Universal HIV Testing and Treatment (UTT) Integrated with Chronic Disease Screening and Treatment: the SEARCH study

Abstract

Purpose of review: The growing burden of untreated chronic disease among persons with HIV (PWH) threatens to reverse heath gains from ART expansion. Universal test and treat (UTT)'s population-based approach provides opportunity to jointly identify and treat HIV and other chronic diseases. This review's purpose is to describe SEARCH UTT study's integrated disease strategy and related approaches in Sub-Saharan Africa.

Recent findings: In SEARCH, 97% of adults were HIV tested, 85% were screened for hypertension, and 79% for diabetes at health fairs after 2 years, for an additional $1.16/person. After 3 years, population-level hypertension control was 26% higher in intervention versus control communities. Other mobile/home-based multi-disease screening approaches have proven successful, but data on multi-disease care delivery are extremely limited and show little effect on clinical outcomes. Integration of chronic disease into HIV in the UTT era is feasible and can achieve population level effects; however, optimization and implementation remain a huge unmet need.

Keywords: HIV testing; HIV treatment; Hypertension; Non-communicable disease; Treatment as prevention.

Conflict of interest statement

Conflict of Interest

Gabriel Chamie, Matthew Hickey, Dalsone Kwarisiima, James Ayieko, and Moses Kamya declare that they have no conflict of interest. Diane Havlir has received nonfinancial support from Gilead Sciences.

Figures

Figure.

Community health campaign participant flow for universal, integrated HIV and multi-disease screening, referral, and linkage.