Secondary Logo

Institutional members access full text with Ovid®

Acceptability of Home-Based Human Immunodeficiency Virus Testing and Counseling in Low- and Middle-Income Countries

A Systematic Scoping Review

Sekgaila, Moshoeu Prisca, BSc; Kuupiel, Desmond, MPH; Mashamba-Thompson, Tivani P., PhD

doi: 10.1097/POC.0000000000000172
Review Article

Evidence on the acceptability of home-based human immunodeficiency virus testing and counseling (HB-HTC) in low- and middle-income countries (LMICs) remains unclear. We aimed to map evidence on the acceptability of HB-HTC in LMICs. We searched PubMed, EBSCOhost, Google Scholar, Science Direct, World Health Organization library database, and UNAIDS databases from January 2013 to October 2017. Two independent reviewers screened the studies using the eligibility criteria both at abstract and full article screening stages as well as performing quality assessment of the included articles. Discrepancies at the abstract stage were resolved through discussions while a third reviewer was involved at the full article screening stage. The risk of bias of included studies was appraised using Mixed Methods Appraisal Tool version 2011. Thematic content analysis was performed to identify patterns of acceptability of HB-HTC. Of 620 studies identified from the data bases searched, 30 studies were included for data extraction. All included studies were published between 2013 and 2017. Most of the study participants from these included studies were aged between 18 months to 100 years comprising of males (59%) and females (41%). These included studies were conducted in diverse locations including South Africa, Kenya, Lesotho, Malawi, China, Zimbabwe, Zambia, Uganda, and Brazil. Most of the studies were conducted in South Africa (9) and Kenya (7). Evidence showed that HB-HTC was most accepted by the female population compared with males in LMICs. In conclusion, there is adequate evidence on acceptability of HB-HTC in LMICs and linkage to care. This study additionally demonstrates that HB-HTC approach was more acceptable compared with facility-based HTC.

From the Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.

Reprints: Desmond Kuupiel, MPH, Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, 2nd Floor, George Campbell Bldg, Durban, 4001, South Africa. E-mail:

This study was funded by the University of KwaZulu-Natal, College of Health Sciences Research Scholarship.

Ethical approval and consent to participate: This article is a systematic scoping review that relied strictly on existing literature. There were no human participants; hence, ethical approval was not required.

Availability of data and material: The data supporting the conclusions of this article are available through the detailed reference list. No original data sets are presented, owing to the fact that this is a review of already existing literature.

Authors’ contributions: MPS and TPM-T conceptualized and designed the study. DK contributed in the abstract, full article screening and the quality assessment of the included studies. TPM-T contributed in the synthesis of data and the design of the sifting and data extraction processes. TPM-T and DK assisted with the manuscript preparation. MPS prepared the first draft of the study. All authors reviewed draft versions of the manuscript and approved the final version of the manuscript.

The authors declare no conflict of interest.

Supplemental digital contents are available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved