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

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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

TaalEngels
Artikel nummer21
TijdschriftAIDS Research and Therapy
Volume15
Aantal pagina's15
ISSN1742-6405
DOI's
StatusGepubliceerd - 2018

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