Effect of organizational models of provider-initiated testing and counseling (PITC) in health facilities on adult HIV testing coverage in sub-Saharan Africa
type: Article
item type: journalArticle
is part of: AIDS Care
authors: Person
  surname: Inghels
  given name: Maxime
authors: Person
  surname: Carillon
  given name: Séverine
authors: Person
  surname: Desgrées du Loû
  given name: Annabel
authors: Person
  surname: Larmarange
  given name: Joseph
subject: HIV testing
subject: Provider initiated testing and counseling
subject: Sub-Saharan Africa
subject: organizational models
subject: testing cover
abstract: The purpose of this paper is to identify which Provider-Initiated HIV Testing and Counseling (PITC) organizational models are the most efficient to maximize testing coverage. We conducted a systematic literature review to identify published articles that evaluated routine PITC programs implemented in adult health facilities in Sub-Saharan Africa. We considered only articles measuring PITC offer, PITC acceptability and PITC coverage. Adjusted meta-regression models were performed to measure the association between PITC offer, acceptability and coverage with PITC organizational model. A total of 30 articles were included in the meta-analysis. Overall, 85.4% [95%CI: 77.2–93.5] of patients were offered a test, and 87.1% [82.4–91.7] accepted the test resulting in a PITC coverage of 74.3% [66–82.6]. Four types of PITC organizational models were identified: PITC initiated and performed during the consultation (model A), PITC initiated before consultation (model B), PITC referred on-site (model C) and PITC referred off-site (model D). Compared to model A, model B had a similar coverage (aOR: 1.02 [0.82–1.26]). However, coverage was lower for model C (aOR: 0.81 [0.68–0.97]) and model D (aOR: 0.58 [0.44–0.77]). Initiating the testing process before or during medical consultation is recommended for maximizing testing coverage among patients.
date: 2020-02-01
pages: 163-169
citation key: inghelsEffectOrganizationalModels2020
date submitted: 2020-01-06 10:14:16
PMID: 31163976
archive: Horizon
coverage: fdi:010077484
library catalog: Taylor and Francis+NEJM
rights: All rights reserved

AIDS Care
type: Journal
volume: 32
number: 2
identifier: DOI 10.1080/09540121.2019.1626339
identifier: ISSN 0954-0121