Year 2021
October 2021


Abstract Title
Universal voluntary HIV counseling and testing on psychosocial, behavioral, and clinical epidemiological outcomes: An umbrella review of systematic reviews and meta-analyses



National University of Singapore1

Background & Hypothesis

Despite progress in reducing global HIV-related mortality, HIV incidence is decreasing at a much slower rate. HIV testing remains crucial to the prevention of HIV and its treatment. This review aims to examine the credibility and strength of evidence arising from systematic reviews of psychosocial, behavioral, and clinical epidemiology outcomes associated with different delivery models of voluntary HIV Counseling and Testing (VCT).


An umbrella review was used. Reviews published in English between, 1 January 2000 and 9 February 2021 were considered. PubMed, EMBASE, CINAHL, the Cochrane Library, Web of Science, ProQuest, and Scopus were searched. Two independent reviewers assessed the reviews for methodological quality employing the Joanna Briggs Institute Critical Appraisal Checklist. Evidence from meta-analyses was graded into conclusive, highly suggestive, suggestive, or weak evidence.


A total of 17 review papers were identified, and most of them focused on home-based VCT, community-based VCT, and facility-based VCT. The most studied clinical epidemiology outcomes include uptake rate, acceptance rate/ acceptability, linkage to care and access to treatment. The most reported behavioral outcomes are multiple sex partners and condom use, while the most studied psychosocial outcome is stigmatization. Using the evidence classification criteria, most of the outcomes were presented with suggestive evidence (class III).

Discussion & Conclusion

This umbrella review supported the provision of a combination of these models of VCT and demand generation strategies. However, there is scope for further high-quality reviews and meta-analyses to provide greater insights into the impacts of the different models of VCT on behavioral and psychosocial outcomes in middle-high-income countries.