Home-based HIV voluntary counseling and testing in developing countries (Review)

Plain language summary Home-based HIV voluntary counseling and testing (VCT) in developing countries The HIV AIDS epidemic remains a significant global problem, with the brunt of the epidemic borne by developing countries. Diagnosis and control of the infection depends on affected individuals seeking and knowing their HIV status and changing their behavior to remain uninfectedor, if already HIV-infected, to seek to change their behavior in order to avoid infecting others. The uptake of VCT remains low, particularly in developing countries, and some of the challenges include ease of getting an HIV test. Researchers theorised that providing HIV testing and or results in homes would lead to wider acceptance of HIV testing. Worldwide, it is estimated that 38 million people are infected with HIV, with over 90 in developing countries and 64 in sub-Saharan Africa alone (24.5 million). In developing countries, only about 10 of those who need VCT have access to it. Challenges of HIV testing in those countries include the difficulty and cost of obtaining an HIV test. The objective of this review was to identify and critically appraise studies addressing the implementation of home-based HIV voluntary counseling and testing in developing countries, and to determine whether home-based HIV voluntary counseling and testing (HBVCT) is associated with improvement in HIV testing outcomes compared to facility-based models. The two trials found to meet our inclusion criteria were both done in developing countries and, together, involved 2,717 participants. The researchers compared acceptance of home-delivered testing or receiving HIV test results to clinic-based testing and receiving HIV test results. This review of two trials did not find sufficient evidence to recommend home-based VCT, although our results suggested that it led to better acceptance of HIV testing.