CROI 2019 Abstract eBook

Abstract eBook

Poster Abstracts

HIV case identification, the National AIDS Control Programme introduce new strategies including index case testing and partner notification services whereas a trained HTS provider ask people diagnosed with HIV about their sexual partners, drug injecting partners and biological children under 15 years from HIV positive mothers and offered themwith HIV testing. These services are provided in both facility and community setting. The index client is the center and partners and contacts are either by the index or HIV testing providers Methods: In 2017 reviewed its HIV strategic plans for 2018 to 2022, one among the new strategies the Ministry of health adopted is intensification of Index testing Services and Partner Notification services as one of the National strategy for Identification of the PLHIV .To prepare for facility and community index case testing, National guidelines, training package and HTS and Care treatment Monitoring tools were reviewed aiming to integrate index testing into existing health systems. Providers training and monitoring of services was important. Monthly data reviewmeeting and identification of patient files which did not attempt to elicit index and took action . The Home Based Care teams facilitated contacts to come for testing. For convenience purposes, holidays and weekend are used for HIV testing services. Results: From July 2017 to June 2018 total 12,455,037 people were tested among them 332,824 were HIV positive (2.7%). Through index tested 933,073 tested and Index positive 44,44796 (48%). Across the months, HIV positive yield increased with age and across the quarters, suggesting sexual partners testing. At the same time yield increase in lower age bands suggesting increased fidelity of index testing. Two third of the positive partners are from community index testing modality. The positive yield of sexual and needle sharing partners ranges from 10%-13%, while for children ranges from 1%-3%. These are the true index contacts that imply fidelity of the index testing. Conclusion: Index case testing is a promising strategy for identification of New HIV case in Tanzania. 930 HIGH ACCEPTABILITY AND HIV YIELD AMONG PARTNERS OF KEY POPULATIONS IN CENTRAL AMERICA Erickson Noj-Lara 1 , Ricardo Mendizabal-Burastero 1 , Nasim Farach 2 , Carlos Vargas 1 , Mayte Paredes 1 , Rene Gutierrez 1 , Renato Santa-Luce 1 , Sanny Northbrook 2 , for the Central America partner notification group 1 Universidad del Valle de Guatemala, Guatemala City, Guatemala, 2 CDC, Atlanta, GA, USA Background: Since December 2017, key population clinics, known as VICITS, have implemented assisted partner notification and partner testing in Guatemala, Honduras, and Nicaragua. We describe results of the first study utilizing four partner notification strategies to increase the uptake of HIV testing among partners of HIV positive key populations in these countries. Methods: Individuals diagnosed with HIV between December 2017 and July 2018 at 9 participating VICITS clinics were included in the analysis. HIV diagnosis was performed on-site following national HIV testing guidelines. Newly diagnosed HIV individuals were offered partner notification/testing services and the rapid HIV recency assay (Sedia Biosciences) to determine recency of infection. Three assisted partner notification (dual, contract, provider) and one passive strategy (coupon) were offered to newly diagnosed cases. Non- identifiable demographic and behavioral data of index cases and their partners who returned to the clinic for HIV testing were captured using a smartphone based application on site and uploaded into a server daily. All analyses were conducted using STATA 13.0 Results: Of 241 index cases reported during the project period, 109 (45.2%) were from Nicaragua, 106 (44.0%) from Guatemala, and 26 (10.8%) from Honduras. Of these, 149 (61.8%) accepted partner notification and testing services, with higher acceptance seen in Nicaragua (105, 70.6%) followed by Honduras (86, 57.7%) and Guatemala (80, 53.8%) (p<0.01). Eighty (33.2%) index cases tested recent for HIV infection with 47 (58.8%) from Guatemala. A total of 206 sex partners were reported by index cases with 45 (21.8%) already linked to HIV testing services and 61 (29.6%) in care. Provider-assisted notification had the highest number of partners referred (39.3%) followed by contract (24.3%); however the highest proportion of partners returning to the clinic for HIV testing services was by contract (48.0%) followed by dual notification (46.9%). Of 63 partners tested for HIV, 44 (69.8%) tested positive and 8 (23.5%) tested recent for HIV. The highest HIV yield among partners was reported in Nicaragua (87.9%, p<0.01). Conclusion: Partner testing at VICITS clinics was accepted and yielded high HIV positivity among partners in these three countries. Additional strategies are

needed to increase notification and linkage of partners to HIV testing services among key populations.

