***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 Objective : Due to high rates of undiagnosed and untreated HIV infection in Africa , we compared HIV counseling and testing ( VCT ) uptake among household members of patients receiving antiretroviral therapy . Methods : HIV-infected persons attending an AIDS clinic were r and omized to a home-based or clinic-based antiretroviral therapy program including VCT for household members . Clinic arm participants were given free VCT vouchers and encouraged to invite their household members to the clinic for VCT . Home arm participants were visited , and their household members offered VCT using a 3-test rapid finger-stick testing algorithm .  VCT uptake and HIV prevalence were compared . Findings : Of 7184 household members , 3974 ( 55.3 % ) were female and 4798 ( 66.8 % ) were in the home arm . Home arm household members were more likely to receive VCT  than those from the clinic arm ( 55.8 % vs. 10.9 % , odds ratio : 10.41 , 95 % confidence interval : 7.89 to 13.73 ; P < 0.001 ) , although the proportion of HIV-infected household members was higher in the clinic arm ( 17.3 % vs. 7.1 % , odds ratio : 2.76 , 95 % confidence interval : 1.97 to 3.86 , P < 0.001 ) . HIV prevalence among all household members tested in the home arm was 56 % compared with 27 % in the clinic arm . Of 148 spouses of HIV-infected patients , 69 ( 46.6 % ) were uninfected . Persons aged 15 - 24 were less likely to test than other age groups , and in the home arm , women were more likely to test than men . Conclusions : Home-based VCT for household members of HIV-infected persons was feasible , associated with lower prevalence , higher uptake , and increased identification of HIV-infected persons than clinic-based provision Background There have been few reports of long-term survival of HIV-infected patients on antiretroviral therapy ( ART ) in Africa managed under near normal health service conditions . Methods Participants starting ART between February 2005 and December 2006 in The AIDS Support ( TASO ) clinic in Jinja , Ug and a , were enrolled into a cluster-r and omised trial of home versus facility-based care and followed up to January 2009 . The trial was integrated into normal service delivery with patients managed by TASO staff according to national guidelines . Rates of survival , virological failure , hospital admissions and CD4 count over time were similar between the two arms . Data for the present analysis were analysed using Cox regression analyses . Results 1453 subjects were enrolled with baseline median count of 108 cells/μl . Over time , 119 ( 8 % ) withdrew and 34 ( 2 % ) were lost to follow-up . 197/1453 ( 14 % ) died . Mortality rates ( 95 % CI ) per 100 person-years were 11.8 ( 10.1 , 13.8 ) deaths in the first year and 2.4 ( 1.8 , 3.2 ) deaths thereafter . The one , two and three year survival probabilities ( 95 % CI ) were 0.89 ( 0.87 - 0.91 ) , 0.86 ( 0.84 - 0.88 ) and 0.85 ( 0.83 - 0.87 ) respectively . Low baseline CD4 count , low body weight , advanced clinical condition ( WHO stages III and IV ) , not being on cotrimoxazole prophylaxis and male gender were associated independently with increased mortality . Tuberculosis , cryptococcal meningitis and diarrhoeal disease were estimated to be major causes of death . Conclusion Practical and affordable interventions are needed to enable earlier initiation of ART and to reduce mortality risk among those who present late for treatment with advanced disease Background The objective of the study was to evaluate the effect of a written invitation letter to the spouses of new antenatal clinic attendees on attendance by couples and on male partner  acceptance of HIV testing at subsequent antenatal clinic visits . Methods The trial was conducted with 1060 new attendees from October 2009 to February 2010 in an antenatal clinic at Mbale Regional Referral Hospital , Mbale District , eastern Ug and a. The intervention comprised an invitation letter delivered to the spouses of new antenatal attendees , while the  control group received an information letter , a leaflet , concerning antenatal care . The primary outcome measure was the proportion of pregnant women who attended antenatal care with their male partners  during a follow-up period of four weeks . Eligible pregnant women were r and omly assigned to the intervention or non-intervention groups using a r and omization sequence , which was computer generated utilizing a r and om sequence generator ( R AND OM ORG ) that employed a simple r and omization procedure . Respondents , health workers and research assistants were masked to group assignments . Results The trial was completed with 530 women enrolled in each group . Participants were analyzed as originally assigned ( intention to treat ) . For the primary outcome , the percentage of trial participants who attended the antenatal clinic with their partners were 16.2 % ( 86/530 ) and 14.2 % ( 75/530 ) in the intervention and non-intervention groups , respectively ( OR = 1.2 ; 95 % CI : 0.8 , 1.6 ) . For the secondary outcome , most of the 161 male partners  attended the antenatal clinic ; 82 of 86 ( 95 % ) in the intervention group and 68 of 75 ( 91 % ) in the non-intervention group were tested for HIV ( OR = 2.1 ; 95 % CI : 0.6 to 7.5 ) . Conclusions The effect of the intervention and the control on couple antenatal attendance was similar . In addition , the trial demonstrated that a simple