Community-Based HIV and Health Testing for High-Risk Adolescents and Youth

AIDS Patient Care STDS. 2016 Aug;30(8):371-8. doi: 10.1089/apc.2016.0102.

Abstract

Adolescents account for 40% of new HIV infections, and HIV testing strategies to increase uptake of testing are needed. A community-based adolescent and youth HIV and health testing campaign was conducted in seven slum neighborhoods of Port-au-Prince, Haiti, from December 2014 to September 2015. Community health workers provided community sensitization and recruited 10- to 24-year-olds to test for HIV, syphilis, gonorrhea/chlamydia, and to screen for tuberculosis (TB) and pregnancy. HIV-infected individuals were escorted to the GHESKIO HIV clinic for same-day enrollment in care. Among 3425 individuals eligible for testing, 3348 (98%) accepted an HIV test. HIV prevalence was 2.65% (n = 89). Median age was 19 [interquartile range (IQR) 17-20]; 73% were female. HIV prevalence was 0.6-7.4% across slum neighborhoods. All HIV-infected individuals enrolled in care the same day as testing; median CD4 was 529 cells/μL [IQR 363-761]. Syphilis prevalence was 2.60% (65/2536) and gonorrhea/chlamydia prevalence was 6.25% (96/1536). Among 168 (5%) individuals who reported TB symptoms, 7.7% (13/168) had microbiologically confirmed disease. One hundred twenty-nine females (5% of all females) were pregnant. This community-based testing campaign identified an adolescent and youth population with an HIV prevalence six times higher than the estimated national adolescent HIV prevalence (0.4%) in Haiti, including perinatally infected adolescents. This type of community-based campaign for HIV testing within a package of services can serve as a model for other resource-poor settings to identify high-risk adolescents and youth, and curb the global HIV epidemic among adolescents.

MeSH terms

  • Adolescent
  • Adult
  • Ambulatory Care Facilities
  • Community Health Services
  • Female
  • HIV Infections / diagnosis*
  • HIV Infections / epidemiology
  • Haiti / epidemiology
  • Health Promotion*
  • Humans
  • Male
  • Mass Screening / organization & administration*
  • Poverty Areas*
  • Pregnancy
  • Prevalence
  • Risk
  • Syphilis / diagnosis
  • Syphilis / epidemiology
  • Tuberculosis / diagnosis
  • Vulnerable Populations*