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. 2023 May 29;24(1):1482.
doi: 10.4102/sajhivmed.v24i1.1482. eCollection 2023.

Outcomes of a model for re-testing HIV-negative index contacts in Sedibeng, South Africa

Ditebogo L Phiri  1   2 , Kate Rees  2   3 , Natasha Davies  4
Affiliations

Outcomes of a model for re-testing HIV-negative index contacts in Sedibeng, South Africa

Ditebogo L Phiri et al. South Afr J HIV Med. .

Abstract

Background: Index contact testing is an HIV case-finding approach that elicits sexual or needle-sharing partners, as well as biological children, of people living with HIV (PLHIV) and offers them HIV testing services.

Objectives: We aim to describe the results of an innovative project in Sedibeng District that expanded index testing by retesting previously negative contacts and incorporating status-neutral testing.

Method: We used registers to identify people who previously tested HIV-negative through index testing from March 2019 to September 2021. The individuals were telephonically traced and offered HIV retesting. Data were collected on a weekly basis using REDCap®. We monitored the number of individuals called, those who came back for retest, and their HIV results.

Results: Fifteen counsellors contacted 968 people over 12 months. Forty-eight percent (462 out of 968) of those called returned for testing. Of those, 121 (26%) tested positive. Overall, 66 out of 276 (24%) men with HIV and 55 out of 186 (30%) women with HIV were identified and linked to antiretroviral treatment (ART). Fifty-seven percent (194 out of 341) of clients who tested HIV-negative were offered, and 124 out of 194 (64%) initiated, pre-exposure prophylaxis (PrEP). All individuals who retested HIV-positive had a new diagnosis; none reported having had another positive test result between the original negative and the positive retest.

Conclusion: Revisiting index clients with a previous negative HIV test result is worthwhile, creating an opportunity to identify undiagnosed PLHIV and high-risk people for PrEP. The high positivity rate highlights the importance of providing a sero-neutral approach to HIV testing, including integrating prevention messaging and linkage to PrEP services.

Keywords: HIV case-finding; REDCAP; U=U; index contacts testing; pre-exposure prophylaxis; routine data; sero-different couples; seroconversion.

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Conflict of interest statement

The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article.

Figures

FIGURE 1
FIGURE 1
Index contact recall weekly process flow, Sedibeng District.
See this image and copyright information in PMC

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References

    1. South Africa National Department of Health . National consolidated guidelines for the management of HIV in adults, children and infants and prevention of mother to child transmission. Pretoria: DoH; 2020.
    1. PEPFAR . Country operational plan PEPFAR South Africa 2022 strategic direction summary [homepage on the Internet]. Washington, DC; 2022. [cited 2022 Dec 12]. Available from: https://www.state.gov/2022-country-operational-plan-guidance/
    1. Mwango LK, Stafford KA, Blanco NC, et al. . Index and targeted community-based testing to optimize HIV case finding and ART linkage among men in Zambia [homepage on the Internet]. 2020. [cited 2023 Mar 28]. Available 28 March 2023, from: http://onlinelibrary.wiley.com/doi/10.1002/jia2.25520/full - DOI - PMC - PubMed
    1. Mahachi N, Muchedzi A, Tafuma TA, et al. . Sustained high HIV case-finding through index testing and partner notification services: Experiences from three provinces in Zimbabwe [homepage on the Internet]. 2019. [cited 2023 Apr 04]. Available from: http://onlinelibrary.wiley.com/doi/10.1002/jia2.25321/full - DOI - PMC - PubMed
    1. Joseph Davey D, KM Wall, C Serrao, et al. . HIV Positivity and referral to treatment following testing of partners and children of PLHIV index patients in public sector facilities in South Africa. J Acquir Immune Defic Syndr (1988). 2019;81(4):365–370. 10.1097/QAI.0000000000002048 - DOI - PMC - PubMed

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