***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background HIV counselling and testing is a key component of both HIV care and HIV prevention , but uptake is currently low . We investigated the impact of rapid HIV testing at the workplace on uptake of  voluntary counselling and testing ( VCT ) . Methods and Findings The study was a cluster-r and omised trial of two VCT strategies , with business occupational health clinics as the unit of r and omisation . VCT was directly offered to all employees , followed by 2 y of open access to VCT and basic HIV care .  Businesses were r and omised to either on-site rapid HIV testing at their occupational clinic ( 11 businesses ) or to vouchers for off-site VCT at a chain of free-st and ing centres also using rapid tests ( 11 businesses ) . Baseline anonymised HIV serology was requested from all employees . HIV prevalence was 19.8 % and 18.4 % , respectively , at businesses r and omised to on-site and off-site VCT . In total , 1,957 of 3,950 employees at clinics r and omised to on-site testing had VCT ( mean uptake by site 51.1 % ) compared to 586 of 3,532 employees taking vouchers at clinics r and omised to off-site testing ( mean uptake by site 19.2 % ) . The risk ratio for on-site VCT compared to voucher uptake was 2.8 ( 95 % confidence interval 1.8 to 3.8 ) after adjustment for potential confounders . Only 125 employees ( mean uptake by site 4.3 % ) reported using their voucher , so that the true adjusted risk ratio for on-site compared to off-site VCT may have been as high as 12.5 ( 95 % confidence interval 8.2 to 16.8 ) . Conclusions High-impact VCT strategies are urgently needed to maximise HIV prevention and access to care in Africa . VCT at the workplace offers the potential for high uptake when offered on-site and linked to basic HIV care . Convenience and accessibility appear to have critical roles in the acceptability of community-based VCT Background Antiretroviral therapy ( ART ) has been scaled-up rapidly in Africa . Programme reports typically focus on loss to follow-up and mortality among patients receiving ART . However , little is known about linkage and retention in care of individuals prior to starting ART . Methodology Data on adult residents from a periurban community in Cape Town were collected at a primary care clinic and hospital . HIV testing registers , CD4 count results provided by the National Health Laboratory System and ART registers were linked . A r and om sample ( n = 885 ) was drawn from adults testing HIV positive through antenatal care , sexual transmitted disease and voluntary testing and counseling services between January 2004 and March 2009 . All adults ( n = 103 ) testing HIV positive through TB services during the same time period were also included in the study . Linkage to HIV care was defined as attending for a CD4 count measurement within 6 months of HIV diagnosis . Linkage to ART care was defined as initiating ART within 6 months of HIV diagnosis in individuals with a CD4 count ≤200 cells/µl taken within 6 months of HIV diagnosis . Findings Only 62.6 % of individuals attended for a CD4 count measurement within 6 months of testing HIV positive . Individuals testing through sexually transmitted infection services had the best ( 84.1 % ) and individuals testing on their own initiative ( 53.5 % ) the worst linkage to HIV care . One third of individuals with timely CD4 counts were eligible for ART and 66.7 % of those were successfully linked to ART care . Linkage to ART care was highest among antenatal care clients . Among individuals not yet eligible for ART only 46.3 % had a repeat CD4 count . Linkage to HIV care improved in patients tested in more recent calendar period . Conclusion Linkage to HIV and ART care was low in this poor peri-urban community despite free services available within close proximity . More efforts are needed to link VCT scale-up to subsequent care Background Human re source limitations are a challenge to the delivery of antiretroviral therapy ( ART ) in low-re source setting s. We conducted a cluster r and omized trial to assess the effect of community-based peer health workers ( PHW ) on AIDS care of adults in Rakai , Ug and a. Methodology /Principal Findings 15 AIDS clinics were r and omized 2∶1 to receive the PHW intervention ( n = 10 ) or control ( n = 5 ) . PHW tasks included clinic and home-based provision of counseling , clinical , adherence to ART , and social support . Primary outcomes were adherence and cumulative risk of virologic failure ( > 400 copies/mL ) . Secondary outcomes were virologic failure at each 24 week time point up to 192 weeks of ART . Analysis was by intention to treat . From May 2006 to July 2008 , 1336 patients were followed . 