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Feasibility, acceptability and cost of home‐based HIV testing in rural Kenya
Author(s) -
Negin Joel,
Wariero James,
Mutuo Patrick,
Jan Stephen,
Pronyk Paul
Publication year - 2009
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/j.1365-3156.2009.02304.x
Subject(s) - medicine , psychological intervention , human immunodeficiency virus (hiv) , feeling , family medicine , developing country , marital status , enthusiasm , rural area , environmental health , program evaluation , qualitative property , population , gerontology , nursing , psychology , social psychology , economic growth , political science , economics , pathology , public administration , machine learning , computer science
Summary Objective To demonstrate the feasibility, acceptability and cost of home‐based HIV testing and to examine the applicability of the model to high HIV prevalence settings. Methods Quantitative, qualitative and cost data were collected during a home‐based HIV testing program in a high‐prevalence rural area of Kenya; data on age, gender and marital status along with HIV test results were collected. This was complemented with qualitative research including key informant interviews with counselors and program managers to highlight experiences and challenges. Direct costs of the interventions were estimated through the review of budgets and monthly expenditure sheets. Results Of 3180 15–49‐year olds exposed to a community awareness campaign, 2033 (63.9%) agreed to be visited by counselors, of whom 1984 (97.6%) agreed to be tested and receive the results. Adult HIV prevalence was 8.2% and married women were 4.8 times more likely to be HIV‐positive than those never married. Counselors reported feeling welcomed and noted the enthusiasm of the community towards testing. The total cost of the exercise was $17 569. The program cost was $2.60 for each of the 6750 community members, $5.88 for each person tested, and $84 per positive case detected. Conclusion This study suggests that home‐based HIV testing is feasible with high uptake, and has the potential to substantially expand access to HIV testing services. There is a strong economic case for the extension of such a screening program to other communities.