ArticleJournal of the International AIDS Society2020
Index and targeted community-based testing to optimize HIV case finding and ART linkage among men in Zambia.
Article in Journal of the International AIDS Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 2 of them syntheses that pooled it.
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Who cites it
40 citing papers in PubMed, 2 syntheses or guidelines pooled it, 62 citations in OpenAlex.
- Characterizing the HIV care continuum among children and adolescents with HIV in eastern and southern Africa in the era of "Universal Test and Treat": A systematic review and meta-analysis.Journal of the International AIDS Society · 2025Pooled it
- Pooled it
- Effect of index HIV self-testing for sexual partners of clients enrolled in antiretroviral therapy (ART) programs in Malawi: A randomized controlled trial.PLoS medicine · 2023Trial
- Addition of HIV self-test kits to partner notification services to increase HIV testing of male partners of pregnant women in Zambia: two parallel randomised trials.The Lancet. Global health · 2021Trial
- Epidemiological yield and cost-effectiveness of non-targeted community HIV screening in a low-prevalence district: a prospective quasi-experimental study.Frontiers in public health · 2026Article
- The Asanté™ HIV-1 Rapid Recency® Assay is reliable, feasible, and acceptable for use at the point-of-care in Lusaka, Zambia.PloS one · 2026Article
- Enhancing Antiretroviral Therapy Initiation for Hospitalized and Recently Discharged People Living With HIV in Johannesburg, South Africa.Global health, science and practice · 2025Article
- HIV pre-exposure prophylaxis initiation in community safe spaces increases PrEP access among key populations in Zambia.Journal of the International AIDS Society · 2025Article
- Health worker acceptability of an HIV testing mobile health application within a rural Zambian HIV treatment programme.PloS one · 2025Article
- Facilitators and barriers to community-based HIV testing in Guinea: a CFIR-based implementation analysis.Frontiers in public health · 2025Article
- Barriers and facilitators to HIV index contact testing in facility and community settings.Southern African journal of HIV medicine · 2025Article
- Effectiveness of Human Immunodeficiency Virus Index Testing: A Global Scoping Review.International journal of MCH and AIDS · 2025Review
- Innovations in Providing HIV Index Testing Services: A Retrospective Evaluation of Partner Elicitation Models in Southern Nigeria.Global health, science and practice · 2024Article
- Mixed-methods protocol for the WiSSPr study: Women in Sex work, Stigma and psychosocial barriers to Pre-exposure prophylaxis in Zambia.BMJ open · 2024Article
- Hypertension treatment cascade among men and women of reproductive age group in India: analysis of National Family Health Survey-5 (2019-2021).The Lancet regional health. Southeast Asia · 2024Article
- Achieving HIV Epidemic Control and Improving Maternal Healthcare Services with Community-Based HIV Service Delivery in Zambia: Mixed-Methods Assessment of the SMACHT Project.AIDS and behavior · 2023Article
- Strategies to improve antiretroviral therapy (ART) initiation and early engagement among men in sub-Saharan Africa: A scoping review of interventions in the era of universal treatment.Tropical medicine & international health : TM & IH · 2023Article
- Implementation process and challenges of index testing in Côte d'Ivoire from healthcare workers' perspectives.PloS one · 2023Article
- Article
- Outcomes of a model for re-testing HIV-negative index contacts in Sedibeng, South Africa.Southern African journal of HIV medicine · 2023Article
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Authors and funding
17 authors at 4 institutions in 2 countries.
Funding
Abstract
introductionCurrent healthcare systems fail to provide adequate HIV services to men. In Zambia, 25% of adult men living with HIV were unaware of their HIV status in 2018, and 12% of those who were unaware of their HIV statu were not receiving antiretroviral therapy (ART) due to pervasive barriers to HIV testing services (HTS) and linkage to ART. To identify men and key and priority populations living with HIV in Zambia, and link them to care and treatment, we implemented the Community Impact to Reach Key and Underserved Individuals for Treatment and Support (CIRKUITS) project. We present HTS and ART linkage results from the first year of CIRKUITS.
methodsCIRKUITS aimed to reach beneficiaries by training, mentoring, and deploying community health workers to provide index testing services and targeted community HTS. Community leaders and workplace supervisors were engaged to enable workplace HTS for men. To evaluate the effects of these interventions, we collected age- and sex-disaggregated routinely collected programme data for the first 12 months of the project (October 2018 to September 2019) across 37 CIRKUITS-supported facilities in three provinces. We performed descriptive statistics and estimated index cascades for indicators of interest, and used Chi square tests to compare indicators by age, sex, and district strata.
resultsOver 12 months, CIRKUITS tested 38,255 persons for HIV, identifying 10,974 (29%) new people living with HIV, of whom 10,239 (93%) were linked to ART. Among men, CIRKUITS tested 18,336 clients and identified 4458 (24%) as HIV positive, linked 4132 (93%) to ART. Men who tested HIV negative were referred to preventative services. Of the men found HIV positive, and 13.0% were aged 15 to 24 years, 60.3% were aged 25 to 39, 20.9% were aged 40 to 49 and 5.8% were ≥50 years old. Index testing services identified 2186 (49%) of HIV-positive men, with a positivity yield of 40% and linkage of 88%. Targeted community testing modalities accounted for 2272 (51%) of HIV-positive men identified, with positivity yield of 17% and linkage of 97%.
conclusionsIndex testing and targeted community-based HTS are effective strategies to identify men living with HIV in Zambia. Index testing results in higher yield, but lower linkage and fewer absolute men identified compared to targeted community-based HTS.
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