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How home HIV testing and counselling with follow-up support achieves high testing coverage and linkage to treatment and prevention: a qualitative analysis from Uganda

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dc.date.accessioned 2021-02-28T16:16:22Z
dc.date.available 2021-02-28T16:16:22Z
dc.date.issued 2016-07-05 en
dc.identifier.uri http://hdl.handle.net/20.500.11910/9819
dc.description.abstract The successes of HIV treatment scale-up and the availability of new prevention tools have raised hopes that the epidemic can finally be controlled and ended. Reduction in HIV incidence and control of the epidemic requires high testing rates at population levels, followed by linkage to treatment or prevention. As effective linkage strategies are identified, it becomes important to understand how these strategies work. We use qualitative data from The Linkages Study, a recent community intervention trial of community-based testing with linkage interventions in sub-Saharan Africa, to show how lay counsellor home HIV testing and counselling (home HTC) with follow-up support leads to linkage to clinic-based HIV treatment and medical male circumcision services. The research team conducted 99 semi-structured individual interviews with study participants and three focus groups with 16 lay counsellors in Kabwohe, Sheema District, Uganda. The participant sample included both HIV men and women (N=47) and HIV-uncircumcised men (N=52). Interview and focus group audio-recordings were translated and transcribed. Each transcript was summarized. The summaries were analyzed inductively to identify emergent themes. Thematic concepts were grouped to develop general constructs and framing propositional statements. Trial participants expressed interest in linking to clinic-based services at testing, but faced obstacles that eroded their initial enthusiasm. Follow-up support by lay counsellors intervened to restore interest and inspire action. Together, home HTC and follow-up support improved morale, created a desire to reciprocate, and provided reassurance that services were trustworthy. In different ways, these functions built links to the health service system. They worked to strengthen individuals' general sense of capability, while making the idea of accessing services more manageable and familiar, thus reducing linkage barriers. Home HTC with follow-up support leads to linkage by building 'social bridges', interpersonal connections established and developed through repeated face-to-face contact between counsellors and prospective users of HIV treatment and male circumcision services. Social bridges link communities to the service system, inspiring individuals to overcome obstacles and access care. en
dc.format.medium Print en
dc.subject HIV TESTING AND COUNSELLING (HTC) en
dc.subject UGANDA en
dc.subject HOME CARE en
dc.title How home HIV testing and counselling with follow-up support achieves high testing coverage and linkage to treatment and prevention: a qualitative analysis from Uganda en
dc.type Journal Article en
dc.description.version Y en
dc.ProjectNumber N/A en
dc.Volume 19 en
dc.BudgetYear 2016/17 en
dc.ResearchGroup Human and Social Development en
dc.SourceTitle Journal of the International AIDS Society en
dc.ArchiveNumber 9255 en
dc.URL http://ktree.hsrc.ac.za/doc_read_all.php?docid=16531 en
dc.PageNumber Online en
dc.outputnumber 8063 en
dc.bibliographictitle Ware, N.C., Wyatt, M.A., Asiimwe, S., Turyamureeba, B., Tumwesigye, E., Van Rooyen, H., Barnabas, R.V. & Celum, C.L. (2016) How home HIV testing and counselling with follow-up support achieves high testing coverage and linkage to treatment and prevention: a qualitative analysis from Uganda. <i>Journal of the International AIDS Society</i>. 19:Online. http://hdl.handle.net/20.500.11910/9819 en
dc.publicationyear 2016 en
dc.contributor.author1 Ware, N.C. en
dc.contributor.author2 Wyatt, M.A. en
dc.contributor.author3 Asiimwe, S. en
dc.contributor.author4 Turyamureeba, B. en
dc.contributor.author5 Tumwesigye, E. en
dc.contributor.author6 Van Rooyen, H. en
dc.contributor.author7 Barnabas, R.V. en
dc.contributor.author8 Celum, C.L. en


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