CROI 2020 Abstract eBook

Abstract eBook

Poster Abstracts

to care and followed up longitudinally. The case surveillance system captures core demographic, epidemiological and service delivery variables. Paper forms and electronic Case Report Forms (eCRF) hosted within the District Health Information System 2 are used to collect these data variables and for storage. The data were exported to Microsoft Excel and STATA statistical package for analysis. Results: Between October and June 2019, 2598 index cases were registered. Of them, 1792, 624, 156 and 26 Index cases were registered from voluntary counseling and testing, provider initiated testing, antenatal clinic and maternity respectively. From the total index cases, 2316 (89.1%) provided partner’s information for the last 12 months with an index case to partner ratio of 1.5 (3844 elicited partners, mean=1.5). Of those, 3344 (86.9%) partners were successfully contacted; 37%were reached through client referral, 32% by provider and 31% by contract referral. Of all partners contacted, 2833 (84.7%) came to the health facility for HIV testing and 118 (4.2%) were already aware of their HIV+ status. Of 2715 who previously self-reported testing negative or never tested, 2442(89.9%) were tested for HIV. Of those 2442, 218 (8.9%) tested HIV+ and 203 (93.1%) of those were linked to treatment. Compared to client referral, provider testing was more effective in identifying people with HIV, odds ratio 1.86 (95% confidence interval, CI, 1.02-3.38). Conclusion: The High level of partner testing through Active case finding highlight the substantial impact that active case finding can have on Rwanda’s pathway towards HIV epidemic control. 943 EXPANDING HIV IDENTIFICATION BY TESTING CONTACTS OF DECEASED HIV INDEX CLIENTS Neema Makyao 1 , Angela Ramadhani 1 , Peris L.Urasa 1 , Leonard Subi 2 , Neusta Kwesigabo 1 , Prosper F. Njau 1 1 National AIDS Control Program, Dar es Salaam, Tanzania, United Republic of, 2 Tanzania Ministry of Health, Community Development, Gender, Elderly, and Children, Dar es Salaam, Tanzania, United Republic of Tanzania Background: Tanzania is at 61% and among countries that lag behind on UNAIDS first 95 target, which requires 90% of all people living with HIV (PLHIV) to know their status. Index HIV testing is an optimized HIV testing modality, aimed at accelerating progress towards UNAIDS first 90, which targets identification of undiagnosed HIV infected individuals through testing of sexual contacts, and biological children of index PLHIV. There is, however, a missed opportunity in reaching contacts of deceased HIV clients. In October 2018, THPS extended Index Testing Initiative (TEI) was designed, an innovation where sexual contacts and biological children of deceased PLHIV were reached and given opportunity to test for HIV infection. Methods: The study aimed to to expand HIV positive clients’ identification, through testing index contacts of deceased HIV positive clientsDetails of deceased HIV clients, at 24 supported health facilities in Kigoma (15) and Pwani (9) regions were accessed through CTC2 cards and HIV status of sexual partners, treatment supporter’s mobile number and home address documented. Peer educators contacted sexual partners through mobile phone and arranged home visits for HIV testing sensitization and education. HIV testing was performed by healthcare providers. Results: A total of 906 archived files of deceased HIV clients were reviewed and a list of 530 sexual partners extracted, among whom 168 (32%) had known HIV status. The remaining 362 sexual partners had unknown HIV status, 233 (64%) were reached for HIV testing whereby 45 (19%) were newly identified HIV positive. All 45 positives were linked to HIV care and treatment. Conclusion: There is an opportunity to expand HIV identification from deceased HIV clients. Correct contact information documentation improves tracing of index contacts. We recommend scale up of this initiative to reach potential groups of HIV infected individuals such as contacts of deceased clients. 944 NONENROLLMENT AMONG HIV-POSITIVE KENYAN FEMALE INDEX CLIENTS IN PARTNER NOTIFICATION Beatrice Wamuti 1 , Monisha Sharma 1 , Emily Kemunto 2 , George Otieno 2 , Christopher Obong'O 2 , Judith Onsomu 2 , Cecilia Audo 2 , Dominic Mutai 2 , Paul Macharia 3 , Rose Bosire 1 , Sarah Masyuko 3 , Kariithi Edward 2 , Mary Mugambi 3 , Carey Farquhar 1 1 University of Washington, Seattle, WA, USA, 2 PATH, Seattle, WA, USA, 3 Ministry of Health, Nairobi, Kenya Background: Assisted partner services (aPS) involves notification and HIV testing for sexual partners of persons diagnosed HIV-positive (index cases).

