IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0219826.html
   My bibliography  Save this article

Which community-based HIV initiatives are effective in achieving UNAIDS 90-90-90 targets? A systematic review and meta-analysis of evidence (2007-2018)

Author

Listed:
  • Sailly Dave
  • Trevor Peter
  • Clare Fogarty
  • Nicolaos Karatzas
  • Nandi Belinsky
  • Nitika Pant Pai

Abstract

Background: Reaching the Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 targets to end the HIV epidemic relies on effective interventions that engage untested HIV+ individuals and retain them in care. Evidence on community-based interventions through the lens of the targets has not yet been synthesized, reflecting a knowledge gap. We conducted a systematic review and meta-analysis to shed light on successful community-based interventions that have been effective in contributing, directly or indirectly, towards the UNAIDS 90-90-90 targets: knowledge of HIV status, linkage to care/on treatment, and viral suppression. Linkage to care was also included in this review due to the limitations of studies. Methods: We conducted a systematic review and meta-analysis of the period 2007–2018. Eleven databases were searched to identify community-based interventions designed to improve knowledge of HIV status (in particular HIV testing), linkage to care/on treatment, and/or viral suppression. Eligible studies were classified by intervention, population, country income level, outcomes and success. Success was defined as interventions demonstrating statistical significance between intervention and control group or that reached any target by proportion; 90% testing, 81% linked to care/on treatment and 73% viral suppression. Results: Of 82 eligible studies, 51.2% (42/82) reported on HIV testing (first 90), 20.7% (17/82) on linkage to care/ on treatment (second 90), and 45.1% (37/82) on viral suppression (third 90). In all, 67.1% (55/82) of studies reported success; 21 studies on the first 90, 9 towards linkage to care/on treatment, and 25 towards the third. By strategies, 36.6% deployed community workers/peers, 22% used combined test and treat strategies, 12.2% used educational methods, 8.5% used mobile testing, 7.3% used campaigns and 13.4% used technology. For HIV testing/linkage, combined test/treat interventions were often used, for viral suppression, educational interventions and technologies were commonly deployed. Our pooled analysis suggested that deployment of community health care workers/peer workers significantly improved viral suppression (pooled OR: 1.40 95% CI 1.06–1.86). Of the studies published after 2014, 50.0% reported metrics aligned with UNAIDS targets. Conclusions: Data on linkage to care/on treatment (second target) remained weak, because many studies reported successes on the first and third targets. Stratification by targets and country income levels is informative and guides adaptation of successful interventions in comparable settings. Consistent reporting of clear metrics aligned with UNAIDS targets will aid in synergy of study data with programmatic data that will help reportage. Exploration of innovative interventions, for engagement and linkage and deployment of community/ peer workers is strongly encouraged.

Suggested Citation

  • Sailly Dave & Trevor Peter & Clare Fogarty & Nicolaos Karatzas & Nandi Belinsky & Nitika Pant Pai, 2019. "Which community-based HIV initiatives are effective in achieving UNAIDS 90-90-90 targets? A systematic review and meta-analysis of evidence (2007-2018)," PLOS ONE, Public Library of Science, vol. 14(7), pages 1-18, July.
  • Handle: RePEc:plo:pone00:0219826
    DOI: 10.1371/journal.pone.0219826
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0219826
    Download Restriction: no

    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0219826&type=printable
    Download Restriction: no

