Institute of Human Virology Nigeria, Pent House, Maina Court, Plot 252, Herbert Macaulay Way, Central Business District, P.O. Box 9396, Garki, Abuja, Nigeria.
Institute of Human Virology Nigeria, Pent House, Maina Court, Plot 252, Herbert Macaulay Way, Central Business District, P.O. Box 9396, Garki, Abuja, Nigeria.
Int J Infect Dis. 2018 Sep;74:54-60. doi: 10.1016/j.ijid.2018.06.018. Epub 2018 Jul 7.
Strategic Index Case Testing (STRICT), a form of partner notification service, was initiated to track, identify and notify sexual partners of people living with HIV (Index clients) with the sole aim of testing them to determine their HIV status and linking clients who are positive to Anti-Retroviral Therapy (ART). This research analyzed the HIV sero-prevalence among sexual partners of HIV positive clients using STRICT and determines the role of STRICT in HIV epidemic control.
This is a non-control Interventional study that determined the impact of Strategic Index Case Testing (STRICT) on detecting previously undiagnosed HIV infections among sexual partners of positive index clients. This study was conducted in seven Local Government Areas (LGAs) of Karu, Nasarawa, Lafia, Doma, AMAC, Bwari, and Ushongo. These LGAs were selected for HIV epidemic control due to projected high prevalence of HIV from previous program level data. HTS was offered to sexual partners of index PLHIV from facility and community within the LGAs. Index clients were PLHIV diagnosed from outreaches, hot spots set up in strategic places and Provider Initiated Testing and Counseling (PITC) in comprehensive and primary health care facilities. Newly diagnosed PLHIV and those already enrolled and commenced on ART from October 2015 to July 2016 were identified from source registers. These index clients were counseled on how to notify their sexual partners about their HIV status and on bringing them for HIV Testing and Counseling (HTS). Those unable to do so after a given period of time were assisted by health workers in informing their various sexual partners based on the confidential agreement and informed consent signed by the Index clients.
A total of 1277 index cases were counseled and interviewed with 879 index clients agreeing to disclosure, giving a disclosure rate of 68.3%. We identified 888 sexual partners from the interviews and traced 870 (97.9%) sexual contacts. A total of 741 (85.2%) of 870 sexual contacts traced were tested for HIV, out of which 378 (51%) tested positive using an HIV rapid test kit, and this was statistically significant at P Value=0.0254. A total of 348 (92.1%) out of 378 HIV positive sexual partners were immediately commenced on ART using the recommended UNAIDS Test and Treat approach to HIV epidemic control.
STRICT identifies the need for reaching out to sexual partners of index clients and providing them with HIV Testing Services (HTS) as they belong to a high risk priority population and also linking them to care and treatment. This group of people must be reached with HTS strategies in order to end the HIV epidemic as evidenced by high sero-prevalence of 51% among them.
策略性索引病例检测（STRICT）是一种伴侣通知服务形式，旨在追踪、识别和通知艾滋病毒感染者（索引客户）的性伴侣，目的是对他们进行检测，以确定其艾滋病毒状况，并将阳性客户与抗逆转录病毒治疗（ART）联系起来。本研究分析了利用 STRICT 对艾滋病毒阳性客户的性伴侣进行艾滋病毒血清阳性率检测的情况，并确定了 STRICT 在艾滋病毒流行控制中的作用。
这是一项非对照干预研究，旨在确定战略索引病例检测（STRICT）在检测艾滋病毒阳性索引客户的性伴侣中以前未确诊的艾滋病毒感染方面的影响。这项研究在卡鲁、纳萨拉瓦、拉菲亚、多马、AMAC、博瓦里和乌松戈的七个地方政府区域（LGAs）进行。这些 LGA 因之前的项目水平数据显示艾滋病毒流行率预计较高，因此被选中用于艾滋病毒流行控制。在 LGA 内的医疗机构和社区向性伴侣提供艾滋病毒检测服务。索引客户是在外地、战略地点设立的热点以及综合和初级保健设施中的提供者发起的检测和咨询（PITC）中诊断出的艾滋病毒感染者。从 2015 年 10 月至 2016 年 7 月，从来源登记册中确定了新诊断的艾滋病毒感染者和已经登记并开始接受抗逆转录病毒治疗（ART）的患者。对这些索引客户进行了有关如何通知其性伴侣其艾滋病毒状况以及进行艾滋病毒检测和咨询（HTS）的咨询。在给定的一段时间后，无法这样做的人将由卫生工作者根据索引客户签署的保密协议和知情同意书，协助通知他们的各种性伴侣。
共对 1277 例索引病例进行了咨询和访谈，其中 879 例索引客户同意披露，披露率为 68.3%。我们从访谈中识别了 888 名性伴侣，并追踪到 870 名（97.9%）性接触者。总共对 870 名追踪到的性接触者中的 741 名（85.2%）进行了艾滋病毒检测，其中 378 名（51%）使用艾滋病毒快速检测试剂盒检测呈阳性，这在 P 值=0.0254 时具有统计学意义。在 378 名艾滋病毒阳性性伴侣中，共有 348 名（92.1%）立即按照推荐的艾滋病病毒检测和治疗方法开始接受抗逆转录病毒治疗，以控制艾滋病病毒流行。
STRICT 确定需要与索引客户的性伴侣接触，并为他们提供艾滋病毒检测服务（HTS），因为他们属于高风险优先人群，同时将他们与护理和治疗联系起来。这组人必须通过 HTS 策略来接触，以便根据他们 51%的高血清阳性率来结束艾滋病毒流行。
