Phiri Ditebogo L, Rees Kate, Davies Natasha
HIV Testing Services, Faculty of Public Health, Johannesburg, South Africa.
Anova Health Institute, Johannesburg, South Africa.
South Afr J HIV Med. 2023 May 29;24(1):1482. doi: 10.4102/sajhivmed.v24i1.1482. eCollection 2023.
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.
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.
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.
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.
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.
索引接触者检测是一种艾滋病毒病例发现方法，可找出艾滋病毒感染者（PLHIV）的性伴侣、共用针头伙伴以及亲生孩子，并为他们提供艾滋病毒检测服务。
我们旨在描述塞迪本格区一个创新项目的结果，该项目通过对之前检测结果为阴性的接触者进行重新检测并纳入无状态检测来扩大索引检测。
我们使用登记册来识别2019年3月至2021年9月期间通过索引检测先前艾滋病毒检测呈阴性的人员。通过电话追踪这些人并提供艾滋病毒重新检测。每周使用REDCap收集数据。我们监测了被联系的人数、回来重新检测的人数及其艾滋病毒检测结果。
15名咨询师在12个月内联系了968人。其中48%（968人中的462人）被联系者回来进行检测。在这些人中，121人（26%）检测呈阳性。总体而言，276名艾滋病毒阳性男性中有66人（24%）以及186名艾滋病毒阳性女性中有55人（30%）被识别并与抗逆转录病毒治疗（ART）建立联系。艾滋病毒检测呈阴性的客户中有57%（341人中的194人）被提供了暴露前预防（PrEP），其中194人中有124人（64%）开始接受PrEP。所有重新检测艾滋病毒呈阳性的个体均为新诊断；没有人报告在最初检测为阴性和重新检测为阳性之间有过另一次阳性检测结果。
对之前艾滋病毒检测结果为阴性的索引客户进行回访是值得的，这为识别未确诊的艾滋病毒感染者和PrEP的高危人群创造了机会。高阳性率凸显了提供艾滋病毒无状态检测方法的重要性，包括整合预防信息以及与PrEP服务建立联系。
