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A systematic review and meta-analysis of the evidence for community-based HIV testing on men’s engagement in the HIV care cascade
Review   Open access   Peer reviewed

A systematic review and meta-analysis of the evidence for community-based HIV testing on men’s engagement in the HIV care cascade

Allison K Groves, Petra Stankard, Sarah L Bowler, Muhammad S Jamil, Luwam T Gebrekristos, Patrick D Smith, Caitlin Quinn, Ndoungou Salla Ba, Thato Chidarikire, Van Thi Thuy Nguyen, …
International Journal of STD & AIDS, pp 9564624221111277-9564624221111277
03 Jul 2022
DOI: https://doi.org/10.1177/09564624221111277
Featured in Collection :   UN Sustainable Development Goals @ Drexel
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https://doi.org/10.1177/09564624221111277View
Published, Version of Record (VoR)CC BY V4.0,  Open

Abstract

HIV care continuum HIV prevention gender men who have sex with men Community testing
Objective Men with HIV are less likely than women to know their status, be on antiretroviral therapy, and be virally suppressed. This review examined men’s community-based HIV testing services (CB-HTS) outcomes. Design Systematic review and meta-analysis. Methods We searched seven databases and conference abstracts through July 2018. We estimated pooled proportions and/or risk ratios (for meta-analyses) for each outcome using random effects models. Results 188 studies met inclusion criteria. Common testing models included targeted outreach (e.g. mobile testing), home-based testing, and testing at stand-alone community sites. Across 25 studies reporting uptake, 81% (CI: 75–86%) of men offered testing accepted it. Uptake was higher among men reached through CB-HTS than facility-based HTS (RR = 1.39; CI: 1.13–1.71). Over 69% (CI: 64–71%) of those tested through CB-HTS were men, across 184 studies. Across studies reporting new HIV-positivity among men (n = 18), 96% were newly diagnosed (CI: 77–100%). Across studies reporting linkage to HIV care (n = 8), 70% (CI: 36–103%) of men were linked to care. Across 57 studies reporting sex-disaggregated data for CB-HTS conducted among key populations, men’s uptake was high (80%; CI: 70–88%) and nearly all were newly diagnosed and linked to care (95%; CI: 94–100%; and 94%; CI: 88–100%, respectively). Conclusion CB-HTS is an important strategy for reaching undiagnosed men with HIV from the general population and key population groups, particularly using targeted outreach models. When compared to facility-based HIV testing services, men tested through CB-HTS are more likely to uptake testing, and nearly all men who tested positive through CB-HTS were newly diagnosed. Linkage to care may be a challenge following CB-HTS, and greater efforts and research are needed to effectively implement testing strategies that facilitate rapid ART initiation and linkage to prevention services.

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19 Record Views
15 citations in Web of Science
9 citations in Scopus

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
International collaboration
Web of Science research areas
Immunology
Infectious Diseases
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