A Case of TASO Tororo Surge Strategy: Using Double Layered Screening to Increase the Rate of Identification of New HIV Positive Clients in the Community

Ronald Opito; Mastula Nanfuka; Levicatus Mugenyi; Michael Bernard Etukoit; Kenneth Mugisha; Lynette Opendi; Betty Nabukonde; David Kagimu; Godfrey Muzaaya; Caroline Karutu

doi:doi:10.11648/j.ijhpebs.20190501.13

A Case of TASO Tororo Surge Strategy: Using Double Layered Screening to Increase the Rate of Identification of New HIV Positive Clients in the Community

Ronald Opito, Mastula Nanfuka, Levicatus Mugenyi, Michael Bernard Etukoit, Kenneth Mugisha, Lynette Opendi, Betty Nabukonde, David Kagimu, Godfrey Muzaaya, Caroline Karutu

Published in International Journal of HIV/AIDS Prevention, Education and Behavioural Science (Volume 5, Issue 1)

Received: 5 January 2019 Accepted: 7 February 2019 Published: 28 February 2019

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Abstract

Introduction: HIV testing services is the entry point to HIV prevention, care, treatment, and support services. According to Uganda Population HIV impact assessment preliminary report released in 2018, 72.5% of people living with HIV in Uganda knew their status, which is below the UNAIDS target of 90%. We proposed a double layered screening of the population using the Ministry of Health HIV Testing Services (HTS) screening tool to identify more HIV positives and start them on treatment. The objective of this study was to assess the impact of the double layered screening approach on HIV test yield. Methods: A double layered screening approach involved using community and technical teams from TASO Tororo HIV clinic through the surge strategy. The community team (first layer) comprised of expert clients, local council 1, market and church leaders who were trained on how to screen the people in the community using the HTS screening tool. The technical team (second layer) comprised of medical personnel and counselors who subjected all people mobilized and screened by the community team to a second layered screening before offering an HIV test. We compared proportions of HIV test yields before and after the implementation of the double layered HTS strategy using proportions test and we assessed the impact of the double layered screening using a difference in difference (DID) evaluation method. Results; There was a general increase in HIV test yield from 4.75% with single screening (period: January-March 2018) to 12.25% with double screening (period: April – June 2018) (P<0.001). The increase was more in males (from 3.51% to 11.06%) than in females (from 6.36% to 13.31%) and this difference was significant (P=0.035). The increase in HIV test yield did not differ by age (P=0.060), by marital status (P=0.606) or by first time tester (P=0.167), Conclusion: The double layered screening before HIV test could be an effective strategy to maximize HIV test yield in the general population, which if scaled up can save huge resources, time and help focus on actual targets for HIV testing services, leading to early attainment of the UNAIDS 1st target of 90-90-90.

Published in	International Journal of HIV/AIDS Prevention, Education and Behavioural Science (Volume 5, Issue 1)
DOI	10.11648/j.ijhpebs.20190501.13
Page(s)	19-25
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

Uganda, Mass Screening, AIDS, Marital Status, Ambulatory Care Facility, Health Personnel

