Home-based counseling and testing effective in diagnosis but not in treatment
Extensive efforts to test all adults for HIV in a rural area of Kenya has resulted in the discovery of 1,300 people newly infected which HIV. However, only a few of these newly diagnosed took up treatment after diagnosis, as concluded in a new study in the Lancet HIV.
The study took place in Bunyala, a district of Kenya, and tested 32,000 adults through home-based counseling and testing (HBCT) between 2009 and 2011. During this time 3,482 people were diagnosed as living with HIV, of which 1,360 were newly diagnosed. This means that nearly 40 percent of the people living with HIV would not have known their status if they were not included in the study.
Although HBCT successfully identified individuals who were unaware of their infection, only 15 percent of those newly diagnosed consequently consulted an HIV care provider within four years of diagnosis. This low link to medical care is likely to be explained by the fact that newly diagnosed people often do not feel sick, and therefore do not seek medical assistance until they feel they need it
The lack of uptake of services by people diagnosed through HBCT, has identified the need to develop new and innovative strategies to get asymptomatic newly diagnosed people engaging with care providers. HBCT must therefore involve effective strategies to provide newly diagnosed people with care, and also to be effective in terms of individual and population viral suppression. Therefore, research to understand the barriers to engaging with HIV care, and interventions to overcome them, particularly in individuals who are newly diagnosed with HIV, is urgently needed.