Trial reportJournal of the International AIDS Society2021
A randomized controlled trial evaluating combination detection of HIV in Malawian sexually transmitted infections clinics.
Trial report in Journal of the International AIDS Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The Effectiveness of Contact Tracing to Reduce Transmission of Infectious Diseases During Epidemic or Pandemic Response: Rapid Systematic Review.JMIR public health and surveillance · 2026Pooled it
- Effectiveness of contact tracing in the control of infectious diseases: a systematic review.The Lancet. Public health · 2022Pooled it
- Impact of family networks on uptake of health interventions: evidence from a community-randomized control trial aimed at increasing HIV testing in South Africa.Journal of the International AIDS Society · 2023Trial
- A randomized controlled trial evaluating combination detection of HIV in Malawian sexually transmitted infections clinics.Journal of the International AIDS Society · 2021Trial
- Assisted partner notification as a strategy to enhance Pre-Exposure Prophylaxis (PrEP) screening and uptake - results from a prospective cohort study in Lilongwe, Malawi.BMC health services research · 2025Article
- Article
- Geospatial and phylogenetic clustering of acute and recent HIV infections in Lilongwe, Malawi.PLOS global public health · 2025Article
- Article
- Testing a systematically braided alcohol reduction and HIV status neutral intervention among people receiving STI care in Malawi: study protocol for a pilot hybrid type 1 effectiveness-implementation randomized controlled trial.Frontiers in public health · 2025Article
- Integration of a social network strategy into index testing to increase HIV case finding among Haitian migrants and their descendants in the Dominican Republic.BMC infectious diseases · 2024Article
- Depression, Alcohol Use, and Sexual Behaviors by HIV Infection Stage and Diagnosis Timing Among STI Clinic Patients in Lilongwe, Malawi.AIDS and behavior · 2023Article
- Profile of partners who completed HIV testing and received a new HIV diagnosis in Ukraine's HIV index testing program: a retrospective cohort study to inform program improvement.BMC infectious diseases · 2023Observational
- Article
Corrections and comments
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Authors and funding
15 authors.
Funding
Abstract
introductionHIV diagnosis is the necessary first step towards HIV care initiation, yet many persons living with HIV (PLWH) remain undiagnosed. Employing multiple HIV testing strategies in tandem could increase HIV detection and promote linkage to care. We aimed to assess an intervention to improve HIV detection within socio-sexual networks of PLWH in two sexually transmitted infections (STI) clinics in Lilongwe, Malawi.
methodsWe conducted a randomized controlled trial to evaluate an intervention combining acute HIV infection (AHI) screening, contract partner notification and social contact referral versus the Malawian standard of care: serial rapid serological HIV tests and passive partner referral. Enrolment occurred between 2015 and 2019. HIV-seropositive persons (two positive rapid tests) were randomized to the trial arms and HIV-seronegative (one negative rapid test) and -serodiscordant (one positive test followed by a negative confirmatory test) persons were screened for AHI with HIV RNA testing. Those found to have AHI were offered enrolment into the intervention arm. Our primary outcome of interest was the number of new HIV diagnoses made per index participant within participants' sexual and social networks. We also calculated total persons, sexual partners and PLWH (including those previously diagnosed) referred per index participant.
resultsA total of 1230 HIV-seropositive persons were randomized to the control arm, and 561 to the intervention arm. Another 12,713 HIV-seronegative or -serodiscordant persons underwent AHI screening, resulting in 136 AHI cases, of whom 94 enrolled into the intervention arm. The intervention increased the number of new HIV diagnoses made per index participant versus the control (ratio: 1.9; 95% confidence interval (CI): 1.2 to 3.1). The intervention also increased the numbers of persons (ratio: 2.5; 95% CI: 2.0 to 3.2), sexual partners (ratio: 1.7; 95% CI: 1.4 to 2.0) and PLWH (ratio: 2.3; 95% CI: 1.7 to 3.2) referred per index participant.
conclusionsCombining three distinct HIV testing and referral strategies increased the detection of previously undiagnosed HIV infections within the socio-sexual networks of PLWH seeking STI care. Combination HIV detection strategies that leverage AHI screening and socio-sexual contact networks offer a novel and efficacious approach to increasing HIV status awareness.
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