Provider-Initiated HIV Testing and Counseling in Low- and Middle-Income Countries: A Systematic Review

Provider-initiated HIV testing and counseling (PITC) has expanded since 2007 WHO guidelines were established. We conducted a systematic review of PITC in low- and middle-income countries. Peer-reviewed studies were included if they measured pre-post or multi-arm outcomes. Two coders abstracted data...

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Bibliographic Details
Published in:AIDS and behavior 2013-06, Vol.17 (5), p.1571-1590
Main Authors: Kennedy, Caitlin E., Fonner, Virginia A., Sweat, Michael D., Okero, F. Amolo, Baggaley, Rachel, O’Reilly, Kevin R.
Format: Article
Language:English
Subjects:
Acquired Immune Deficiency Syndrome
AIDS Serodiagnosis - methods
AIDS Serodiagnosis - statistics & numerical data
Asia
Condoms
Counseling
Counselling
Developing Countries
Disease transmission
Family Planning
Female
Health Planning
Health Psychology
HIV
HIV Infections - diagnosis
HIV Infections - prevention & control
Human immunodeficiency virus
Humans
Infectious Diseases
Intervention
Male
Medical screening
Medical tests
Medicine
Medicine & Public Health
Mycobacterium
Original Paper
Public Health
Sexually transmitted diseases
STD
Sub Saharan Africa
Systematic review
Testing
Tuberculosis
Uptake
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Summary:Provider-initiated HIV testing and counseling (PITC) has expanded since 2007 WHO guidelines were established. We conducted a systematic review of PITC in low- and middle-income countries. Peer-reviewed studies were included if they measured pre-post or multi-arm outcomes. Two coders abstracted data using standardized forms. Nineteen studies were included, all from sub-Saharan Africa (N = 15) or Asia (N = 4). Studies were conducted in clinics for antenatal/family planning/child health (N = 12), tuberculosis (N = 4), outpatient (N = 1), sexually transmitted diseases (N = 1), and methadone maintenance (N = 1). HIV testing uptake increased after PITC. Condom use also increased following PITC in most studies; nevirapine uptake and other outcomes were mixed. Few negative outcomes were identified. Findings support PITC as an important intervention to increase HIV testing. PITC’s impact on other outcomes is mixed, but does not appear to be worse than voluntary counseling and testing. PITC should continue to be expanded and rigorously evaluated across settings and outcomes.
ISSN:1090-7165
1573-3254
DOI:10.1007/s10461-012-0241-y