444 ( 33 % ) of these patients were already on ART at the start of the study . No significant differences were found in lack of adherence ( < 95 % pill count adherence risk ratio [ RR ] 0.55 , 95 % confidence interval [ CI ] 0.23–1.35 ; < 100 % adherence RR 1.10 , 95 % CI 0.94–1.30 ) , cumulative risk of virologic failure ( RR 0.81 , 95 % CI 0.61–1.08 ) or in shorter-term virologic outcomes ( 24 week virologic failure RR 0.93 , 95 % CI 0.65–1.32 ; 48 week , RR 0.83 , 95 % CI 0.47–1.48 ; 72 week , RR 0.81 , 95 % CI 0.44–1.49 ) . However , virologic failure rates ≥96 weeks into ART were significantly decreased in the intervention arm compared to the control arm ( 96 week failure RR 0.50 , 95 % CI 0.31–0.81 ; 120 week , RR 0.59 , 95 % CI 0.22–1.60 ; 144 week , RR 0.39 , 95 % CI 0.16–0.95 ; 168 week , RR 0.30 , 95 % CI 0.097–0.92 ; 192 week , RR 0.067 , 95 % CI 0.0065–0.71 ) . Conclusions / Significance A PHW intervention was associated with decreased virologic failure rates occurring 96 weeks and longer into ART , but did not affect cumulative risk of virologic failure , adherence measures , or shorter-term virologic outcomes . PHWs may be an effective intervention to sustain long-term ART in low-re source setting s. Trial Registration Clinical Trials.gov Objective : To explore the effects of four types of short message service ( SMS ) plus real-time adherence monitoring on antiretroviral therapy ( ART ) adherence : daily reminders , weekly reminders , reminders triggered after a late or missed dose ( delivered to patients ) , and notifications triggered by sustained adherence lapses ( delivered to patient-nominated social supporters ) . Design : Pilot r and omized controlled trial . Methods : Sixty-three individuals initiating ART received a real-time adherence monitor  and were r and omized ( 1 : 1 : 1 ) : ( 1 ) Scheduled SMS reminders ( daily for 1 month , weekly for 2 months ) , then SMS reminders triggered by a late or missed dose ( no monitoring signal within 2 h of expected dosing ) ; SMS notifications to social supporters for sustained adherence lapses ( no monitoring signal for > 48 h ) added after 3 months . ( 2 ) Triggered SMS reminders starting at enrolment ; SMS notifications to social supporters added after 3 months . ( 3 ) Control : No SMS .  HIV RNA was determined at 9 months . Percentage adherence and adherence lapses were compared by linear generalized estimating equations and Poisson regression , respectively . Results : Median age was 31 years , 65 % were women , and median enrolment CD4 + cell count was 322 cells/&mgr;l 97 % took once daily tenofovir/emtricitabine/efavirenz . Compared to control , adherence was 11.1 % higher ( P = 0.04 ) and more than 48-h lapses were less frequent ( IRR 0.6 , P = 0.02 ) in the scheduled SMS arm . Adherence and more than 48-h lapses were similar in the triggered SMS arm and control . No differences in HIV RNA were seen . Conclusion : Scheduled SMS reminders improved ART in the context of real-time monitoring . Larger studies are needed to determine the impact of triggered reminders and role of social supporters in improving adherence We evaluated a nurse-delivered adherence intervention in a preliminary r and omized controlled trial among 70 HIV-positive out patients initiating antiretroviral therapy ( ART ) in Beijing , China . In both arms , participants received a 30-min educational session , a pillbox , and a referral to a peer support group . In the enhanced arm , participants could choose an electronic reminder device , three sessions of counseling either alone or with a treatment adherence partner , or both reminder and counseling .  