An effective strategy to diagnose HIV infection: findings from a national audit of HIV partner notification outcomes in sexual health and infectious disease clinics in the UK

Rayment, Michael; Curtis, Hilary; Carne, C A; McClean, Hugo; Bell, Gill; Estcourt, Claudia; Roberts, Jonathan; Wilkins, Ed; Estreich, S.; Morris, Georgina; Phattey, Jara; Sullivan, Ann

doi:10.1136/sextrans-2015-052532

Cited by 16 publications

(12 citation statements)

References 6 publications

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“…To address low case finding, strategies such as enhanced (network‐ and performance‐based) peer outreach and using data to better target those at higher risk were proposed to reach and test KP individuals who had not been previously been identified . Programmes also were encouraged to increase index partner testing of KPLHIV of sexual and injection contacts to improve HIV case finding .…”

Section: Discussionmentioning

confidence: 99%

Think global, act local: the experience of Global Fund and PEPFAR joint cascade assessments to harmonize and strengthen key population HIV programmes in eight countries

Lillie

Baer²,

Adams

et al. 2018

J Intern AIDS Soc

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IntroductionThe Global Fund and the US President's Emergency Plan for AIDS Relief (PEPFAR) are major donors to HIV services with key populations (KPs) to achieve the UNAIDS 95‐95‐95 epidemic control goals. The programmes they fund are not always well aligned or coordinated, decreasing their effectiveness. Joint assessments are designed and led by LINKAGES, a project funded by PEPFAR and the US Agency for International Development, to improve coordination among donors and on‐the‐ground implementation of KP HIV programmes. Joint assessments help identify barriers that prevent KPs from accessing interventions along the cascade of prevention, diagnosis and treatment services, and provide recommendations to improve and align programmes. Detailed reports from eight assessments in Malawi, Cameroon, Swaziland, Haiti, Angola, Nepal, Côte d'Ivoire and Botswana were analysed for thematic challenges, and recommendations are presented. The purpose of the paper is to identify commonalities across KP HIV programmes that were found through the assessments so others can learn and then strengthen their programmes to become more effective.DiscussionThe joint cascade assessments offered countries feedback on HIV programme challenges and recommendations for strengthening them at national, subnational and local levels. Shared intervention areas included: (1) robust population size estimates to inform service delivery targets and to budget resources for KP outreach; (2) accessible and KP‐friendly services most relevant to individuals to increase retention in the HIV cascade; (3) decentralized, community‐based services for HIV testing and antiretroviral therapy, and new approaches including self‐testing and PrEP; (4) addressing structural issues of stigma, discrimination and violence against KPs to create a more enabling environment; and (5) more effective and continual tracking of KPs across the cascade, and coordinated, harmonized monitoring tools and reporting systems between donor‐funded and national programmes.ConclusionsThe assessment teams and country stakeholders viewed the assessments as a best practice for coordinating donor‐funded programmes that may overlap or inefficiently serve KPs. Global and national HIV programmes need investments of time, resources, and commitment from stakeholders to continually course‐correct to align and improve programmes for sustained impact. The type of continued partnership demonstrated by the joint assessments is key to address HIV among KPs globally.

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Section: Discussionmentioning

confidence: 99%

Think global, act local: the experience of Global Fund and PEPFAR joint cascade assessments to harmonize and strengthen key population HIV programmes in eight countries

Lillie

Baer²,

Adams

et al. 2018

J Intern AIDS Soc

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“…Assisted partner notification (aPN) services, where providers offer direct assistance to PLHIV to contact their sexual or drug‐injecting partners, are acceptable and highly effective for HIV case‐finding, and facilitating linkage to prevention and care services . Several programmes in concentrated epidemics have successfully implemented aPN methods .…”

Section: Introductionmentioning

confidence: 99%

Community‐led HIV testing services including HIV self‐testing and assisted partner notification services in Vietnam: lessons from a pilot study in a concentrated epidemic setting

