Mozambique HIV Testing and Counseling (HTC) Linkages Assessment
The Mozambique HIV Testing and Counseling (HTC) ‘Linkages Assessment’ Study was proposed by the United States Agency for International Development (USAID) and the Ministry of Health (MOH) in Mozambique to generate knowledge about HIV testing and care services in Mozambique. It specifically focuses on the extent to which patients tested HIV+ enroll in HIV care, and why. The study will utilize a mixed methods approach to assess these linkages at 8 HIV care and treatment health facilities (sites) in Manica and Sofala Provinces, Central Mozambique, for approximately six months between 2013 and 2014. USAID is funding the research and Health Alliance International (HAI) is the implementation institution in partnership with the University of Washington (UW), the Mozambique MOH Center for Operations Research in Beira (Centro de Investigação Operacional de Beira-CIOB) and Population Council.
By employing a mixed methods approach the study design aims to capture current the situation of HIV testing and linkages to care, by qualitatively exploring issues related to these linkages, with a focus on how the system is working (or not working) for patients, assess patients and stakeholders (community leaders, community healthcare workers, health facility directors) perspectives regarding healthcare system, community and household factors that influence linkages to care. The qualitative component will utilize in-depth interviews (IDIs) and focus group discussions (FGDs) to engage HIV+ patients, community leaders, health care workers (HCWs) and health facility (HF) directors, and estimates to include 300-340 research participants. The quantitative component will include abstraction of data from clinic registry books for HIV testing, HIV care and treatment and de-identified patient charts. The total sample for this component is estimated at about 800.
The study has been approved by the relevant Institutional Review Boards (IRB) in Mozambique and in the United States. Stringent ethical safeguards will be implemented to ensure anonymity of participants and confidentiality of information collected by the study at all stages (including data collection, analysis and reporting). In this regard, data collectors will be trained on ethical procedures applicable to research involving human subjects and the study Principal Investigators will closely monitor respect for these procedures. The study will provide recommendations on improving linkages to HIV care in Mozambique, for consideration by the MOH and USAID in Mozambique. This is also an opportunity to further strengthen the operations research capacity of the CIOB for future implementation of similar studies.