References

[1]	Ministry of Health. Consolidated Guidelines for Prevention and Treatment of HIV in Uganda. 2018.
[2]	UNAIDS. Joint United Nations Programme on HIV/AIDS (UNAIDS). 2017.
[3]	Staveteig S, Croft TN, Kampa KT, Head SK. Reaching the ‘first 90’: Gaps in coverage of HIV testing among people living with HIV in 16 African countries. PLoS One. 2017; 12 (10):1–16.
[4]	UPHIA. Uganda Population-based HIV Impact Assessment: UPHIA 2016-2017 Extended Summary Sheet: Preliminary Findings. 2018; (April):1–6.
[5]	Uganda Ministry of Health. Implementation Guide for Differentiated Service Delivery Models of HIV Services in Uganda. 2017.
[6]	Uganda Ministry of Health. National HIV Testing Service Policy and Implementation Guidelines. 4th ed. 2016.
[7]	UBOS. The National Population and Housing Census 2014 – Main Report, Kampala, Uganda. 2016.
[8]	Legisso TZ, Erango MA. The Effect of HIV Related Risk Factors on HIV Status : A Case of Gamo-Gofa Free Standing Voluntary Counseling and Testing Center. 2018; 6 (4):130–4.
[9]	Kimani J, Ettarh R, Ziraba A YN. Marital status and Risk of HIV Infection in Informaal Urban Settings of Nairobi, Kenya: Results from a Cross-sectionaal Survey. J Epidemiol Community Heal August 2011. 2011; 65:340–1.
[10]	Adeniyi F, Babatunde S, Idemudia E. Marital status and HIV prevalence among women in Nigeria : Ingredients for evidence-based programming. Int J Infect Dis [Internet]. 2016; 48:57–63. Available from: http://dx.doi.org/10.1016/j.ijid.2016.05.002.
[11]	Adebayo SB, Olukolade RI, Idogho O, Anyanti J. Marital Status and HIV Prevalence in Nigeria : Implications for Effective Prevention Programmes for Women. Adv Infect Dis. 2013; (September).
[12]	Matovu JKB, Bukuluki PW, Mafigiri DK, Mudondo H. HIV counseling and testing practices among clients presenting at a market HIV clinic in Kampala, Uganda: A cross-sectional study. Afr Health Sci. 2017; 17 (3):729–37.
[13]	Regan S, Losina E, Chetty S, Giddy J, Walensky RP. Factors Associated with Self-Reported Repeat HIV Testing after a Negative Result in Durban, South Africa. 2013; 8 (4):1–7.
[14]	Kavic M, Blaz TN. Repeat HIV Testing at Voluntary Testing and Counseling Centers in Croatia : Successful HIV Prevention or Failure to Modify Risk Behaviors ? 2014; 9 (4):1–8.
[15]	Sharma M, Barnabas R V, Celum C. Community-based strategies to strengthen men’s engagement in the HIV care cascade in sub-Saharan Africa. 2017; 1–13.

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Ronald Opito, Mastula Nanfuka, Levicatus Mugenyi, Michael Bernard Etukoit, Kenneth Mugisha, et al. (2019). A Case of TASO Tororo Surge Strategy: Using Double Layered Screening to Increase the Rate of Identification of New HIV Positive Clients in the Community. International Journal of HIV/AIDS Prevention, Education and Behavioural Science, 5(1), 19-25. https://doi.org/10.11648/j.ijhpebs.20190501.13

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ACS Style

Ronald Opito; Mastula Nanfuka; Levicatus Mugenyi; Michael Bernard Etukoit; Kenneth Mugisha, et al. A Case of TASO Tororo Surge Strategy: Using Double Layered Screening to Increase the Rate of Identification of New HIV Positive Clients in the Community. Int. J. HIV/AIDS Prev. Educ. Behav. Sci. 2019, 5(1), 19-25. doi: 10.11648/j.ijhpebs.20190501.13

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AMA Style

Ronald Opito, Mastula Nanfuka, Levicatus Mugenyi, Michael Bernard Etukoit, Kenneth Mugisha, et al. A Case of TASO Tororo Surge Strategy: Using Double Layered Screening to Increase the Rate of Identification of New HIV Positive Clients in the Community. Int J HIV/AIDS Prev Educ Behav Sci. 2019;5(1):19-25. doi: 10.11648/j.ijhpebs.20190501.13

