A family-centered approach increases HIV testing among family members of persons in care for HIV
Poster presentation at 5th International AIDS Society (IAS) Conference on HIV Pathogenesis, Treatment and Prevention, Cape Town, 19-22 July
Sheehy,Meredith; Scorgie,Fiona; Mini,Nomtandazo Patricia; Tun,Waimar; Kellerman,Scott E.
Publication date: 2009
In South Africa, three-quarters of HIV-infected children are living in households where another family member is infected, but opportunities to test children for HIV are limited beyond PMTCT, and HIV testing in general forms a bottleneck to getting infected people of any age into care. We targeted adults receiving care for HIV and encouraged them to refer family members for HIV testing.
We implemented this intervention in five health facilities with HIV services in Rustenburg, South Africa over six weeks in 2008, training 12 service providers to encourage HIV-positive patients in care to refer family members of unknown HIV status for testing. To monitor effectiveness, patients were given referral cards and instructed to pass them to family members who they felt needed to be tested for HIV, who in turn would present the cards to clinic staff for testing.
278 adult clinic attendees participated: average age 38, 76 percent female, 69 percent single, and 85 percent had on average 2.2 children. Seventeen percent of participants reported having HIV-positive children, 50 percent reported having HIV-negative children, and 33 percent reported not knowing their children's HIV status. Referral cards were accepted by 98 percent of adult participants, and a total of 21 referral cards, 1 per 14 participants, were returned by referred individuals. The referred population was 74 percent female with a mean age of 34 years. 19 of 21 referrals tested positive for HIV.
This pilot demonstrated the effectiveness of HIV-positive persons in care effectively referring at-risk family members for testing. While most referrals in this pilot were adults, we believe this approach can increase pediatric HIV testing if the messages are refined. To strengthen the intervention, we are currently piloting a video for continuous playback in ART clinic waiting rooms to encourage HIV-infected adults in-care to test their children for HIV.