HIV testing services
Policy Brief
December 2016
HOW ICAP IS BUILDING NURSING AND MIDWIFERY CAPACITY AND STRENGTHENING HEALTH SYSTEMS
Thirty-three years after its discovery, the Human Immunodeficiency Virus (HIV), responsible for the AIDS pandemic, remains a major public health problem despite advanced researches providing better diagnostic and therapeutic tools. The virus targets
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especially CD4+ T cells, leading to deficiency of the immune system and altering therefore defense against infections and cancer cells. Antiretroviral
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Journal of the International AIDS Society Vol. 21 (2018) e25133
Many prevention of mother-to-child HIV transmission programmes across Africa initiate HIV-infected (
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HIV positive) pregnant women on lifelong antiretroviral therapy (ART) on the first day of antenatal care (“same-day” initiation). However, there are concerns that same-day initiation may limit patient preparation before starting ART and contribute to subsequent non-adherence, disengagement from care and raised viral load. We examined if same-day initiation was associated with viral suppression and engagement in care during pregnancy.
The data suggest that same-day ART initiation during pregnancy is not associated with lower levels of engagement in care or viral suppression through 12 months post-delivery in this setting, providing reassurance to ART programmes implementing Option B+.
https://doi.org/10.1002/jia2.25133
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(2016) School, supervision and adolescent-sensitive clinic care: combination social protection and reduced unprotected sex among HIV-positive adolescents in South Africa, AIDS and Behaviour, 2016. D
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OI: 10.1007/s10461-016-1539-y
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TB and HIV services offered to a patient at the same time and location (Patient Centered Care)
Despite progress in improving antiretroviral therapy (ART) for people with HIV in Malawi, the burden of HIV infections and HIV treatment outcomes a
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mong key populations is suboptimal. Client-centered differentiated service delivery approaches may facilitate addressing HIV prevention and treatment needs of key populations in Malawi.
Methods
De-identified program data routinely collected as part of the LINKAGES project–Malawi were assembled from October 2017 to September 2019. HIV case finding was compared across different testing modalities for each population. Poisson regression was used to estimate the association between testing modalities and ART initiation.
Results
Of the 18 397 people included in analyses, 10 627 (58%) were female sex workers (FSWs), 2219 (12%) were men who have sex with men (MSM), and 4970 (27%) were clients of FSWs. HIV case finding varied by modality and population, with index testing and enhanced peer outreach demonstrating high yield despite reaching relatively few individuals. FSWs who tested positive through risk network referral testing were more likely to initiate ART within 30 days compared with those who tested positive through clinic-based testing (adjusted risk ratio [aRR], 1.50; 95% CI, 1.23–1.82). For MSM, index testing (aRR, 1.45; 95% CI, 1.06–2.00) and testing through a drop-in center (aRR, 1.82; 95% CI, 1.19–2.78) were associated with 30-day ART initiation.
Conclusions
These data suggest that differentiated HIV testing and outreach approaches tailored to the needs of different key populations may facilitate improved ART initiation in Malawi. Achieving 0 new infections by 2030 suggests the need to adapt treatment strategies given individual and structural barriers to treatment for key populations with HIV in high-prevalence settings.
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HIV testing
Policy Brief
July 2015
Information Note
Advice for countries using or planning
to introduce dual HIV/syphilis RDT in antenatal services and other testing sites.
WHO/RHR/17.01
A treatment literacy guide for pregnant women and mothers living with HIV
Positive Health, Dignity and Prevention for Women and their Babies is intended for use by networks of women living with HIV, women’s groups, peer educators and o
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thers wishing to help guide women living with HIV through the decisions they will need to take before, during and after their pregnancy. It is not intended as a substitute for going to a health facility and seeking information from a healthcare worker.
The facilitator’s manual and flipchart are intended to be used by leaders of support groups, peer educators or lay counsellors to facilitate small groups or community sessions with women living with HIV. Together, they provide accurate and comprehensive information to enable pregnant women and mothers living with HIV to know their rights and make informed decisions about their health, and the health of their baby.
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Technical Brief
HIV patient monitoring and case surveillance
WHO/HIV/2017.11