Tools
Tools
Jones, Harriet, Machingura, Fortunate, Gaihai, Leah, Makamba, Memory, Chanyowedza, Thomas, Masvikeni, Panganai, Matsikire, Edward, Matambanadzo, Primrose, Musemburi, Sithembile, Chida, Phillip N., Dirawo, Jeffery, Mugurungi, Owen, Bourdin, Sarah, Hensen, Bernadette, Platt, Lucy, Murphy, Gary, Hargreaves, James R., Cowan, Frances 
ORCID: https://orcid.org/0000-0003-3087-4422 and Rice, Brian
(2024)
'Recent infection testing to inform HIV prevention responses and surveillance in a programme context: lessons from implementation within a nationally scaled female sex worker programme in Zimbabwe'. Journal of the International AIDS Society, Vol 27, Issue 12, e26391.
|
Text
jia2.26391.pdf - Published Version Available under License Creative Commons Attribution. Download (317kB) | Preview |
Abstract
Introduction
In the context of key population HIV testing programmes, identifying new HIV acquisitions, tracking incidence, and responding with prevention and treatment interventions will be critical for achieving HIV epidemic control. Laboratory tests for recently acquired HIV used as part of a “recent infection testing algorithm” (RITA), offer a potential tool to support this work. We implemented a RITA for female sex workers (FSWs) in Zimbabwe to explore opportunities and programmatic benefits.
Methods
Between October 2021 and January 2023, recency testing was offered to FSWs attending the Centre for Sexual Health and HIV/AIDS Research (CeSHHAR) Zimbabwe's key populations programme. Dried blood spot (DBS) samples were taken at 86 clinic sites across 10 provinces and Laboratory LAg Avidity and viral load testing conducted. RITA results were analysed and linked to programme data to explore geographical differences and calculate HIV incidence. We describe concurrent efforts in HIV testing for social (social network testing [SNT]) and sexual (index case testing [ICT]) contacts of those testing HIV positive.
Results
Among 24,976 FSWs tested at programme sites, 9.5% (2363/24,976) were confirmed HIV positive. We enrolled 55.5% (1311/2363) of eligible HIV-positive FSWs to our study, of whom 11.7% (153/1311) were identified as having recently acquired HIV. It took a median of 37 days (IQR 20–67) for samples to be processed. Enrolment rates varied between provinces but the proportion of recently acquired HIV was similar (range: 18.4% to 4.0%). Overall HIV incidence was 3.4 (95% CI 2.7−4.0) per 100py. Where results could be linked to routinely collected data, we found no evidence of a difference in test-positivity between the ICT and SNT contacts of those with recently acquired compared to those with long-term HIV.
Conclusions
Implementation of a RITA was possible within a nationally scaled sex worker programme, and while challenging to implement, can provide an understanding of transmission dynamics and HIV incidence in this context. Sub-optimal recruitment and data linkage limited the interpretation of our findings and opportunities for strategic gains though focusing on HIV prevention efforts.
| Item Type: | Article |
|---|---|
| Subjects: | WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503 Acquired immunodeficiency syndrome. HIV infections |
| Faculty: Department: | Clinical Sciences & International Health > International Public Health Department |
| Digital Object Identifer (DOI): | https://doi.org/10.1002/jia2.26391 |
| SWORD Depositor: | JISC Pubrouter |
| Depositing User: | JISC Pubrouter |
| Date Deposited: | 27 Nov 2024 09:02 |
| Last Modified: | 27 Nov 2024 09:02 |
| URI: | https://archive.lstmed.ac.uk/id/eprint/25683 |
Statistics
Actions (login required)
 |
Edit Item |