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
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...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2024-12-01
|
| Series: | Journal of the International AIDS Society |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/jia2.26391 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1846108072540372992 |
|---|---|
| author | Harriet S. Jones Fortunate Machingura Leah Gaihai Memory Makamba Thomas Chanyowedza Panganai Masvikeni Edward Matsikire Primrose Matambanadzo Sithembile Musemburi Phillip N. Chida Jeffery Dirawo Owen Mugurungi Sarah Bourdin Bernadette Hensen Lucy Platt Gary Murphy James R. Hargreaves Frances M. Cowan Brian Rice |
| author_facet | Harriet S. Jones Fortunate Machingura Leah Gaihai Memory Makamba Thomas Chanyowedza Panganai Masvikeni Edward Matsikire Primrose Matambanadzo Sithembile Musemburi Phillip N. Chida Jeffery Dirawo Owen Mugurungi Sarah Bourdin Bernadette Hensen Lucy Platt Gary Murphy James R. Hargreaves Frances M. Cowan Brian Rice |
| author_sort | Harriet S. Jones |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-686e190983b345bea4e9d69b957f0f17 |
| institution | Kabale University |
| issn | 1758-2652 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the International AIDS Society |
| spelling | doaj-art-686e190983b345bea4e9d69b957f0f172024-12-26T04:04:34ZengWileyJournal of the International AIDS Society1758-26522024-12-012712n/an/a10.1002/jia2.26391Recent 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 ZimbabweHarriet S. Jones0Fortunate Machingura1Leah Gaihai2Memory Makamba3Thomas Chanyowedza4Panganai Masvikeni5Edward Matsikire6Primrose Matambanadzo7Sithembile Musemburi8Phillip N. Chida9Jeffery Dirawo10Owen Mugurungi11Sarah Bourdin12Bernadette Hensen13Lucy Platt14Gary Murphy15James R. Hargreaves16Frances M. Cowan17Brian Rice18Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine London UKCentre for Sexual Health and HIV/AIDS Research (CeSHHAR) Zimbabwe Harare ZimbabweCentre for Sexual Health and HIV/AIDS Research (CeSHHAR) Zimbabwe Harare ZimbabweCentre for Sexual Health and HIV/AIDS Research (CeSHHAR) Zimbabwe Harare ZimbabweCentre for Sexual Health and HIV/AIDS Research (CeSHHAR) Zimbabwe Harare ZimbabweCentre for Sexual Health and HIV/AIDS Research (CeSHHAR) Zimbabwe Harare ZimbabweCentre for Sexual Health and HIV/AIDS Research (CeSHHAR) Zimbabwe Harare ZimbabweCentre for Sexual Health and HIV/AIDS Research (CeSHHAR) Zimbabwe Harare ZimbabweCentre for Sexual Health and HIV/AIDS Research (CeSHHAR) Zimbabwe Harare ZimbabweCentre for Sexual Health and HIV/AIDS Research (CeSHHAR) Zimbabwe Harare ZimbabweCentre for Sexual Health and HIV/AIDS Research (CeSHHAR) Zimbabwe Harare ZimbabweAIDS and TB Directorate, Ministry of Health and Child Care Harare ZimbabweFaculty of Public Health and Policy, London School of Hygiene & Tropical Medicine London UKSexual and Reproductive Health Group, Department of Public Health, Institute of Tropical Medicine Antwerp BelgiumFaculty of Public Health and Policy, London School of Hygiene & Tropical Medicine London UKIndependent Consultant London UKFaculty of Public Health and Policy, London School of Hygiene & Tropical Medicine London UKCentre for Sexual Health and HIV/AIDS Research (CeSHHAR) Zimbabwe Harare ZimbabweSheffield Centre for Health and Related Research (SCHARR); School of Medicine and Population Health University of Sheffield Sheffield UKAbstract 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.https://doi.org/10.1002/jia2.26391AfricaHIV epidemiologyHIV preventionpublic healthrecency assayssex workers |
