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Demand creation for HIV testing services: A systematic review and meta-analysis

Author

Listed:
  • Anjuli D Wagner
  • Irene N Njuguna
  • Jillian Neary
  • Kendall A Lawley
  • Diana K N Louden
  • Ruchi Tiwari
  • Wenwen Jiang
  • Ngozi Kalu
  • Rachael M Burke
  • Dorothy Mangale
  • Chris Obermeyer
  • Jaclyn N Escudero
  • Michelle A Bulterys
  • Chloe Waters
  • Bastien Mollo
  • Hannah Han
  • Magdalena Barr-DiChiara
  • Rachel Baggaley
  • Muhammad S Jamil
  • Purvi Shah
  • Vincent J Wong
  • Alison L Drake
  • Cheryl C Johnson

Abstract

Background: HIV testing services (HTS) are the first steps in reaching the UNAIDS 95-95-95 goals to achieve and maintain low HIV incidence. Evaluating the effectiveness of different demand creation interventions to increase uptake of efficient and effective HTS is useful to prioritize limited programmatic resources. This review was undertaken to inform World Health Organization (WHO) 2019 HIV testing guidelines and assessed the research question, “Which demand creation strategies are effective for enhancing uptake of HTS?” focused on populations globally. Methods and findings: The following electronic databases were searched through September 28, 2021: PubMed, PsycInfo, Cochrane CENTRAL, CINAHL Complete, Web of Science Core Collection, EMBASE, and Global Health Database; we searched IAS and AIDS conferences. We systematically searched for randomized controlled trials (RCTs) that compared any demand creation intervention (incentives, mobilization, counseling, tailoring, and digital interventions) to either a control or other demand creation intervention and reported HTS uptake. We pooled trials to evaluate categories of demand creation interventions using random-effects models for meta-analysis and assessed study quality with Cochrane’s risk of bias 1 tool. This study was funded by the WHO and registered in Prospero with ID CRD42022296947. Conclusions: Mobilization, couple- and motivation-oriented counseling, peer-led interventions, conditional fixed value incentives, and SMS are high-impact demand creation interventions and should be prioritized for programmatic consideration. Reduced duration counseling and video-based interventions are an efficient and effective alternative to address staffing shortages. Investment in demand creation activities should prioritize those with undiagnosed HIV or ongoing HIV exposure. Selection of demand creation interventions must consider risks and benefits, context-specific factors, feasibility and sustainability, country ownership, and universal health coverage across disease areas. Anjuli Dawn Wagner and colleagues systematically review and meta-analyse data from randomised clinical trials to explore the effectiveness of demand creation interventions for HIV testing services.Why was this study done?: What did the researchers do and find?: What do these findings mean?:

Suggested Citation

  • Anjuli D Wagner & Irene N Njuguna & Jillian Neary & Kendall A Lawley & Diana K N Louden & Ruchi Tiwari & Wenwen Jiang & Ngozi Kalu & Rachael M Burke & Dorothy Mangale & Chris Obermeyer & Jaclyn N Escu, 2023. "Demand creation for HIV testing services: A systematic review and meta-analysis," PLOS Medicine, Public Library of Science, vol. 20(3), pages 1-41, March.
    • Handle: RePEc:plo:pmed00:1004169
    DOI: 10.1371/journal.pmed.1004169
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    References listed on IDEAS

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    1. Juan Carlos C Montoy & William H Dow & Beth C Kaplan, 2018. "Cash incentives versus defaults for HIV testing: A randomized clinical trial," PLOS ONE, Public Library of Science, vol. 13(7), pages 1-10, July.
    2. Gabriel Chamie & Dalsone Kwarisiima & Alex Ndyabakira & Kara Marson & Carol S Camlin & Diane V Havlir & Moses R Kamya & Harsha Thirumurthy, 2021. "Financial incentives and deposit contracts to promote HIV retesting in Uganda: A randomized trial," PLOS Medicine, Public Library of Science, vol. 18(5), pages 1-13, May.
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    Cited by:

    1. Purity Gakii Micheni & Professor Lucy Gitonga PhD & Dr. Josphat Kiongo PhD & Hellen N. Micheni, 2025. "Health Care Workers Practices That Influence Adherence to National HIV and AIDS Guidelines for Adults at Chuka and Chogoria Hospital," American Journal of Health, Medicine and Nursing Practice, AJPO Journals Limited, vol. 11(2), pages 24-41.

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