931 HIV SELF-TEST UPTAKE, YIELD, AND LINKAGE EXPERIENCES AMONG KEY POPULATIONS IN LESOTHO Betty B. Tukei , Kgotso Maile, Charles Chasela, Thapelo Maotoe, Ian Sanne, Sibongile Zungu, Thembisile Xulu, for the EQUIP Health Right to Care, Johannesburg, South Africa Background: Lesotho has one of the world’s highest HIV prevalence of 25.6% with an annual incidence of 1.47%. While Lesotho seems to be on track in achieving the UNAIDS 90-90-90 targets, results from the recent 2017 LePHIA survey revealed that the 1st 90 was lagging behind at 77.2%, despite the increase and rapid scale-up of HTS in the country. Strategies to improve HIV testing uptake and yield are needed. We describe the HIVST uptake, yield and linkage to care among Men who have sex with men (MSM), Female Sex workers (FSW), and Partners of ART, ANC and PNC clients. Methods: The 6-months HIVST project was undertaken in 19 facilities in 3 districts of Maseru, Mafeteng and Mohale’s Hoek targeting key populations, MSM and FSW and their partners, adolescents, partners of ART, ANC and PNC clients, men, migrants and patients who decline conventional HTS. Trained peer educators and HTS counsellors distributed the HIVST kits to eligible clients. The kits were coded and tracked. Clients were encouraged to drop the used kits in a drop-box. Reactive kits were tracked and their users encouraged to come for confirmation and linkage to care. Results: A total of 5394 HIVST kits were distributed over the project period between March 14, 2018 and September 14, 2018. 2244 kits were returned (42% return rate), 2164 returned with results, 80 returned unused, 98/2164 kits were reactive giving a 5% HIV reactivity rate. Females (67) had higher reactivity when compared to males (31). High reactivity was observed among ages 20-39 with the highest among age 25-29 (21). Reactive kits were mostly among decliners (13) followed by migrants (10) and key populations (9). 58/98 clients whose kits were reactive were linked to care (59% linkage rate). Conclusion: HIVST is feasible and generally acceptable in the target population. It should be scaled up as one of the strategies to increase uptake of HIV testing services. Targeted HIVST identifies positives resulting in a high yield. Testing on site is a more effective linkage strategy 932 HIV TESTING RATES AMONG YOUTH AND ADOLESCENTS IN ZAMBIA: WILL HIV SELF-TESTING HELP? Zumbe Sibale 1 , Roma Chilengi 2 , Charles Chasela 1 , Lawrence Mwananyanda 1 , Alumwi Lungu 1 , Shida Nyimbiri 1 , Pedro Pisa 1 , Precious Robinson 1 , Crispin Moyo 1 , Ntombi Sigwebela 1 , Ian Sanne 1 , Thembisile Xulu 1 , for the EQUIP Health 1 Right to Care, Johannesburg, South Africa, 2 Center for Infectious Disease Research in Zambia, Lusaka, Zambia Background: Zambia’s national HIV prevalence is 13.3 % among the reproductive age, and the 16-24 years constitute 33% of people living with HIV. Data from 2014 indicated low testing rates among the 15-24 age group with only 46% and 37% females and males respectively aware of their status. We describe EQUIP HIV testing uptake, knowledge and use of HIV-ST among 16-24 years age group in Ndola and Kabwe districts in Zambia.

Poster Abstracts

CROI 2019 364