| spellingShingle | Harriet S. Jones Fortunate Machingura Leah Gaihai Memory Makamba Thomas Chanyowedza Panganai Masvikeni Edward Matsikire Primrose Matambanadzo Sithembile Musemburi Phillip N. Chida Jeffery Dirawo Owen Mugurungi Sarah Bourdin Bernadette Hensen Lucy Platt Gary Murphy James R. Hargreaves Frances M. Cowan Brian Rice 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 Africa HIV epidemiology HIV prevention public health recency assays sex workers |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | Africa HIV epidemiology HIV prevention public health recency assays sex workers |
| url | https://doi.org/10.1002/jia2.26391 |
| work_keys_str_mv | AT harrietsjones recentinfectiontestingtoinformhivpreventionresponsesandsurveillanceinaprogrammecontextlessonsfromimplementationwithinanationallyscaledfemalesexworkerprogrammeinzimbabwe AT fortunatemachingura recentinfectiontestingtoinformhivpreventionresponsesandsurveillanceinaprogrammecontextlessonsfromimplementationwithinanationallyscaledfemalesexworkerprogrammeinzimbabwe AT leahgaihai recentinfectiontestingtoinformhivpreventionresponsesandsurveillanceinaprogrammecontextlessonsfromimplementationwithinanationallyscaledfemalesexworkerprogrammeinzimbabwe AT memorymakamba recentinfectiontestingtoinformhivpreventionresponsesandsurveillanceinaprogrammecontextlessonsfromimplementationwithinanationallyscaledfemalesexworkerprogrammeinzimbabwe AT thomaschanyowedza recentinfectiontestingtoinformhivpreventionresponsesandsurveillanceinaprogrammecontextlessonsfromimplementationwithinanationallyscaledfemalesexworkerprogrammeinzimbabwe AT panganaimasvikeni recentinfectiontestingtoinformhivpreventionresponsesandsurveillanceinaprogrammecontextlessonsfromimplementationwithinanationallyscaledfemalesexworkerprogrammeinzimbabwe AT edwardmatsikire recentinfectiontestingtoinformhivpreventionresponsesandsurveillanceinaprogrammecontextlessonsfromimplementationwithinanationallyscaledfemalesexworkerprogrammeinzimbabwe AT primrosematambanadzo recentinfectiontestingtoinformhivpreventionresponsesandsurveillanceinaprogrammecontextlessonsfromimplementationwithinanationallyscaledfemalesexworkerprogrammeinzimbabwe AT sithembilemusemburi recentinfectiontestingtoinformhivpreventionresponsesandsurveillanceinaprogrammecontextlessonsfromimplementationwithinanationallyscaledfemalesexworkerprogrammeinzimbabwe AT phillipnchida recentinfectiontestingtoinformhivpreventionresponsesandsurveillanceinaprogrammecontextlessonsfromimplementationwithinanationallyscaledfemalesexworkerprogrammeinzimbabwe AT jefferydirawo recentinfectiontestingtoinformhivpreventionresponsesandsurveillanceinaprogrammecontextlessonsfromimplementationwithinanationallyscaledfemalesexworkerprogrammeinzimbabwe AT owenmugurungi recentinfectiontestingtoinformhivpreventionresponsesandsurveillanceinaprogrammecontextlessonsfromimplementationwithinanationallyscaledfemalesexworkerprogrammeinzimbabwe AT sarahbourdin recentinfectiontestingtoinformhivpreventionresponsesandsurveillanceinaprogrammecontextlessonsfromimplementationwithinanationallyscaledfemalesexworkerprogrammeinzimbabwe AT bernadettehensen recentinfectiontestingtoinformhivpreventionresponsesandsurveillanceinaprogrammecontextlessonsfromimplementationwithinanationallyscaledfemalesexworkerprogrammeinzimbabwe AT lucyplatt recentinfectiontestingtoinformhivpreventionresponsesandsurveillanceinaprogrammecontextlessonsfromimplementationwithinanationallyscaledfemalesexworkerprogrammeinzimbabwe AT garymurphy recentinfectiontestingtoinformhivpreventionresponsesandsurveillanceinaprogrammecontextlessonsfromimplementationwithinanationallyscaledfemalesexworkerprogrammeinzimbabwe AT jamesrhargreaves recentinfectiontestingtoinformhivpreventionresponsesandsurveillanceinaprogrammecontextlessonsfromimplementationwithinanationallyscaledfemalesexworkerprogrammeinzimbabwe AT francesmcowan recentinfectiontestingtoinformhivpreventionresponsesandsurveillanceinaprogrammecontextlessonsfromimplementationwithinanationallyscaledfemalesexworkerprogrammeinzimbabwe AT brianrice recentinfectiontestingtoinformhivpreventionresponsesandsurveillanceinaprogrammecontextlessonsfromimplementationwithinanationallyscaledfemalesexworkerprogrammeinzimbabwe |