Community-based mobilization to facility-based integrated sexually transmitted infection and HIV testing services, South Africa

In a rural district of the Limpopo province in South Africa, three community-based strategies were employed to mobilize adults with symptoms suggestive of sexually transmitted infection (STI) to access facility-based integrated STI treatment and HIV testing services. An expert outreach team visited the rural primary health centres (PHC) on designated days to offer specialized STI services integrating HIV testing and linkage services. 
 
Community health workers (CHWs) and traditional leaders were trained on the importance of recognising and treating symptoms associated with STIs and were given pamphlets to distribute. These provided information about signs, symptoms and treatment of STIs as well as the importance of HIV testing. In addition, posters with the same information were created and displayed in the PHCs. A rapid HIV test was offered to every client attending the STI clinic, who did not report being HIV positive and on ART. Confirmatory testing and same day ART initiation was available through normal facility procedures. 
 
Impact:  PHC posters emerged as the most effective mobilization strategy (mobilising 57% of clinic attendees) followed by CHW mobilisation (23%). Ninety-seven percent of the STI clinic attendees who did not know their HIV status opted to test, of whom 7% tested positive and initiated ART. In addition, a further six clients who knew their status but had not started ART were identified and successfully linked and initiated on ART. 

Building Blocks

Mobilizing

Testing

Linking