Since the impact of aPS is contingent on high acceptance rates, we sought to assess the characteristics and reasons for non-enrollment of female index cases in an ongoing implementation science study of aPS scale-up in western Kenya. Methods: We analyzed data from HIV-positive females (age ≥15 years) who were offered aPS in 31 health facilities in western Kenya fromMay 2018 to August 2019. Socio-demographics of females were compared by aPS enrollment status (accepted, refused, ineligible) and reasons for refusal and ineligibility were tabulated. We used multivariate binomial regression to assess the association between demographics and aPS refusal. Results: Across facilities, 28,031 females received HIV testing and 1,050 tested HIV-positive (yield: 3.8%). Overall, 839 females accepted aPS (80%), 59 refused (6%) and 152 were ineligible (14%). APS acceptance did not differ by age, testing history or testing type (provider vs. client initiated). Females who refused aPS were more likely to have completed secondary school (adjusted relative risk (aRR) 2.03, 95% CI: 1.13 - 2.82) and be divorced/separated (aRR: 3.09, 95% CI 1.39 - 6.86) or single (2.66 95% CI:1.31 - 5.42) compared to married/cohabitating. The most common reason for refusing aPS was not feeling emotionally ready (31%) and claiming not to have any sexual partners (15%). Common reasons for aPS ineligibility included fear or risk of intimate partner violence (9%), previous HIV diagnosis (9%) or not enough time for aPS provision (3%). Conclusion: APS has high acceptability among HIV-positive females regardless of age or testing history. More counseling may be needed to increase uptake among females with higher education and those who are separated or single. Follow-up for females who are not emotionally ready for aPS or had insufficient time for aPS in their clinic visit can improve program coverage. 945 SCALING UP ASSISTED PARTNER NOTIFICATION SERVICES IN WESTERN KENYA Sarah Masyuko 1 , Monisha Sharma 2 , Emily Kemunto 3 , George Otieno 4 , Christopher Obong'o 3 , Judith Onsomu 3 , Cecilia Audo 3 , Dominic Mutai 4 , Paul Macharia 2 , Beatrice Wamuti 5 , Rose Bosire 6 , Mary Mugambi 1 , Kariithi Edward 4 , Carey Farquhar 2 1 Ministry of Health, Nairobi, Kenya, 2 University of Washington, Seattle, WA, USA, 3 Program for Appropriate Technology in Health, Kisumu, Kenya, 4 Program for Appropriate Technology in Health, Nairobi, Kenya, 5 Kenyatta National Hospital, Nairobi, Kenya, 6 Kenya Medical Research Institute, Nairobi, Kenya Background: Despite high HIV prevalence in Kenya, a substantial proportion of persons living with HIV are not aware of their status. Assisted partner services (aPS), or notification for sexual partners of persons diagnosed HIV-positive, has been shown to increase HIV testing and linkage to care. The World Health Organization (WHO) guidelines recommend scale-up of partner notification services in Africa yet optimal strategies for implementation and aPS performance in a real-world setting are not well-defined. Methods: We report findings from an ongoing implementation science study of aPS in western Kenya. Starting in May 2018, aPS was scaled up by the Ministry of Health in 31 health facilities in Kisumu and Homa Bay counties. Newly diagnosed HIV-positive females ≥15 age years were offered aPS. Those who accepted provided contact information for all male sexual partners in the past 3 years. Healthcare providers notified partners of their potential HIV exposure and provided HIV testing and referral services. Results: FromMay 2018 to mid-September 2019, 29,249 females tested for HIV across facilities and 1,120 were diagnosed HIV-positive (yield: 3.8%). Overall, 899 HIV-positive females were enrolled into aPS (acceptance rate: 80%) and reported an average of 1.7 male partners each (1,497 male partners total). Healthcare workers located and tested 68% of reported male partners, of whom 19%were newly diagnosed HIV-positive. At 6 weeks follow-up, 90% of female index cases and 87% of male partners reported to be on antiretroviral therapy (ART) with few adverse events (2% of female indexes reported relationship dissolution and 0.7% reported intimate partner violence). Conclusion: APS has been safely incorporated into healthcare facilities in western Kenya, with high coverage among female index cases and their male partners and high linkage to ART. APS is a promising strategy to increase HIV testing and linkage and achieve the 95-95-95 targets in Kenya. 946 HIV TESTING AND INTEGRATED HIV/STI/HEPATITIS TESTING, OREGON, 2016

Poster Abstracts

TimW. Menza 1 , Lindsay Hixson 1 , Jeff Capizzi 1 1 Oregon Health Authority, Portland, OR, USA

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