Survey assessment s and blood draws occurred at baseline , post-intervention ( 13 weeks ) , and follow-up ( 25 weeks ) . Primary outcomes were 7-day and 30-day adherence assessed by self-report and electronic drug monitoring ( EDM ) , and secondary outcomes were HIV-1 RNA viral load and CD4 count . The intervention was feasible and well received . It led to some improvement in self-reported and EDM-assessed adherence but not the biological outcomes . Providing counseling and facilitating the use of electronic reminders to patients initiating ART merits further investigation as a culturally viable means of promoting adherence in China Paying for performance provides financial rewards to medical care providers for improvements in performance measured by specific utilization and quality of care indicators . In 2006 , Rw and a began a paying for performance scheme to improve health services delivery , including HIV/AIDS services . This study examines the scheme 's impact on individual and couples HIV testing and counseling and using data from a prospect i ve quasi-experimental design . The study finds a positive impact of paying for  performance  with an increase of 6.1 percentage points in the probability of individuals having ever been tested . This positive impact is stronger for married individuals : 10.2 percentage points . The results also indicate larger impacts of paying for performance on the likelihood that the respondent reports both partners have ever been tested , especially among discordant couples ( 14.7 percentage point increase ) in which only one of the partners is HIV positive Objective : To determine which of 3 HIV testing and counseling ( HTC ) models in outpatient departments ( OPDs ) increases HIV testing and entry of newly identified HIV-infected patients into care . Design : R and omized trial of HTC interventions . Methods : Thirty-six OPDs in South Africa , Tanzania , and Ug and a were r and omly assigned to 3 different HTC models : ( A ) health care providers referred  eligible patients ( aged 18–49 , not tested in the past year , not known HIV positive )  to on-site voluntary counseling and testing for HTC offered and provided by voluntary counseling and testing counselors after clinical consultation ; ( B ) health care providers offered and provided HTC to eligible patients during clinical consultation ; and ( C ) nurse or lay counselors offered and provided HTC to eligible patients before clinical consultation . Data were collected from October 2011 to September 2012 . We describe testing eligibility and acceptance , HIV prevalence , and referral and entry into care . Chi-square analyses were conducted to examine differences by model . Results : Of 79,910 patients , 45 % were age eligible and 16,099 ( 45 % ) age eligibles were tested . Ten percent tested HIV positive . Significant differences were found in percent tested by model . The proportion of age eligible patients tested by Project STATUS was highest for model C ( 54.1 % , 95 % confidence interval [ CI ] : 42.4 to 65.9 ) , followed by model A ( 41.7 % , 95 % CI : 30.7 to 52.8 ) , and then model B ( 33.9 % , 95 % CI : 25.7 to 42.1 ) . Of the 1596 newly identified HIV positive patients , 94 % were referred to care ( 96.1 % in model A , 94.7 % in model B , and 94.9 % in model C ) , and 58 % entered on-site care ( 74.4 % in model A , 54.8 % in model B , and 55.6 % in model C ) with no significant differences in referrals or care entry by model . Conclusions : Model C result ed in the highest proportion of all age-eligible patients receiving a test . Although 94 % of STATUS patients with a positive test result were referred to care , only 58 % entered care . We found no differences in patients entering care by HTC model . Routine HTC in OPDs is acceptable to patients and effective for identifying HIV-infected persons , but additional efforts are needed to increase entry to care Background In r and omized controlled trials , short message service ( SMS ) programs have 
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Dimensions that involved conceptualization of the practice s themselves ( e.g. , actor , dose , temporality ) were in general less well specified than consequences ( e.g. , action target and behavioral target ) .
Dissemination of st and ards for reporting intervention characteristics can potentially promote transparency , reproducibility , and scientific accumulation in the area of implementation science to address HIV in low- and middle-income countries