    File URL: https://libkey.io/10.1371/journal.pone.0219826?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Monisha Sharma & Roger Ying & Gillian Tarr & Ruanne Barnabas, 2015. "Systematic review and meta-analysis of community and facility-based HIV testing to address linkage to care gaps in sub-Saharan Africa," Nature, Nature, vol. 528(7580), pages 77-85, December.
    2. Plax, K. & Garbutt, J. & Kaushik, G.N., 2015. "HIV and sexually transmitted infection testing among high-risk youths: Supporting Positive Opportunities with Teens (SPOT) youth center," American Journal of Public Health, American Public Health Association, vol. 105(7), pages 1394-1398.
    3. Sonia Fernández-Balbuena & María Belza & Elena Urdaneta & Ramón Esteso & M. Rosales-Statkus & Luis Fuente, 2015. "Serving the underserved: an HIV testing program for populations reluctant to attend conventional settings," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 60(1), pages 121-126, January.
    4. Susie Hoffman & Theresa M Exner & Naomi Lince-Deroche & Cheng-Shiun Leu & Jessica L Phillip & Elizabeth A Kelvin & Anisha D Gandhi & Bruce Levin & Dinesh Singh & Joanne E Mantell & Kelly Blanchard & G, 2016. "Immediate Blood Draw for CD4+ Cell Count Is Associated with Linkage to Care in Durban, South Africa: Findings from Pathways to Engagement in HIV Care," PLOS ONE, Public Library of Science, vol. 11(10), pages 1-16, October.
    5. Anaya, H.D. & Butler, J.N. & Knapp, H. & Chan, K. & Conners, E.E. & Rumanes, S.F., 2015. "Implementing an HIV rapid testing-linkage-to-care project among homeless individuals in los angeles county: A collaborative effort between federal, county, and city government," American Journal of Public Health, American Public Health Association, vol. 105(1), pages 85-90.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Arielle Lasry & Mireille B Kalou & Paul R Young & Jacqueline Rurangirwa & Bharat Parekh & Stephanie Behel, 2019. "Cost implications of HIV retesting for verification in Africa," PLOS ONE, Public Library of Science, vol. 14(7), pages 1-15, July.
    2. Roberta Tassinari & Francesca Maranghi, 2021. "Rodent Model of Gender-Affirming Hormone Therapies as Specific Tool for Identifying Susceptibility and Vulnerability of Transgender People and Future Applications for Risk Assessment," IJERPH, MDPI, vol. 18(23), pages 1-14, November.
    3. Dominic Bukenya & Janet Seeley & Grace Tumwekwase & Elizabeth Kabunga & Eugene Ruzagira, 2020. "How Follow-Up Counselling Increases Linkage to Care Among HIV-Positive Persons Identified Through Home-Based HIV Counselling and Testing: A Qualitative Study in Uganda," SAGE Open, , vol. 10(1), pages 21582440199, January.
    4. Rachel A Silverman & Grace C John-Stewart & Ingrid A Beck & Ross Milne & Catherine Kiptinness & Christine J McGrath & Barbra A Richardson & Bhavna Chohan & Samah R Sakr & Lisa M Frenkel & Michael H Ch, 2019. "Predictors of mortality within the first year of initiating antiretroviral therapy in urban and rural Kenya: A prospective cohort study," PLOS ONE, Public Library of Science, vol. 14(10), pages 1-19, October.
    5. Simukai Shamu & Jean Slabbert & Geoffrey Guloba & Dalene Blom & Sikhulile Khupakonke & Nomea Masihleho & Julius Kamera & Suzanne Johnson & Thato Farirai & Nkhensani Nkhwashu, 2019. "Linkage to care of HIV positive clients in a community based HIV counselling and testing programme: A success story of non-governmental organisations in a South African district," PLOS ONE, Public Library of Science, vol. 14(1), pages 1-14, January.
    6. Marc d'Elbée & Métogara Mohamed Traore & Kéba Badiane & Anthony Vautier & Arlette Simo Fotso & Odé Kanku Kabemba & Nicolas Rouveau & Peter Godfrey-Faussett & Mathieu Maheu-Giroux & Marie-Claude Boily , 2021. "Costs and Scale-Up Costs of Integrating HIV Self-Testing Into Civil Society Organisation-Led Programmes for Key Populations in Côte d'Ivoire, Senegal, and Mali," Post-Print ird-03883601, HAL.
    7. Lawrence Mwenge & Linda Sande & Collin Mangenah & Nurilign Ahmed & Sarah Kanema & Marc d’Elbée & Euphemia Sibanda & Thokozani Kalua & Gertrude Ncube & Cheryl C Johnson & Karin Hatzold & Frances M Cowa, 2017. "Costs of facility-based HIV testing in Malawi, Zambia and Zimbabwe," PLOS ONE, Public Library of Science, vol. 12(10), pages 1-16, October.
    8. Paul Wekesa & Jaquin Kataka & Kevin Owuor & Lennah Nyabiage & Fredrick Miruka & Stella Wanjohi & Samuel Omondi, 2020. "Time to HIV testing of sexual contacts identified by HIV-positive index clients in Siaya County, Kenya," PLOS ONE, Public Library of Science, vol. 15(9), pages 1-11, September.
    9. Winnie Kavulani Luseno & Samuel H. Field & Bonita J. Iritani & Fredrick S. Odongo & Daniel Kwaro & Stuart Rennie, 2022. "Does Venue of HIV Testing and Results Disclosure in the Context of a Research Study Affect Adolescent Health and Behavior? Results from a Study in Western Kenya," IJERPH, MDPI, vol. 19(6), pages 1-15, March.
    10. Pamela Bachanas & Mary Grace Alwano & Refeletswe Lebelonyane & Lisa Block & Stephanie Behel & Elliot Raizes & Gene Ussery & Huisheng Wang & Faith Ussery & Molly Pretorius Holme & Connie Sexton & Sherr, 2021. "Finding, treating and retaining persons with HIV in a high HIV prevalence and high treatment coverage country: Results from the Botswana Combination Prevention Project," PLOS ONE, Public Library of Science, vol. 16(4), pages 1-14, April.
    11. Joseph Kamanga & Kayla Stankevitz & Andres Martinez & Robert Chiegil & Lameck Nyirenda & Florence Mulenga & Mario Chen & Mulamuli Mpofu & Sam Lubasi & Moses Bateganya, 2021. "Improved HIV case finding among key populations after differentiated data driven community testing approaches in Zambia," PLOS ONE, Public Library of Science, vol. 16(12), pages 1-13, December.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0219826. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.