Home-based counseling and testing (HBCT) is a highly acceptable, scalable, and cost-effective method to increase HIV testing and linkage to care in sub-Sahara Africa. Our team have developed and evaluated a HBCT model that is an effective 'platform'for increasing knowledge of HIV status with linkage to ART through point-of-care CD4 testing, facilitated referrals to HIV care and lay counselor follow-up visits in a high prevalence, rural setting in KwaZulu-Natal (KZN), South Africa. While HBCT is successful, the full potential for testing entire families, including children and adolescents, has not been sufficiently developed or evaluated. Our goal is to develop an intervention for family-based HBCT that provides not only testing, counseling and linkage to care but supports family members with disclosure, fosters inter-generational discussion about HIV, increases support and health promotion among families affected by HIV. We propose to adapt our current HBCT model for working with families and then assess the feasibility and acceptability of this family-based HBCT model. To address our aims we will conduct formative qualitative work with key informants, community stakeholders and focus group discussions with children and adolescents to assess their needs, concerns and perspectives of a family-based HBCT model. This will be followed by a systematic review of the relevant literature regarding testing of families, encouraging family disclosure and family-based interventions. The results from this first phase will be synthesized and used to adapt the current HBCT model for working with families. In the second phase of our work we will pilot the family-based HBCT model with 50 families, and use a combination of quantitative and qualitative methods to evaluate the feasibility and acceptability of the model. As access to HIV/AIDS testing and treatment becomes increasingly available, family-based approaches are a promising platform for bringing prevention, care and treatment services into the home and linking individuals affected by HIV/AIDS to community-based supports and public health services. If the pilot is successful and offered on a larger scale, it could have significant impact on the HIV epidemic in a high prevalence context.

Public Health Relevance

As access to HIV/AIDS testing and treatment becomes increasingly available, family-based approaches are a promising platform for bringing prevention, care and treatment services into the home and linking individuals affected by HIV/AIDS to community-based supports and public health services. We take a successful model of home-based counseling and testing effective in linking adults to testing and treatment, and adapt it for working with working with families. If the pilot is successful and offered on a larger scale, it could have significant impact on the HIV epidemic in a high prevalence context.

Agency
National Institute of Health (NIH)
Type
Exploratory/Developmental Grants (R21)
Project #
1R21MH103066-01
Application #
8659592
Study Section
Behavioral and Social Science Approaches to Preventing HIV/AIDS Study Section (BSPH)
Program Officer
Allison, Susannah
Project Start
Project End
Budget Start
Budget End
Support Year
1
Fiscal Year
2014
Total Cost
Indirect Cost
Name
Human Sciences Research Council
Department
Type
DUNS #
City
Pretoria
State
Country
South Africa
Zip Code
0001