Original Research

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

Ditebogo L. Phiri, Kate Rees, Natasha Davis
Southern African Journal of HIV Medicine | Vol 24, No 1 | a1482 | DOI: https://doi.org/10.4102/sajhivmed.v24i1.1482 | © 2023 Ditebogo L. Phiri, Kate Rees, Natasha Davies | This work is licensed under CC Attribution 4.0
Submitted: 06 February 2023 | Published: 29 May 2023

About the author(s)

Ditebogo L. Phiri, HIV Testing Services, Faculty of Public Health, Johannesburg, South Africa; and, Anova Health Institute, Johannesburg, South Africa
Kate Rees, HIV Testing Services, Faculty of Public Health, Johannesburg, South Africa; and, Anova Health Institute, Johannesburg, South Africa
Natasha Davis, Department of Clinical Care, Faculty of Public Health, Anova Health Institute, Johannesburg, South Africa

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

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

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