Processes and dynamics of linkage to care from mobile/outreach and facility-based HIV testing models in hard-to-reach settings in rural Tanzania: qualitative findings of a mixed methods study

Erica S. Sanga, Ferdinand C. Mukumbang, Adiel K. Mushi, Willyhelmina Olomi, Wondwossen Lerebo, Christina Zarowsky

Research output: Contribution to journalA1: Web of Science-article

1 Downloads (Pure)

Abstract

BackgroundLike other countries, Tanzania instituted mobile and outreach testing approaches to address low HIV testing rates at health facilities and enhance linkage to care. Available evidence from hard-to-reach rural settings of Mbeya region, Tanzania suggests that clients testing HIV+at facility-based sites are more likely to link to care, and to link sooner, than those testing at mobile sites. This paper (1) describes the populations accessing HIV testing at mobile/outreach and facility-based testing sites, and (2) compares processes and dynamics from testing to linkage to care between these two testing models from the same study context.MethodsAn explanatory sequential mixed-method study (a) reviewed records of all clients (n=11,773) testing at 8 mobile and 8 facility-based testing sites over 6months; (b), reviewed guidelines; (c) observed HIV testing sites (n=10) and Care and Treatment Centers (CTCs) (n=8); (d) applied questionnaires at 0, 3 and 6months to a cohort of 1012 HIV newly-diagnosed clients from the 16 sites; and (e) conducted focus group discussions (n=8) and in-depth qualitative interviews with cohort members (n=10) and health care providers (n=20).ResultsMore clients tested at mobile/outreach than facility-based sites (56% vs 44% of 11,733, p

Original languageEnglish
Article number21
JournalAids Research and Therapy
Volume15
Number of pages15
ISSN1742-6405
DOIs
Publication statusPublished - 2018

Keywords

  • HIV
  • Linkage to care
  • Health systems integration
  • Mixed methods process evaluation
  • Mobile
  • outreach HIV testing
  • Rural health
  • Hard to reach populations
  • Stigma
  • Mbeya
  • Tanzania
  • WESTERN KENYA
  • ANTIRETROVIRAL THERAPY
  • SOUTH-AFRICA
  • RISK-FACTORS
  • RETENTION
  • COMMUNITY
  • BARRIERS

Cite this