A Systematic Review of HIV Testing Implementation Strategies in Sub-Saharan African Countries

Abstract

HIV/AIDS remains a looming presence in public health across the world, particularly in Sub-Saharan Africa. The HIV Care Cascade hinges on testing and knowledge of HIV status. Though significant advances have been made in diagnosing people living with HIV (PLHIV), limitations in understanding which strategies are best suited to certain regions or populations have contributed to the uneven distribution in the success of various HIV testing strategies. Here, we present a conceptual framework that outlines effective HIV testing strategies for four target groups. This framework is based on a systematic literature review of articles published from January 1st, 2008, to December 31st, 2019. The effectiveness of HIV testing strategies depends on various factors including the setting, type of test and service providers. Multiple strategies are needed to reach the UNAIDS target of 95% of individuals knowing their HIV status. Expansion of community-based approaches, self-testing and HIV testing services in antenatal care will further improve the state of HIV testing in Sub-Saharan Africa.

“The targets…are driving the agenda and that probably needs to change”: stakeholder perspectives on HIV partner notification in sub-Saharan Africa

“…Similarly, increased HIV testing (and thereby partner notification) may be supported when integrated with HIV self-testing as evidenced by a study in Zambia [ 72 ]. Finally, VAPN service delivery may also be supported through integration with telehealth services including online HIV result delivery or virtual partner notification (e.g., SMS, Email) to support individuals unable or unwilling to engage with healthcare facilities [ 23 , 65 , 73 ].…”

Awareness and knowledge of female genital schistosomiasis in a population with high endemicity: a cross-sectional study in Madagascar

“…Various health strategies have already been conceptualised, implemented and frequently integrated at different levels of care depending on the type of disease and context ( Ancker et al, 2009 ; Markowski et al, 2021 ). For instance, peer leaders in the fight against HIV have been involved in several health programs in highly endemic countries, such as South Africa ( Ayala et al, 2021 ), not only to raise awareness about the disease but also to promote health services, such as prevention and screening in rural communities ( Mannoh et al, 2022 ). Similarly, for FGS, the involvement of community leaders in health communication campaigns could improve health seeking behaviour of the affected populations.…”

Adolescents and young people in sub-Saharan Africa: overcoming challenges and seizing opportunities to achieve HIV epidemic control

“…These include pre-test and post-test counseling; linkage to appropriate HIV prevention, treatment, and care services; other clinical and support services; and coordination with laboratory services to promote quality assurance and the delivery of accurate results ( 10 ). Numerous countries in SSA have adopted innovative and imaginative HTS strategies, such as facility-based and community-based HTS ( 11 ). While voluntary testing and counseling can be provided in communities, in mobile facilities, and outreach facilities, provider-initiated testing and counseling are often facility-based ( 12 ).…”