Nguyen¹,

Phan²,

Kato³

et al. 2019

J Intern AIDS Soc

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Introduction The HIV epidemic in Vietnam is concentrated in key populations and their partners – people who inject drugs, men who have sex with men, sex workers and partners of people living with HIV. These groups have poor access to and uptake of conventional HIV testing services (HTS). To address this gap, lay provider‐ and self‐testing and assisted partner notification (aPN) were introduced and delivered by the community. We explored the feasibility and effectiveness of implementing aPN as part of community testing services for key populations. Methods Lay provider testing and self‐testing was started in January 2017, and targeted key populations and their partners. Since July 2017, aPN was introduced. HTS was offered at drop‐in houses or coffee shops in Thai Nguyen and Can Tho provinces. All self‐testing was assisted and observed by peer educators. Both in‐person and social network methods were used to mobilize key populations to test for HIV and offer HTS to partners of people living with HIV. Client‐level data, including demographic information and self‐reported risk behaviour, were collected on site by peer educators. Results Between January 2017 and May 2018, 3978 persons from key populations were tested through community‐led HTS; 66.7% were first‐time testers. Of the 3978 clients, 3086 received HTS from a lay provider and 892 self‐tested in the presence of a lay provider. Overall, 245 (6.2% of tested clients) had reactive results, 231 (94.3%) were confirmed to be HIV positive; 215/231 (93.1%) initiated antiretroviral therapy (ART). Of 231 adult HIV‐positive clients, 186 (80.5%) were provided voluntary aPN, and 105 of their partners were contacted and received HTS. The ratio of partners who tested for HIV per index client was 0.56. Forty‐four (41.9%) partners of index clients receiving HTS were diagnosed with HIV, 97.7% initiated ART during the study period. No social harm was identified or reported. Conclusions Including aPN as part of community‐led HTS for key populations and their partners is feasible and effective, particularly for reaching first‐time testers and undiagnosed HIV clients. Scale‐up of aPN within community‐led HTS for key populations is essential for achieving the United Nations 90‐90‐90 targets in Vietnam.

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“…Efforts should be made to pursue partner noti cation to identify people living with HIV infection (18). In Tanzania, 249 partners reaching the facilities, 96% tested for HIV, 148 (61.9%) tested HIV positive, and 104 (70.3%) of partners testing positive were enrolled into ART (19).…”

Section: Introductionmentioning

confidence: 99%

Assessment of the proportion and the factors associated with partner and family based index case HIV testing in Woliso town, Oromia, Ethiopia: a cross-sectional study

Haile¹,

Gulema²

2020

Preprint

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Background: Despite the enormous expansion of HIV testing services (HTS), an estimated 40% of people with HIV infection remain undiagnosed. In Ethiopia, the current working UNAIDS spectrum estimate for PLHIV is 649,264, of the estimated PLHIV, only about 72% know their status. Methods: A facility based cross-sectional study design with internal comparison was conducted among randomly selected 346 people currently on ART in Woliso town. Data entry carried out by Epi Info™ version 7.2.3.1 and analyzed using SPSS version 21.0 statistical software for Windows.Results: Among 345 study participants, 333 (96.5%) with 95 % CI (94.5 - 98.3) of index cases have tested families. The odds of HIV testing were 7.22 times higher among those who disclosed their HIV status (AOR=7.22 95% CI: 1.45, 35.82) compared to those who did not disclosed. Those who have stayed <12 months on ART are 87% less likely to have tested families (AOR=0.13 95% CI: 0.03, 0.63) compared to those who stayed ≥12 months on ART. Conclusion: this study finding shows that higher proportions of families of index cases have been tested for HIV. It also shows that partner and family based index case HIV testing has significant association with HIV status disclosure of index cases and the length of the duration that the index cases stayed on ART. It is essential to sustain the platform of partner and family based index case HIV testing service through strengthening disclosure counselling and assisting HIV status disclosure in health facilities with fully trained provider and qualified health providers. It also suggests the need to focus on those who received ART for less than 12 months duration and communicate on the timing of HIV testing for HIV negative families with ongoing risk of acquiring HIV.

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An effective strategy to diagnose HIV infection: findings from a national audit of HIV partner notification outcomes in sexual health and infectious disease clinics in the UK

Abstract: HIV PN is a highly effective diagnostic strategy. Non-completion of PN thus represents a missed opportunity to diagnose HIV in at-risk populations. Vigorous efforts should be made to pursue PN to identify people living with, and at risk of, HIV infection.

Cited by 16 publications

References 6 publications

Think global, act local: the experience of Global Fund and PEPFAR joint cascade assessments to harmonize and strengthen key population HIV programmes in eight countries

Think global, act local: the experience of Global Fund and PEPFAR joint cascade assessments to harmonize and strengthen key population HIV programmes in eight countries

Community‐led HIV testing services including HIV self‐testing and assisted partner notification services in Vietnam: lessons from a pilot study in a concentrated epidemic setting

Assessment of the proportion and the factors associated with partner and family based index case HIV testing in Woliso town, Oromia, Ethiopia: a cross-sectional study

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