LAUSR

Background A combination of effective and efficient approaches are necessary for scaling up of HIV case-identification, particularly in resource-limited settings. To increase access and coverage, communities need to be linked to facilities via community-based interventions that seek to promote health seeking behavior. This study is a Comparative Analysis of Facility Optimization and Community Based HIV Intervention and compares the effect of community HIV testing services(HTS) to HTS optimization at the facility-level. Methods This is a pre-and post-intervention study conducted in Eleme, one of the priority LGA supported by the USAID funded Strengthening Integrated Delivery of HIV/AIDS Services (SIDHAS) in Rivers State. The pre-intervention phase (PIP1) covers the period November 2015 – October 2016 while the post intervention phase is from November 2016 – Oct 2017. PIP1 involved community entry/mobilization, HIV screening in general population, referrals and linkage to care and treatment services from the community to the facility, while the PIP2 focused on optimization of HIV testing services within the facilities through multipoint/Provider Initiated Testing and Counselling[PITC], targeted testing in the communities, Sexual Network and Genealogy Testing and referrals by escort to Service Delivery Points. We reviewed HTS and ART commencement data to compare differences in positivity yield and linkage between both phases. Results The PIP1 had 107,813 individuals counselled, tested and received result, 1,406 tested HIV Positive and 964 linked to ART while the PIP2 had 24,078 individuals tested, 614 HIV positive and 610 linked to ART. Findings show increase in positivity yield from 1% to 3% and linkage from 87% to 99% in PIP1 and PIP2 respectively. Conclusion Although community outreaches create awareness, a targeted approach to HTS including sexual network/genealogy testing may be a more efficient approach. In addition, PITC in health facilities yields a higher positivity and linkage rates, maximizes use of testing resources by focusing on higher risk populations. Disclosure No significant relationships.