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@article{10.11648/j.ijhpebs.20190501.13,
  author = {Ronald Opito and Mastula Nanfuka and Levicatus Mugenyi and Michael Bernard Etukoit and Kenneth Mugisha and Lynette Opendi and Betty Nabukonde and David Kagimu and Godfrey Muzaaya and Caroline Karutu},
  title = {A Case of TASO Tororo Surge Strategy: Using Double Layered Screening to Increase the Rate of Identification of New HIV Positive Clients in the Community},
  journal = {International Journal of HIV/AIDS Prevention, Education and Behavioural Science},
  volume = {5},
  number = {1},
  pages = {19-25},
  doi = {10.11648/j.ijhpebs.20190501.13},
  url = {https://doi.org/10.11648/j.ijhpebs.20190501.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijhpebs.20190501.13},
  abstract = {Introduction: HIV testing services is the entry point to HIV prevention, care, treatment, and support services. According to Uganda Population HIV impact assessment preliminary report released in 2018, 72.5% of people living with HIV in Uganda knew their status, which is below the UNAIDS target of 90%. We proposed a double layered screening of the population using the Ministry of Health HIV Testing Services (HTS) screening tool to identify more HIV positives and start them on treatment. The objective of this study was to assess the impact of the double layered screening approach on HIV test yield. Methods: A double layered screening approach involved using community and technical teams from TASO Tororo HIV clinic through the surge strategy. The community team (first layer) comprised of expert clients, local council 1, market and church leaders who were trained on how to screen the people in the community using the HTS screening tool. The technical team (second layer) comprised of medical personnel and counselors who subjected all people mobilized and screened by the community team to a second layered screening before offering an HIV test. We compared proportions of HIV test yields before and after the implementation of the double layered HTS strategy using proportions test and we assessed the impact of the double layered screening using a difference in difference (DID) evaluation method. Results; There was a general increase in HIV test yield from 4.75% with single screening (period: January-March 2018) to 12.25% with double screening (period: April – June 2018) (P<0.001). The increase was more in males (from 3.51% to 11.06%) than in females (from 6.36% to 13.31%) and this difference was significant (P=0.035). The increase in HIV test yield did not differ by age (P=0.060), by marital status (P=0.606) or by first time tester (P=0.167), Conclusion: The double layered screening before HIV test could be an effective strategy to maximize HIV test yield in the general population, which if scaled up can save huge resources, time and help focus on actual targets for HIV testing services, leading to early attainment of the UNAIDS 1st target of 90-90-90.},
 year = {2019}
}

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TY  - JOUR
T1  - A Case of TASO Tororo Surge Strategy: Using Double Layered Screening to Increase the Rate of Identification of New HIV Positive Clients in the Community
AU  - Ronald Opito
AU  - Mastula Nanfuka
AU  - Levicatus Mugenyi
AU  - Michael Bernard Etukoit
AU  - Kenneth Mugisha
AU  - Lynette Opendi
AU  - Betty Nabukonde
AU  - David Kagimu
AU  - Godfrey Muzaaya
AU  - Caroline Karutu
Y1  - 2019/02/28
PY  - 2019
N1  - https://doi.org/10.11648/j.ijhpebs.20190501.13
DO  - 10.11648/j.ijhpebs.20190501.13
T2  - International Journal of HIV/AIDS Prevention, Education and Behavioural Science
JF  - International Journal of HIV/AIDS Prevention, Education and Behavioural Science
JO  - International Journal of HIV/AIDS Prevention, Education and Behavioural Science
SP  - 19
EP  - 25
PB  - Science Publishing Group
SN  - 2575-5765
UR  - https://doi.org/10.11648/j.ijhpebs.20190501.13
AB  - Introduction: HIV testing services is the entry point to HIV prevention, care, treatment, and support services. According to Uganda Population HIV impact assessment preliminary report released in 2018, 72.5% of people living with HIV in Uganda knew their status, which is below the UNAIDS target of 90%. We proposed a double layered screening of the population using the Ministry of Health HIV Testing Services (HTS) screening tool to identify more HIV positives and start them on treatment. The objective of this study was to assess the impact of the double layered screening approach on HIV test yield. Methods: A double layered screening approach involved using community and technical teams from TASO Tororo HIV clinic through the surge strategy. The community team (first layer) comprised of expert clients, local council 1, market and church leaders who were trained on how to screen the people in the community using the HTS screening tool. The technical team (second layer) comprised of medical personnel and counselors who subjected all people mobilized and screened by the community team to a second layered screening before offering an HIV test. We compared proportions of HIV test yields before and after the implementation of the double layered HTS strategy using proportions test and we assessed the impact of the double layered screening using a difference in difference (DID) evaluation method. Results; There was a general increase in HIV test yield from 4.75% with single screening (period: January-March 2018) to 12.25% with double screening (period: April – June 2018) (P<0.001). The increase was more in males (from 3.51% to 11.06%) than in females (from 6.36% to 13.31%) and this difference was significant (P=0.035). The increase in HIV test yield did not differ by age (P=0.060), by marital status (P=0.606) or by first time tester (P=0.167), Conclusion: The double layered screening before HIV test could be an effective strategy to maximize HIV test yield in the general population, which if scaled up can save huge resources, time and help focus on actual targets for HIV testing services, leading to early attainment of the UNAIDS 1st target of 90-90-90.
VL  - 5
IS  - 1
ER  -