intervention , such as a letter to the spouse , could increase couple antenatal clinic attendance by 10 % . Significantly , the majority of male partners who attended the antenatal clinic accepted HIV testing . Therefore , to further evaluate this simple and cost-effective intervention method , adequately powered studies are required to assess its effectiveness in increasing partner participation in antenatal clinics and the programme for prevention of mother to child transmission of HIV.Trial Registration Clinical Trials.gov Identifier : NCT01144234 Low male participation in voluntary counselling and testing ( VCT ) services at antenatal clinics ( ANCs ) represents a lost HIV-prevention opportunity . A three-arm r and omized controlled trial ( RCT ) was conducted that offered VCT at a neighbourhood health centre , bar or church to the male partners of pregnant women attending a maternity unit in Kinshasa , Democratic Republic of Congo ( DRC ) . The primary outcome was the proportion of male participation at VCT ;  secondary outcomes were uptake of couple counselling and determinants of male and couple participation .  From a total of 2706 women included in the study , 591 male partners ( 22 % ) attended one of the three venues . Male participation was significantly higher in bars ( 26 % , P < 0.001 ) , and higher but not statistically significant in church-based VCT ( 21 % , P = 0.163 ) compared with health centre VCT ( 18 % ) . Male participation in VCT  associated with ANCs was higher in non-health service setting s , particularly in bars . A combination of different strategies rather than single targeted interventions will be needed to increase  VCT uptake in male partners of women seeking VCT at ANCs Objective : Increased male participation in antenatal care and uptake of couple voluntary counselling and testing ( VCT ) for HIV could reduce horizontal and vertical HIV transmission in sub-Saharan Africa . Methods : R and omized controlled trial to compare pregnant women 's acceptance of written invitations for VCT and pregnancy information sessions ( PISs ) – the control group – for their male sexual partners ( MSPs ) and uptake of VCT  among these pregnancy partners in Khayelitsha , South Africa . Results : All women in the study accepted the invitation letters and agreed to invite their pregnancy partners to attend for VCT or PIS as requested . Thirty-five percent ( 175 of 500 ) pregnant women given VCT invitations for their partners brought their MSPs for antenatal clinic visit compared with 26 % ( 129 of 500 ) given PIS invitations [ relative risk ( RR ) 1.36 , 95 % confidence interval ( CI ) 1.12–1.64 , P = 0.002 ] . Thirty-two percent ( 161 of 500 ) MSPs in the VCT arm underwent HIV testing compared with 11 % ( 57/500 ) in the PIS arm ( RR 2.82 , 95 % CI 2.14–3.72 , P < 0.001 ) . The proportions of women and men reporting unprotected sex during the pregnancy were lower in the MSP VCT arm than in the MSP PIS arm – 25 versus 81 % ( RR 0.30 , 95 % CI 0.22–0.42 , P < 0.001 ) and 26 versus 76 % ( RR 0.34 , 95 % CI 0.25–0.47 , P < 0.001 ) , respectively . No differences were seen in intimate partner violence . Conclusion : Providing pregnant women with a written invitation for their partners increased male participation in antenatal care and uptake of  couple VCT  in a township in Cape Town , South Africa where community sensitization was conducted and antiretroviral therapy was available Objective : To determine whether implementation of provider-initiated human immunodeficiency virus ( HIV ) counseling would increase the proportion of tuberculosis ( TB ) patients who received HIV counseling and testing . Design : Cluster-r and omized trial with clinic as the unit of r and omization . Setting : Twenty , medium-sized primary care TB clinics in the Nelson M and ela Metropolitan Municipality , Port Elizabeth , Eastern Cape Province , South Africa . Subjects : A total of 754 adults ( 18 years and older ) newly registered as TB patients in the 20 study clinics . Intervention : Implementation of provider-initiated HIV counseling and testing . Main Outcome Measures : Percentage of TB patients HIV counseled and tested . Secondary : Percentage of patients with HIV test positive , and percentage of those who received cotrimoxazole and who were referred for HIV care . Results : A total of 754 adults newly registered as TB patients were enrolled . In clinics r and omly assigned to implement provider-initiated HIV counseling and testing , 20.7 % ( 73/352 ) patients were counseled versus 7.7 % ( 31/402 ) in the control clinics ( P = 0.011 ) , and 20.2 % ( n = 71 ) versus 6.5 % ( n = 26 ) underwent HIV testing ( P = 0.009 ) . Of those patients counseled , 97 % in the intervention clinics accepted testing versus 79 % in control clinics ( P = 0.12 ) . The proportion of patients identified as HIV infected in intervention clinics was 8.5 % versus 2.5 % in control clinics ( P = 0.044 ) . Fewer than 40 % of patients with a positive HIV test were prescribed cotrimoxazole 
    Output:
    
Mobile-testing had a significant effect on HIV-testing compared with st and ard voluntary counselling and testing .
Home-based testing also had a significant effect , but reached smaller numbers of men than mobile-testing .
DISCUSSION Interventions to encourage HIV-testing can increase men 's levels of HIV testing .
Community-based programmes in particular had a large effect on population levels of HIV-testing .