Mode Interventions Outcomes
Technology assisted interventions Balan et al., 2019- linkage was achieved through a SMARTtest mobile app that allowed users to filter nearest clinic locations by their zip codes, their operating hours, website links and contact information. SMARTtest app achieved 100% linkage for all 60 participants and their partners
Pai et al., 2018- HIVSmart mobile app where participants were linked to further care by dedicated counsellors after HIVST. All participants 451 (100%) were successfully linked to HIV counselling and other HIV care services
Phanuphak et al., 2020- compared routine HCT with health worker supervised online HIVST, and onsite health worker supervised HIVST. Only 18 out of 60 (52.8%) HIV positive participants were successfully linked to care in the online and onsite supervised HIVST and linkage to care approaches. The routine HCT approach proved superior achieving 84% linkage to care and ART initiation.
Sibanda et al., 2019- Discrete choice experiment where different scenarios of linkage to care following HIVST after test kit distribution were assessed. SMS linkage support, phone call linkage support, in person linkage support and extended clinic operating hours were some of the scenarios assessed for their impact on linkage to care SMS support increased linkage to HIV care by 4.9 percentage points, phone call increased linkage by 6.5%, in person linkage support increased linkage by 6.7% and extending clinic operating hours increased linkage by 2.5%.
Innovative HIV self-testing kits distribution mechanisms Shapiro et al., 2020- For linkage, counsellors provided post-test counselling and referral and SMS reminders for those who delayed sending results. Among 274 men with positive HIVST results, 187 (68%) were successfully linked to ART and other HIV care services.
Chanda et al., 2017- Compared the routine HCT with peer educators’ distribution of oral HIVST kits to participants, and the collection of HIVST kits from a clinic or pharmacy using a coupon. Among participants reporting an HIV positive result after the HIVST, linkage to care was non significantly lower among HIVST groups compared to the routine HCT. Routine HCT- 72/84 (85.7%), peer educator HIVST kits delivery- 53/74 (71.6%) and coupon clinic/pharmacy collection of HIVST kits- 59/77 (76.6%).
Ortblad et. al.,2017 - Compared the routine HCT with direct provision of oral HIVST kits to participants, and the collection of HIVST kits from a health facility using a coupon. Among participants who carried out HIVST, linkage to care was non significantly lower among HIVST groups compared to the routine HCT. Routine HCT- 37/294 (12.6%), direct provision of HIVST kits - 27/260 (10.4%) and coupon health facility collection of HIVST kits- 37/289(12.8%).
Choko et al., 2015- Trained volunteer counsellors oral HIVST kits to adults in the community. Linkage was achieved through a self-referral card given to each participant. The card allowed direct access to the study clinic. Volunteer counsellors provided post-test counselling and referral. Successful linkage was achieved with 524 participants out of 930 participants (56.3%).
MacPherson et al., 2014- Routine facility-based care was compared with optional home initiation of HIV care (including 2 weeks of ART if eligible) after HIVST. A significantly greater proportion of adults in the home base care group were linked to care and initiated ART, 2.2% (181/8194) compared with the routine facility-based group, 0.7% (63/8466).
Korte et al., 2020- compared the routine care and the intervention where women attending antenatal care were each provided with up to 4 OraQuick HIVST kits. Linkage to care was achieved through providing the women with referral resource containing list of clinics and HIV testing sites, contact information of nurse counsellors and follow-up dates at 1-month and at 3 months 26 HIV positive men were identified in the intervention arm among whom 23% (6/26) were successfully linked to HIV care compared to 67% (4/6) from the routine care.
Financial incentives and social entrepreneurship models Zhong et al., 2017- implemented a social entrepreneurship model. Participants bought the HIVST kits at $30 USD which was refunded upon successfully performing the HIVST and relaying the results to health workers. Linkage was achieved through a phone call to all participants with positive HIVST. 8 cases turned positive after HIVST. All cases were successfully linked to further HIV care.
Choko et al., 2019- compared five scenarios of HIVST distribution some hinged on financial incentives: Briefly, the interventions implemented include: women attending antenatal care were provided with 2 HIVST kits for their partner, women attending antenatal care were provided with 2 HIVST kits for their partner plus incentive of $3 USD, women attending ANC were provided with 2 HIVST kits for their partner plus $10, women attending antenatal care were provided with 2 HIVST kits for their partner plus a 10% chance of winning $30 USD in a lottery, women attending antenatal care were provided with 2 HIVST kits for their partner and phone call reminder to the women’s partners. Linkage to care following HIVST increased substantially using financial incentives. Linkage to care within 28 days was 13% with routine care, 40.9% with delivery of test kits only, 51.7% with HIVST kits and financial incentives, 18.6% with HIVST kits plus lottery, and 22.3% with HIVST plus phone reminder.
Use of key community opinion leaders and social media influencers Tun et al., 2018 – Distributed oral HIVST kits to MSM through key opinion leaders. Fourteen MSM tested positive for HIV after the HIVST. All 14 sought presented themselves at the health facility for test results confirmation and were successfully initiated on ART.
Zhang et al., 2020- compared linkage to care, antiretroviral treatment, and cost of HIVST among MSM recruited by social media key opinion leaders and by community-based organisations. Linkage was achieved by peer navigators who were trained volunteers from the local community-based organisation that paired up with the participants to ensure successful linkage The proportion of MSM in the CBO group initiating ART after linkage to care was lower than that in the social media key opinion leaders’ group (94.4% (31/33) compared to 29.0% (29/100)).