Barriers To Optimal Index Testing for Improved HIV Positivity Yield in Lusaka Urban District of Zambia - A Research Protocol

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DOI: 10.21522/TIJPH.2013.09.02.Art009

Authors : Cibangu Katamba

Abstract:

As the proportions of people living with HIV who do not know their HIV infection status decrease, reaching the last mile of those who are asymptomatic and not in contact with the health care system becomes a critical challenge. This project will use an explanatory sequential mixed-methods study design. It will be conducted in three high-volume health facilities in Matero sub-district 3 of Lusaka district in Zambia over a period of one year. The specific objectives are: to understand the perceived facilitators and barriers to HIV partner testing from the perspective of the health-care provider; to propose interventions necessary for improved HIV case finding; and to reach high risk but hard to reach populations in HIV programs such as middle-aged men and adolescent girls and young women (AGYW). The permission to conduct this study will be obtained from the Lusaka provincial health office before its commencement. Ethical clearance will be sought and obtained from the ERES Converge research ethical committee. The authority to conduct research will be sought from the National Health Research Authority. The expected main findings following the address of the identified challenges are: increased number of recipients of care indexed, increased index contact elicitation ration from 1:1 to at least 1:2, improved rate of contacts tested on time, improved HIV case finding through index testing, and overall, increased HIV index testing positivity rate from below 25% (baseline) to above 40% (at the end of the project).

References:

[1] UNAIDS, Joint United Nations Programme on HIV/AIDS, Global AIDS Update 2018. Miles to go: Closing Gaps; Breaking Barriers; righting injustices. https://www.unaids.org/en/resources/documents/2018/global-aids-update.

[2] Zambia Population-Based HIV Impact Assessment Zamphia 2015–2016.

https://phia.icap.columbia.edu/wp-content/uploads/ZAMBIA-Factsheet.FIN_.pdf.

[3] AVERT, Global information and education on HIV and AIDS, HIV and AIDS in Zambia, 2018. https://www.avert.org/professionals/hiv-around-world/sub-saharan-africa/zambia.

[4] M. Katbi, A. Adegboye, A. Adedoyin, F. Yunusa, et al. Effect of clients Strategic Index Case Testing on community-based detection of HIV infections (STRICT study).

https://www.ncbi.nlm.nih.gov/pubmed/term=Effect+of+clients+Strategic+Index+Case+Testing+on+community-based+detection+of+HIV+infections+(STRICT+study).

[5] Partner and Family based Index case testing. A Standard Operating Procedure (SOP). https://static1.squarespace.com/static/5a29b53af9a61e9d04a1cb10/t/5bcf3f4324a69482bb98d34f/1540308814679/Index+Testing+SOP+slides+_v12+October+10+2018.pdf.

[6] Marya Plotkin; Catherine Kahabuka; Alice Christensen; Denice Ochola. Outcomes and Experiences of Men and Women with Partner Notification for HIV Testing in Tanzania: Results from a Mixed Method Study. Open access publication, published online on 31 October 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5758678/.

[7] Gari S, Malungo JRS, Martin-Hilber A, Musheke M, Schindler C, Merten S. HIV testing and tolerance to gender based violence: a cross-sectional study in Zambia. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3749220/.

[8] World Health Organization. HIV status disclosure to sexual partners: rates, barriers, and outcomes for women. Geneva; 2003.

http://apps.who.int/iris/bitstream/10665/42717/1/9241590734.pdf.

[9] Obermeyer C, Osborn M. The utilization of testing and counseling for HIV: a review of the social and behavioural evidence.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1994175/.

[10] K. Selvaraj, A. M. V. Kumar, S. Chawla, K. S. Shringarpure, et al. Are partners of HIV-infected people being tested for HIV? A mixed-methods research from Gujarat, India. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5526482/.

[11] Skovdal M, Campbell C, Madanhire C, Mupambireyi Z, Nyamukapa C, Gregson S. Masculinity as a barrier to men's use of HIV services
in Zimbabwe. Global Health. 2011; 7:13. Published 2011 May 15. doi:10.1186/1744-8603-7-13
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3107786/.

[12] Obermeyer CM, Osborn M. The utilization of testing and counseling for HIV: a review of the social and behavioral evidence. Am J Public Health. 2007;97(10):1762–1774. doi:10.2105/AJPH.2006.096263 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1994175/.

[13] Obermeyer CM, Sankara A, Bastien V, Parsons M. Gender and HIV testing in Burkina Faso: an exploratory study. Soc Sci Med. 2009;69(6):877–884. doi:10.1016/j.socscimed.2009.07.003 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4260152/.

[14] Brown LB, Miller WC, Kamanga G, et al. HIV partner notification is effective and feasible in sub-Saharan Africa: opportunities for HIV treatment and prevention. J Acquir Immune Defic Syndr. 2011;56(5):437–442. doi:10.1097/qai.0b013e318202bf7d https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3207356/.

[15] Plotkin M, Kahabuka C, Christensen A, et al. Outcomes and Experiences of Men and Women with Partner Notification for HIV Testing in Tanzania: Results from a Mixed Method Study. AIDS Behav. 2018;22(1):102–116. doi:10.1007/s10461-017-1936-x. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5758678/.