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The 5 years plan to scale up HIV Testing and Counselling Services in Malawi 2006-2010
HIV testing and counselling in Estonian prisons, 2012 to 2013: aims, processes and impacts
The Estonian Ministry of Justice; Prison Department; Rehabilitation Division
European Centre for Disease Prevention and Control
(2014)
CC
Euro Surveillance 2014;19(47):pii=20970, p.31-37
DHS Working Papers No. 110 | Zimbabwe Working Papers No. 11
Tokar A, et al. Sex Transm Infect 2019;95:193–200. doi:10.1136/sextrans-2018-053684
This implementation brief addresses integration of HIV testing services into family planning (FP) services. It is intended as a practical resource for national health programmes seeking to introduce
...
or scale up HIV testing and linkage to HIV prevention, sexually transmitted infection, and antiretroviral therapy services in FP.
This document highlights emerging good practices and country experiences of integrated HIV prevention and testing services within FP and advocates for increased linkage for FP clients to HIV services according to their needs. It also brings together information on models of integration of HIV testing into FP services, programme examples from east and southern Africa and guidance on the implementation monitoring process.
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Despite progress in improving antiretroviral therapy (ART) for people with HIV in Malawi, the burden of HIV infections and HIV treatment outcomes a
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mong key populations is suboptimal. Client-centered differentiated service delivery approaches may facilitate addressing HIV prevention and treatment needs of key populations in Malawi.
Methods
De-identified program data routinely collected as part of the LINKAGES project–Malawi were assembled from October 2017 to September 2019. HIV case finding was compared across different testing modalities for each population. Poisson regression was used to estimate the association between testing modalities and ART initiation.
Results
Of the 18 397 people included in analyses, 10 627 (58%) were female sex workers (FSWs), 2219 (12%) were men who have sex with men (MSM), and 4970 (27%) were clients of FSWs. HIV case finding varied by modality and population, with index testing and enhanced peer outreach demonstrating high yield despite reaching relatively few individuals. FSWs who tested positive through risk network referral testing were more likely to initiate ART within 30 days compared with those who tested positive through clinic-based testing (adjusted risk ratio [aRR], 1.50; 95% CI, 1.23–1.82). For MSM, index testing (aRR, 1.45; 95% CI, 1.06–2.00) and testing through a drop-in center (aRR, 1.82; 95% CI, 1.19–2.78) were associated with 30-day ART initiation.
Conclusions
These data suggest that differentiated HIV testing and outreach approaches tailored to the needs of different key populations may facilitate improved ART initiation in Malawi. Achieving 0 new infections by 2030 suggests the need to adapt treatment strategies given individual and structural barriers to treatment for key populations with HIV in high-prevalence settings.
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HIV testing is an essential health service and a gateway to lifesaving treatment and high-impact strategies that
stop new HIV infections. However,
...
reductions in international funding for global health—including national HIV programs—are causing disruptions in service delivery. This FAQ, developed alongside the 12 May WHO-PSI webinar, offers practical guidance for countries aiming to sustain HIV testing services by implementing cost-effective and differentiated strategies.
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Policy brief.
HIV self-testing (HIVST) is a convenient and confidential option for HIV testing
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. In 2016 WHO recommended HIVST as a safe, accurate and effective way to reach people who may not test otherwise, including people from key populations, men and young people. Lay users can perform HIVST reliably and accurately and achieve performance comparable to that of trained health-care workers.
Globally, many countries have developed HIVST policies, and implementation is growing rapidly. This policy brief highlights new guidance to optimize HIVST implementation, including effective service delivery models, linkage to care and support tools.
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Countries are making progress toward the global goal of 95% of people living with HIV knowing their status by 2025. However, considerable gaps remain in achieving these goals globally. Men in high HIV
...
burden settings and men from key populations in all settings are consistently less likely to know their HIV status than women. Globally, 78% of men ages 15 years and older who are living with HIV are aware of their HIV status, compared with 86% of women with HIV of these ages.
Offering HIV testing services, including HIV self-testing, at formal and informal workplaces has emerged as an effective, acceptable and feasible approach for reaching men. A 2018 World Health Organization (WHO) and International Labour Organization (ILO) policy brief provides key guiding principles for HIVST implementation at workplaces. Building on the 2018 policy brief, this brief captures early experience with HIVST implementation at workplaces and discusses emerging approaches of sustainable financing that can be adapted for HIV self-testing at workplaces.
The primary audiences for this policy brief are ministries of health and labour, national HIV programmes, employers’ organizations, workers’ organizations (labour unions), enterprises, implementing partners, including civil society organizations, and health insurance agencies.
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