Community-based HIV testing services can help increase HIV testing rates in western Kenya

The United Nations Program on HIV/AIDS (UNAIDS) set a testing target of 90% of all individuals with HIV knowing their HIV status, which some countries are struggling to meet. Kisumu County in western Kenya has an estimated HIV prevalence of 3.6 times higher than the national prevalence. According to the latest survey data from Kenya, HIV testing was lower among men than among women, as well as lower among adolescents than older adults. In order to reach the UNAIDS testing target, it’s vital to reach people who are unaware of their HIV-positive status. Community-based HIV testing programs can help achieve this aim. 

New research details the implementation of the Community Health Initiative, a hybrid HIV testing approach, in the urban settlement of Obunga in western Kenya. Researchers conducted community mobilization, community mapping, household census, multi-disease community health campaigns, and tracking activities to offer home-based HIV testing services. In addition to HIV testing, the program also included screening, testing, and referrals for tuberculosis, malaria, diabetes, and hypertension.

The Community Health Initiative provided HIV testing in Obunga and identified people who were HIV-positive but were unaware of their status. More than 97% of eligible people accepted testing and just under one-third of those were first-time testers. Among people who were newly identified as HIV-positive, 93% started antiretroviral therapy (ART) treatment the same day. The Community Health Initiative was successful at reaching, and surpassing, the UNAIDS testing and treatment targets of 90%. This is the first known time that a community-based hybrid HIV testing approach has been successfully implemented in an urban setting in sub-Saharan Africa.

The Community Health Initiative’s experiences can help to inform the efficient implementation of community-based HIV testing approaches. Using innovative strategies like these will help make HIV testing more accessible and acceptable to the community, which is crucial for achieving UNAIDS testing goals.