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COMMUNITY INTERVENTION IMPROVES ADOLESCENT HIV STATUS KNOWLEDGE:HPTN 071 STUDY ZAMBIA
Kwame Shanaube1, Mwate J. Chaila1, David Macleod2, Ab Schaap1, S. Floyd2, Conred Jani1, Graeme Hoddinott3, Richard Hayes2, Sarah Fidler4, H. Ayles5
1Zambart, Lusaka, Zambia,2London Sch of Hygiene and Trop Med, London, UK,3Univ of Stellenbosch, Cape Town, South Africa,4Imperial Coll London, London, UK,5London Sch of Hygiene and Trop Med, Lusaka, Zambia
The PopART for Youth (P-ART-Y) study aims to evaluate the acceptability and uptake of a HIV prevention package, including universal HIV testing and treatment (UTT), among young people. It also assess the need for specific youth targeted interventions in the context of community wide UTT. The study's primary outcome is uptake of HIV counselling and testing (HCT) in the previous 12 months among 15-19 year old adolescents. The study is nested within the HPTN071 (PopART) trial, a 3-arm community randomized study in 21 communities in Zambia and South Africa. Arm A of the study provides the 'full' combination HIV prevention package including home based HCT which is delivered in annual rounds by Community HIV Care Providers (CHiPs) to all household members irrespective of age.
Adolescents contacted in their homes were offered participation in the PopART intervention which included HCT and linkage to prevention and treatment. Uptake of the intervention was recorded electronically by the CHiPs during household visits. We present data on the uptake of HCT in 4 Arm A communities in Zambia among adolescents aged 15-19 years. Data were analysed for the second annual round of the intervention, October 2015 to June 2016.
A total of 13,828 adolescents were enumerated of which 71.9% (n=9,943) agreed to participate in the intervention; 1.6% (n=225) refused and 25.9% (n=3,576) were not found at home (figure 1). More males (2,052/6,267; 32.7%) than females (1,524/7,561; 20.2%) were not found at home. Acceptance of HCT was similar in females, 81.4% (4,643/5,706) and males, 80.4% (3,147/3,915). HIV prevalence as tested by the CHiPs was 1.3% (104/7,790) and varied by sex (Males, 0.6%; Females, 1.9%). Following the CHiPs' visit, using the definition that they either reported they were HIV positive (n=62), or were tested by the CHiPs (n=7,790) or reported to have been tested in the previous 12 months (n=704 among those who declined, and n=1803 among those who accepted, HCT by CHiPs), knowledge of HIV status increased from 26.5% (2569/9,683) to 88.4% (8,556/9,683).
Through a home-based approach of offering a combination HIV prevention package the percentage of adolescents who knew their HIV status increased from ~27% to ~90%, among those who were contacted and consented to participate. Delivering a community level door-to-door combination HIV prevention package is acceptable but complementary strategies tailored to finding more males maybe required.