HIV testing services
Policy Brief
November 2018
WHO/CDS/HIV/18.48
HIV-1 drug resistance (HIVDR) genotyping is an essential component of the WHO global HIVDR surveillance strategy. Plasma “gold standard” specimen type for HIVDR genotyping, but its use may not be feasible in rural, remote areas in low- and middl
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e-income countries, since preparing and storing it require personnel and laboratory infrastructure that are often lacking. An alternative specimen type is dried blood spots (DBS), which can be made without special laboratory processing. DBS are more easily transported than plasma because they can be shipped at ambient temperature as non-hazardous materials using regular mail or courier services.
3rd edition
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Choko AT et al. Journal of the International AIDS Society 2017, 20:21610 http://www.jiasociety.org/index.php/jias/article/view/21610 | http://dx.doi.org/10.7448/IAS.20.1.21610
HTC COUNTRY REPORT | LESOTHO
Journal of the International AIDS Society, vol. 21 Issue no. 6 e 25142
Weaknesses in care programmes providing anti‐retroviral therapy (ART) persist and are often instigated by late HIV diagnosis and poor linkage to care. We investigated the
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potential for a home‐based counselling and testing (HBCT) campaign to be improved through the optimal timing and enhancement of testing rounds to generate greater health outcomes at minimum cost.
Countries implementing HBCT can reduce costs by optimally timing rounds and generate greater health outcomes through improving linkage, coverage, and retention. Tailoring HBCT campaigns to individual settings can enhance patient outcomes for minimal cost.
https://doi.org/10.1002/jia2.25142
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Social network-based HIV testing is an approach for engaging sexual and drug injecting partners and social contacts of key population members with HIV
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and of those who are HIV-negative and at ongoing risk in voluntary HTS.
By addressing people’s confidentiality concerns and broadening the reach to social contacts, social network-based HIV testing approaches can improve the acceptability of partner services among key populations and so reach more people who may not otherwise test for HIV. WHO now recommends that social network-based HIV testing approaches can be offered for key populations
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Djibuti et al. BMC Public Health (2015) 15:427 DOI 10.1186/s12889-015-1760-z
WHO recommends replacing western blotting and line immunoassays with simpler tests in HIV testing services. These simpler tests include rapid diagnostic tests (RDTs) that can be used at the point-of
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-care, and enzyme immunoassays (EIAs).
These tests get results to the client faster, produce accurate results more often, cost less, can be performed by various cadres of health providers, and can thus facilitate greater access and uptake of HIV testing services among those who need it most.
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Published:December 21, 2018
DOI:https://doi.org/10.1016/S2352-3018(18)30289-3
Live Life positively
Know your HIV status
Accessed: 03.03.2020
Policy Brief, Updated in March 2017
Key messages
• The criminalisation of male-to-male sex heightens HIV and other sexually transmissible infection (STI) risks and vulnerabilities, and hinders access to
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HIV and STI services including HCT.
• Men who have sex with men (MSM) and transgender persons (TG) are not a homogeneous group. As such, a variety of HCT service models are needed to reach the various segments of these populations.
• Stigma and discrimination remain ongoing issues at a number of service points. Targeted training of service providers is therefore needed so that MSM and TG are not discouraged from seeking HCT and high-quality prevention, treatment and care services.
• Specific guidelines on HIV prevention, treatment and care services for MSM or TG help improve the delivery of services.
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Policy Brief
HIV testing services
December 2016
WHO/HIV/2016.21
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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