
authors: Elaine J
authors: EJ
authors: Abrams
authors: 1 Department of Medicine, Center for Global Health, Weill Cornell Medical College , New York, New York.|2 GHESKIO Center , Port-au-Prince, Haiti .
authors: Jean W
authors: JW
authors: Pape
authors: 1 Department of Medicine, Center for Global Health, Weill Cornell Medical College , New York, New York.
authors: Daniel W
authors: DW
authors: Fitzgerald
authors: 1 Department of Medicine, Center for Global Health, Weill Cornell Medical College , New York, New York.|5 Division of General Medicine, Department of Medicine, Weill Cornell Medical College , New York, New York.
authors: Margaret L
authors: ML
authors: McNairy
mesh_terms: D000293:Adolescent; D000328:Adult; D000554:Ambulatory Care Facilities; D003153:Community Health Services; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology; D006205:Haiti / Q000453:epidemiology; D006293:Health Promotion; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000458:organization & administration*; D011204:Poverty Areas; D011247:Pregnancy; D015995:Prevalence; D012306:Risk; D013587:Syphilis / Q000175:diagnosis / Q000453:epidemiology; D014376:Tuberculosis / Q000175:diagnosis; D035862:Vulnerable Populations