The HPTN071 (PopART) trial is a 3-arm community randomized trial in 12 communities in Zambia and 9 communities in South Africa evaluating the impact of a combination HIV prevention package, including a universal test and treat intervention, on HIV incidence. Arm A of the study provides the “full” combination HIV prevention package including home-based HIV voluntary counselling and testing, promotion of VMMC, and offer of immediate ART for those testing HIV-positive. The intervention in Zambia is offered in 8 of the 12 communities and is delivered in annual rounds by Community HIV Care Providers (CHiPs). We present data from the first annual round across the 4 Arm A communities in Zambia, which have an adult population of about 100,000.
Individuals who are contacted are offered participation in the study intervention, with verbal consent. Uptake of different components of the intervention, including HIV testing, was recorded electronically by the CHiPs during household visits. Data were analysed for the first annual round of the intervention, December 2013 to June 2015.
48,790 households (~100%) were visited by CHiPs during the first round, enumeration of individual household members was completed for 96% (46,899/48,790), and 83% (101,578/121,698) of adults (≥ 18 years) consented to participate. Refusal rate was 6.5% (7958/121,698) and 9% (10,962/121,698) were not contacted. Of those that consented to participate 45% (45,610/101,578) were men and the median age was 29. Prior to the CHiP visit, 47% (48,006/101,578) “knew their HIV status”, using a definition that they either reported they were HIV-positive (n=7,732), or that they had tested for HIV in the previous 12 months and were HIV-negative (n=40,274). Among those who did not self-report they were HIV-positive, 71% (66,829/93,846) accepted the offer of HIV counselling and testing from CHiPs, and 7.6% (5,108/66,829) tested HIV-positive. Among those consenting, 90% of women (50,619/55,968) and 87% (39,551/45,610) of men knew their HIV status by the end of Round 1; 16% (8,701/55,968) of women and 9% of men (4,139/45,610) self-reported or tested HIV-positive.
Through a home-based approach of offering a combination HIV prevention package the percentage of adults who knew their HIV status increased from ~50% to ~90%, among those who were contacted and consented to participate.