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Author Information

Ronald Opito

Directorate of Program Management and Capacity Development, the Aids Support Organization, Kampala, Uganda
Mastula Nanfuka

Directorate of Program Management and Capacity Development, the Aids Support Organization, Kampala, Uganda
Levicatus Mugenyi

Directorate of Program Management and Capacity Development, the Aids Support Organization, Kampala, Uganda
Michael Bernard Etukoit

Directorate of Program Management and Capacity Development, the Aids Support Organization, Kampala, Uganda
Kenneth Mugisha

Directorate of Program Management and Capacity Development, the Aids Support Organization, Kampala, Uganda
Lynette Opendi

Directorate of Program Management and Capacity Development, the Aids Support Organization, Kampala, Uganda
Betty Nabukonde

Directorate of Program Management and Capacity Development, the Aids Support Organization, Kampala, Uganda
David Kagimu

Directorate of Program Management and Capacity Development, the Aids Support Organization, Kampala, Uganda
Godfrey Muzaaya

Directorate of Program Management and Capacity Development, the Aids Support Organization, Kampala, Uganda
Caroline Karutu

USAID Regional Health Integration to Enhance Services in Eastern Uganda, IntraHealth International, Mbale, Uganda

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APA Style

Ronald Opito, Mastula Nanfuka, Levicatus Mugenyi, Michael Bernard Etukoit, Kenneth Mugisha, et al. (2019). A Case of TASO Tororo Surge Strategy: Using Double Layered Screening to Increase the Rate of Identification of New HIV Positive Clients in the Community. International Journal of HIV/AIDS Prevention, Education and Behavioural Science, 5(1), 19-25. https://doi.org/10.11648/j.ijhpebs.20190501.13

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ACS Style

Ronald Opito; Mastula Nanfuka; Levicatus Mugenyi; Michael Bernard Etukoit; Kenneth Mugisha, et al. A Case of TASO Tororo Surge Strategy: Using Double Layered Screening to Increase the Rate of Identification of New HIV Positive Clients in the Community. Int. J. HIV/AIDS Prev. Educ. Behav. Sci. 2019, 5(1), 19-25. doi: 10.11648/j.ijhpebs.20190501.13

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AMA Style

Ronald Opito, Mastula Nanfuka, Levicatus Mugenyi, Michael Bernard Etukoit, Kenneth Mugisha, et al. A Case of TASO Tororo Surge Strategy: Using Double Layered Screening to Increase the Rate of Identification of New HIV Positive Clients in the Community. Int J HIV/AIDS Prev Educ Behav Sci. 2019;5(1):19-25. doi: 10.11648/j.ijhpebs.20190501.13

