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Finding HIV in Hard to Reach Populations: Mobile HIV Testing and Geospatial Mapping in Umlazi Township, Durban, South Africa

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Abstract

Mobile, community-based HIV testing may help achieve universal HIV testing in South Africa. We compared the yield, geographic distribution, and demographic characteristics of populations tested by mobile- and clinic-based HIV testing programs deployed by iThembalabantu Clinic in Durban, South Africa. From July to November 2011, 4,701 subjects were tested; HIV prevalence was 35 % among IPHC testers and 10 % among mobile testers (p < 0.001). Mobile testers varied in mean age (22–37 years) and % males (26–67 %). HIV prevalence at mobile sites ranged from 0 to 26 %. Testers traveled further than the clinic closest to their home; mobile testers were more likely to test ≥5 km away from home. Mobile HIV testing can improve testing access and identify testing sites with high HIV prevalence. Individuals often access mobile testing sites farther from home than their nearest clinic. Geospatial techniques can help optimize deployment of mobile units to maximize yield in hard-to-reach populations.

Resumen

La prueba del VIH que es móvil y basada en la comunidad puede ayudar a lograr prueba universal del VIH en Sudáfrica. Se comparó el rendimiento, la distribución geográfica y las características demográficas de las poblaciones probadas por programas y móviles por la clínica basada en pruebas de VIH desplegados por la Clínica iThembalabantu en Durban, Sudáfrica. De julio a noviembre de 2011, 4.701 sujetos fueron evaluados; la prevalencia del VIH fue del 35 % entre los probadores en la clinica y el 10 % entre los probadores móviles (p < 0,001). Probadores móviles variaron en edad media (22–37 años) y los hombres (26–67 %). La prevalencia del VIH en los sitios móviles osciló de 0 a 26 %. Probadores viajaron más allá de la clínica más cercana a su hogar; probadores móviles eran más propensos a probar ≥5 km de casa. Pruebas de VIH móvil puede mejorar el acceso de pruebas e identificar sitios de prueba con alta prevalencia de VIH. Las personas a menudo acceden a sitios de pruebas móviles más lejos de casa que su clínica más cercana. Técnicas geoespaciales pueden ayudar a optimizar el despliegue de unidades móviles para maximizar el rendimiento en poblaciones de difícil acceso.

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Acknowledgments

We would like to acknowledge the assistance of Njabulo Mabaso and Philisiwe Luthuli and the dedication of the research team at the iThembalabantu People’s Hope Clinic. Research reported in this publication was supported by the National Institute of Allergy and Infectious Diseases and National Institute of Mental Health of the National Institutes of Health under Awards R01 MH090326, R01 AI058736 and R01 MH073445. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This Project was also supported by the AIDS Healthcare Foundation and the Harvard Center for AIDS Research (P30 AI042851).

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The authors declare no conflicts of interest.

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Correspondence to Ingrid V. Bassett.

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Bassett, I.V., Regan, S., Mbonambi, H. et al. Finding HIV in Hard to Reach Populations: Mobile HIV Testing and Geospatial Mapping in Umlazi Township, Durban, South Africa. AIDS Behav 19, 1888–1895 (2015). https://doi.org/10.1007/s10461-015-1012-3

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