A Systematic Review of HIV Testing Implementation Strategies in Sub-Saharan African Countries

AIDS Behav. 2022 May;26(5):1660-1671. doi: 10.1007/s10461-021-03518-z. Epub 2021 Nov 19.

Abstract

HIV/AIDS remains a looming presence in public health across the world, particularly in Sub-Saharan Africa. The HIV Care Cascade hinges on testing and knowledge of HIV status. Though significant advances have been made in diagnosing people living with HIV (PLHIV), limitations in understanding which strategies are best suited to certain regions or populations have contributed to the uneven distribution in the success of various HIV testing strategies. Here, we present a conceptual framework that outlines effective HIV testing strategies for four target groups. This framework is based on a systematic literature review of articles published from January 1st, 2008, to December 31st, 2019. The effectiveness of HIV testing strategies depends on various factors including the setting, type of test and service providers. Multiple strategies are needed to reach the UNAIDS target of 95% of individuals knowing their HIV status. Expansion of community-based approaches, self-testing and HIV testing services in antenatal care will further improve the state of HIV testing in Sub-Saharan Africa.

Keywords: HIV testing; Healthcare delivery; Sub-Saharan Africa; Treatment cascade.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Africa South of the Sahara / epidemiology
  • Female
  • HIV Infections* / diagnosis
  • HIV Infections* / epidemiology
  • HIV Infections* / prevention & control
  • HIV Testing
  • Humans
  • Pregnancy