A systematic review and meta-analysis of the evidence for community-based HIV testing on men's engagement in the HIV care cascade.


Journal article


Allison K. Groves, Petra Stankard, S. Bowler, M. Jamil, L. Gebrekristos, Patrick D. Smith, C. Quinn, Ndoungou Salla Ba, T. Chidarikire, V. Nguyen, R. Baggaley, C. Johnson
International journal of STD & AIDS, 2022

Semantic Scholar DOI PubMed
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APA   Click to copy
Groves, A. K., Stankard, P., Bowler, S., Jamil, M., Gebrekristos, L., Smith, P. D., … Johnson, C. (2022). A systematic review and meta-analysis of the evidence for community-based HIV testing on men's engagement in the HIV care cascade. International Journal of STD &Amp; AIDS.


Chicago/Turabian   Click to copy
Groves, Allison K., Petra Stankard, S. Bowler, M. Jamil, L. Gebrekristos, Patrick D. Smith, C. Quinn, et al. “A Systematic Review and Meta-Analysis of the Evidence for Community-Based HIV Testing on Men's Engagement in the HIV Care Cascade.” International journal of STD & AIDS (2022).


MLA   Click to copy
Groves, Allison K., et al. “A Systematic Review and Meta-Analysis of the Evidence for Community-Based HIV Testing on Men's Engagement in the HIV Care Cascade.” International Journal of STD &Amp; AIDS, 2022.


BibTeX   Click to copy

@article{allison2022a,
  title = {A systematic review and meta-analysis of the evidence for community-based HIV testing on men's engagement in the HIV care cascade.},
  year = {2022},
  journal = {International journal of STD & AIDS},
  author = {Groves, Allison K. and Stankard, Petra and Bowler, S. and Jamil, M. and Gebrekristos, L. and Smith, Patrick D. and Quinn, C. and Ba, Ndoungou Salla and Chidarikire, T. and Nguyen, V. and Baggaley, R. and Johnson, C.}
}

Abstract

OBJECTIVE Men with HIV are less likely than women to know their status, be on antiretroviral therapy, and be virally suppressed. This review examined men's community-based HIV testing services (CB-HTS) outcomes.

DESIGN Systematic review and meta-analysis.

METHODS We searched seven databases and conference abstracts through July 2018. We estimated pooled proportions and/or risk ratios (for meta-analyses) for each outcome using random effects models.

RESULTS 188 studies met inclusion criteria. Common testing models included targeted outreach (e.g. mobile testing), home-based testing, and testing at stand-alone community sites. Across 25 studies reporting uptake, 81% (CI: 75-86%) of men offered testing accepted it. Uptake was higher among men reached through CB-HTS than facility-based HTS (RR = 1.39; CI: 1.13-1.71). Over 69% (CI: 64-71%) of those tested through CB-HTS were men, across 184 studies. Across studies reporting new HIV-positivity among men (n = 18), 96% were newly diagnosed (CI: 77-100%). Across studies reporting linkage to HIV care (n = 8), 70% (CI: 36-103%) of men were linked to care. Across 57 studies reporting sex-disaggregated data for CB-HTS conducted among key populations, men's uptake was high (80%; CI: 70-88%) and nearly all were newly diagnosed and linked to care (95%; CI: 94-100%; and 94%; CI: 88-100%, respectively).

CONCLUSION CB-HTS is an important strategy for reaching undiagnosed men with HIV from the general population and key population groups, particularly using targeted outreach models. When compared to facility-based HIV testing services, men tested through CB-HTS are more likely to uptake testing, and nearly all men who tested positive through CB-HTS were newly diagnosed. Linkage to care may be a challenge following CB-HTS, and greater efforts and research are needed to effectively implement testing strategies that facilitate rapid ART initiation and linkage to prevention services.


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