Acceptability of Home-Based Human Immunodeficiency Virus Testing and Counseling in Low- and Middle-Income Countries: A Systematic Scoping Review

Abstract 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.