Improving identification of new HIV positive children and adults: the role of community structures

The USAID Applying Science to Strengthen and Improve Systems project (ASSIST), in collaboration with orphans and vulnerable children (OVC) implementing partner, Uganda Private Health Support Program (UPHS), set out to improve case finding of HIV-infected children and their caregivers using a quality improvement (QI) approach in the central region of Uganda.

Stigma and discrimination associated with HIV positive results are known challenges to accessing HIV counseling and testing services (UNAIDS 2015). There is an opportunity of using community based organizations that have structures in some communities to address the challenges. ASSIST, UPHS and Fishing Community Health Initiative therefore considered strengthening the capacity of community structures to identify more positives in the community with the help of the new HIV positive case-finding criteria tool to identify HIV positive suspects and refer them for HIV testing and ensure enrolment for children who are not in HIV care.

The use of the criteria has improved identification of new HIV positive individuals. In 18 communities, a total of 144/200 HIV positive individuals have been identified, most of whom were children 0-14 (80) and 64 were individuals 15 and older. Children and direct beneficiaries 15 and older with known HIV status improved to 80% (806/1000) and 81% (621/762) respectively. Of the HIV positives, 100% (128/128) of children and 98% (368/374) of beneficiaries 15 and older are enrolled in HIV care.

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ASSIST publication
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