Home Based HIV Testing and Counseling in Suba District, Kenya Ulo Benson Suba District (2007) Hard to reach resource poor setting Population – 200,000 (33,000 households) Mainly fishing community Generalized epidemic; HIV prevalence – 30% (National 7.4%) HBCT done MOPDD0203

Household Education Decline Testing Risk reduction VCT VMMC PMTCT Negative Clients Positive Clients Individual session Accept Testing Risk reduction Support groups VMMC PMTCT Follow up Referral Referra Household Education Household Education Individual session Household Education Individual session Household Education Accept Testing Individual session Household Education Accept Testing Individual session Household Education Decline Testing Accept Testing Individual session Household Education Decline Testing Accept Testing Individual session Household Education Referral Decline Testing Accept Testing Individual session Household Education Risk reduction VCT VMMC PMTCT Referral Decline Testing Accept Testing Individual session Household Education Follow up Risk reduction VCT VMMC PMTCT Referral Decline Testing Accept Testing Individual session Household Education Follow up Risk reduction VCT VMMC PMTCT Referral Decline Testing Accept Testing Individual session Household Education Follow up Risk reduction VCT VMMC PMTCT Referral Decline Testing Accept Testing Individual session Household Education Referral Follow up Risk reduction VCT VMMC PMTCT Referral Decline Testing Accept Testing Individual session Household Education Positive Clients Referral Follow up Risk reduction VCT VMMC PMTCT Referral Decline Testing Accept Testing Individual session Household Education Positive Clients Referral Follow up Risk reduction VCT VMMC PMTCT Referral Decline Testing Accept Testing Individual session Household Education Risk reduction Support groups VMMC PMTCT Positive Clients Referral Follow up Risk reduction VCT VMMC PMTCT Referral Decline Testing Accept Testing Individual session Risk reduction Support groups VMMC PMTCT Positive Clients Referral Follow up Risk reduction VCT VMMC PMTCT Referral Decline Testing Accept Testing Individual session Referral Risk reduction Support groups VMMC PMTCT Positive Clients Referral Follow up Risk reduction VCT VMMC PMTCT Referral Decline Testing Accept Testing Individual session Negative Clients Referral Risk reduction Support groups VMMC PMTCT Positive Clients Referral Follow up Risk reduction VCT VMMC PMTCT Referral Decline Testing Accept Testing Individual session Individual session Individual session Accept Testing Individual session Accept Testing Individual session Negative Clients Accept Testing Individual session Referral Negative Clients Accept Testing Individual session Referral Negative Clients Accept Testing Individual session Referral Negative Clients Accept Testing Individual session Risk reduction Support groups VMMC PMTCT Referral Negative Clients Accept Testing Individual session Risk reduction Support groups VMMC PMTCT Referral Negative Clients Accept Testing Individual session Follow up Risk reduction Support groups VMMC PMTCT Referral Negative Clients Accept Testing Individual session Follow up Risk reduction Support groups VMMC PMTCT Referral Negative Clients Accept Testing Individual session Follow up Risk reduction Support groups VMMC PMTCT Referral Negative Clients Accept Testing Individual session Referral Follow up Risk reduction Support groups VMMC PMTCT Referral Negative Clients Accept Testing Individual session Positive Clients Referral Follow up Risk reduction Support groups VMMC PMTCT Referral Negative Clients Accept Testing Individual session Positive Clients Referral Follow up Risk reduction Support groups VMMC PMTCT Referral Negative Clients Accept Testing Individual session Risk reduction VCT VMMC PMTCT Positive Clients Referral Follow up Risk reduction Support groups VMMC PMTCT Referral Negative Clients Accept Testing Individual session Risk reduction VCT VMMC PMTCT Positive Clients Referral Follow up Risk reduction Support groups VMMC PMTCT Referral Negative Clients Accept Testing Individual session Referral Risk reduction VCT VMMC PMTCT Positive Clients Referral Risk reduction Support groups VMMC PMTCT Referral Negative Clients Accept Testing Individual session Decline Testing Risk reduction VCT VMMC PMTCT Positive Clients Referral Risk reduction Support groups VMMC PMTCT Referral Negative Clients Accept Testing Individual session Decline Testing Risk reduction VCT VMMC PMTCT Positive Clients Referral CCC/PMTCT Support group Risk reduction Support groups VCT/VMMC PMTCT Referral Negative Clients Accept Testing Counseling session Household Education Community Mobilization METHODS - HBHCT Model Volunteers

Results and Conclusion Results 84% of targeted households accepted HBTC 68,315 (10,790 couples), (57% F; 43% M) males tested 60.3% – first time testers. HIV prevalence was 10.5% (F % ; M - 8.2%). 9% of the 10,790 couples were discordant. Conclusion Rapid HTC scale up for all age groups Identification of discordant couples Potential to increase enrollment into care early

Thank you Suba district – Vision 2030 Typical Island in Suba district (2011)