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@article{10.11648/j.ijhpebs.20190501.13,
  author = {Ronald Opito and Mastula Nanfuka and Levicatus Mugenyi and Michael Bernard Etukoit and Kenneth Mugisha and Lynette Opendi and Betty Nabukonde and David Kagimu and Godfrey Muzaaya and Caroline Karutu},
  title = {A Case of TASO Tororo Surge Strategy: Using Double Layered Screening to Increase the Rate of Identification of New HIV Positive Clients in the Community},
  journal = {International Journal of HIV/AIDS Prevention, Education and Behavioural Science},
  volume = {5},
  number = {1},
  pages = {19-25},
  doi = {10.11648/j.ijhpebs.20190501.13},
  url = {https://doi.org/10.11648/j.ijhpebs.20190501.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijhpebs.20190501.13},
  abstract = {Introduction: HIV testing services is the entry point to HIV prevention, care, treatment, and support services. According to Uganda Population HIV impact assessment preliminary report released in 2018, 72.5% of people living with HIV in Uganda knew their status, which is below the UNAIDS target of 90%. We proposed a double layered screening of the population using the Ministry of Health HIV Testing Services (HTS) screening tool to identify more HIV positives and start them on treatment. The objective of this study was to assess the impact of the double layered screening approach on HIV test yield. Methods: A double layered screening approach involved using community and technical teams from TASO Tororo HIV clinic through the surge strategy. The community team (first layer) comprised of expert clients, local council 1, market and church leaders who were trained on how to screen the people in the community using the HTS screening tool. The technical team (second layer) comprised of medical personnel and counselors who subjected all people mobilized and screened by the community team to a second layered screening before offering an HIV test. We compared proportions of HIV test yields before and after the implementation of the double layered HTS strategy using proportions test and we assessed the impact of the double layered screening using a difference in difference (DID) evaluation method. Results; There was a general increase in HIV test yield from 4.75% with single screening (period: January-March 2018) to 12.25% with double screening (period: April – June 2018) (P<0.001). The increase was more in males (from 3.51% to 11.06%) than in females (from 6.36% to 13.31%) and this difference was significant (P=0.035). The increase in HIV test yield did not differ by age (P=0.060), by marital status (P=0.606) or by first time tester (P=0.167), Conclusion: The double layered screening before HIV test could be an effective strategy to maximize HIV test yield in the general population, which if scaled up can save huge resources, time and help focus on actual targets for HIV testing services, leading to early attainment of the UNAIDS 1st target of 90-90-90.},
 year = {2019}
}

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TY  - JOUR
T1  - A Case of TASO Tororo Surge Strategy: Using Double Layered Screening to Increase the Rate of Identification of New HIV Positive Clients in the Community
AU  - Ronald Opito
AU  - Mastula Nanfuka
AU  - Levicatus Mugenyi
AU  - Michael Bernard Etukoit
AU  - Kenneth Mugisha
AU  - Lynette Opendi
AU  - Betty Nabukonde
AU  - David Kagimu
AU  - Godfrey Muzaaya
AU  - Caroline Karutu
Y1  - 2019/02/28
PY  - 2019
N1  - https://doi.org/10.11648/j.ijhpebs.20190501.13
DO  - 10.11648/j.ijhpebs.20190501.13
T2  - International Journal of HIV/AIDS Prevention, Education and Behavioural Science
JF  - International Journal of HIV/AIDS Prevention, Education and Behavioural Science
JO  - International Journal of HIV/AIDS Prevention, Education and Behavioural Science
SP  - 19
EP  - 25
PB  - Science Publishing Group
SN  - 2575-5765
UR  - https://doi.org/10.11648/j.ijhpebs.20190501.13
AB  - Introduction: HIV testing services is the entry point to HIV prevention, care, treatment, and support services. According to Uganda Population HIV impact assessment preliminary report released in 2018, 72.5% of people living with HIV in Uganda knew their status, which is below the UNAIDS target of 90%. We proposed a double layered screening of the population using the Ministry of Health HIV Testing Services (HTS) screening tool to identify more HIV positives and start them on treatment. The objective of this study was to assess the impact of the double layered screening approach on HIV test yield. Methods: A double layered screening approach involved using community and technical teams from TASO Tororo HIV clinic through the surge strategy. The community team (first layer) comprised of expert clients, local council 1, market and church leaders who were trained on how to screen the people in the community using the HTS screening tool. The technical team (second layer) comprised of medical personnel and counselors who subjected all people mobilized and screened by the community team to a second layered screening before offering an HIV test. We compared proportions of HIV test yields before and after the implementation of the double layered HTS strategy using proportions test and we assessed the impact of the double layered screening using a difference in difference (DID) evaluation method. Results; There was a general increase in HIV test yield from 4.75% with single screening (period: January-March 2018) to 12.25% with double screening (period: April – June 2018) (P<0.001). The increase was more in males (from 3.51% to 11.06%) than in females (from 6.36% to 13.31%) and this difference was significant (P=0.035). The increase in HIV test yield did not differ by age (P=0.060), by marital status (P=0.606) or by first time tester (P=0.167), Conclusion: The double layered screening before HIV test could be an effective strategy to maximize HIV test yield in the general population, which if scaled up can save huge resources, time and help focus on actual targets for HIV testing services, leading to early attainment of the UNAIDS 1st target of 90-90-90.
VL  - 5
IS  - 1
ER  -

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