Effect of organizational models of provider-initiated testing and counseling (PITC) in health facilities on adult HIV testing coverage in sub-Saharan Africa.
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.
['Inghels|M|M|0000-0002-9340-2054', 'Carillon|S|S|', 'Desgrees du Lou|A|A|0000-0002-2223-5316', 'Larmarange|J|J|0000-0001-7097-700X']
D015492:AIDS Serodiagnosis D000328:Adult D017954:Africa South of the Sahara D003376:Counseling D005260:Female D015658:HIV Infections D006268:Health Facilities D006291:Health Policy D006801:Humans D008297:Male D008403:Mass Screening D017146:Models, Organizational D012017:Referral and Consultation D012698:Serologic Tests
organizational models HIV testing Sub-Saharan Africa Provider initiated testing and counseling testing cover