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The cascade of care following community-based detection of HIV in sub-Saharan Africa – A systematic review with 90-90-90 targets in sight

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  • Kalpana Sabapathy
  • Bernadette Hensen
  • Olivia Varsaneux
  • Sian Floyd
  • Sarah Fidler
  • Richard Hayes

Abstract

Introduction: We aimed to establish how effective community-based HIV testing services (HTS), including home and community location based (non-health facility) HIV testing services (HB-/CLB-HTS), are in improving care in sub-Saharan Africa (SSA), with a view to achieving the 90-90-90 targets. Methods: We conducted a systematic review of published literature from 2007–17 which reported on the proportion of individuals who link-to-care and/or initiate ART after detection with HIV through community-based testing. A meta-analysis was deemed inappropriate due to heterogeneity in reporting. Results and discussion: Twenty-five care cascades from 6 SSA countries were examined in the final review– 15 HB-HTS, 8 CLB-HTS, 2 combined HB-/CLB-HTS. Proportions linked-to-care over 1–12 months ranged from 14–96% for HB-HTS and 10–79% for CLB-HTS, with most studies reporting outcomes over short periods (3 months). Fewer studies reported ART-related outcomes following community-based testing and most of these studies included

Suggested Citation

  • Kalpana Sabapathy & Bernadette Hensen & Olivia Varsaneux & Sian Floyd & Sarah Fidler & Richard Hayes, 2018. "The cascade of care following community-based detection of HIV in sub-Saharan Africa – A systematic review with 90-90-90 targets in sight," PLOS ONE, Public Library of Science, vol. 13(7), pages 1-22, July.
    • Handle: RePEc:plo:pone00:0200737
    DOI: 10.1371/journal.pone.0200737
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