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High HIV Positivity Rates Following Large-Scale HIV Self-Testing Implementation in Zimbabwe, 2018–2020
Introduction: HIV self-testing (HIV-ST) is an innovative strategy to increase HIV case identification. This analysis shares the outcomes of HIV-ST implementation within the Zimbabwe HIV Care and Treatment (ZHCT) project for the period October 2018–March, 2020. Materials and Methods: We extracted HIV...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8021778/ https://www.ncbi.nlm.nih.gov/pubmed/33834013 http://dx.doi.org/10.3389/fpubh.2021.606376 |
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author | Muchedzi, Auxilia Mpofu, Mulamuli Mudzengerere, Fungai H. Bateganya, Moses Mavimba, Tarirai Satti, Hind Dhliwayo, Rumbidzai Zulu, Tinashe Tapera, Talent Samushonga, Tendai Nyagura, Tendai Ncube, Getrude Tafuma, Taurayi A. |
author_facet | Muchedzi, Auxilia Mpofu, Mulamuli Mudzengerere, Fungai H. Bateganya, Moses Mavimba, Tarirai Satti, Hind Dhliwayo, Rumbidzai Zulu, Tinashe Tapera, Talent Samushonga, Tendai Nyagura, Tendai Ncube, Getrude Tafuma, Taurayi A. |
author_sort | Muchedzi, Auxilia |
collection | PubMed |
description | Introduction: HIV self-testing (HIV-ST) is an innovative strategy to increase HIV case identification. This analysis shares the outcomes of HIV-ST implementation within the Zimbabwe HIV Care and Treatment (ZHCT) project for the period October 2018–March, 2020. Materials and Methods: We extracted HIV-ST data for the period October 2018 to March 2020 from the project database and assessed (1) the proportion of reactive HIV-ST results; (2) the concordance between reactive HIV-ST results against rapid confirmatory HIV tests using Determine™ and Chembio™ in parallel; and (3) the monthly contribution of HIV-ST to total HIV positive individuals identified within project. The Chi-square test was used to assess for statistical differences in HIV positivity between age groups, by sex and district; as well as the difference in HIV positivity between the HIV-ST and index and mobile testing strategies. Findings: Between October 2018 and March 2020, the ZHCT project distributed 11,983 HIV-ST kits; 11,924 (99.8%) were used and 2,616 (21.9%) were reactive. Of the reactive tests, 2,610 (99.8%) were confirmed HIV positive giving a final positivity rate of 21.9%, and a concordance rate of 99.8% between the HIV-ST results and the confirmatory tests. Proportion of reactive results differed by age-groups (p < 0.001); with the 35–49 years having the highest positivity rate of 25.5%. The contribution of HIV-ST to total new positives increased from 10% in October 2018 to 80% at the end of March 2020 (p < 0.001). Positivity rates from HIV-ST were significantly different by age-groups, sex and district (p = 0.04). Additionally, index and mobile testing had a higher positivity rate compared to HIV-ST (p < 0.001). Conclusion: The ZHCT project has successfully scaled up HIV self-testing which contributed significantly to HIV case finding. Countries should consider using the lessons to scale-up the intervention which will contribute in reaching under-served and undiagnosed populations. |
format | Online Article Text |
id | pubmed-8021778 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-80217782021-04-07 High HIV Positivity Rates Following Large-Scale HIV Self-Testing Implementation in Zimbabwe, 2018–2020 Muchedzi, Auxilia Mpofu, Mulamuli Mudzengerere, Fungai H. Bateganya, Moses Mavimba, Tarirai Satti, Hind Dhliwayo, Rumbidzai Zulu, Tinashe Tapera, Talent Samushonga, Tendai Nyagura, Tendai Ncube, Getrude Tafuma, Taurayi A. Front Public Health Public Health Introduction: HIV self-testing (HIV-ST) is an innovative strategy to increase HIV case identification. This analysis shares the outcomes of HIV-ST implementation within the Zimbabwe HIV Care and Treatment (ZHCT) project for the period October 2018–March, 2020. Materials and Methods: We extracted HIV-ST data for the period October 2018 to March 2020 from the project database and assessed (1) the proportion of reactive HIV-ST results; (2) the concordance between reactive HIV-ST results against rapid confirmatory HIV tests using Determine™ and Chembio™ in parallel; and (3) the monthly contribution of HIV-ST to total HIV positive individuals identified within project. The Chi-square test was used to assess for statistical differences in HIV positivity between age groups, by sex and district; as well as the difference in HIV positivity between the HIV-ST and index and mobile testing strategies. Findings: Between October 2018 and March 2020, the ZHCT project distributed 11,983 HIV-ST kits; 11,924 (99.8%) were used and 2,616 (21.9%) were reactive. Of the reactive tests, 2,610 (99.8%) were confirmed HIV positive giving a final positivity rate of 21.9%, and a concordance rate of 99.8% between the HIV-ST results and the confirmatory tests. Proportion of reactive results differed by age-groups (p < 0.001); with the 35–49 years having the highest positivity rate of 25.5%. The contribution of HIV-ST to total new positives increased from 10% in October 2018 to 80% at the end of March 2020 (p < 0.001). Positivity rates from HIV-ST were significantly different by age-groups, sex and district (p = 0.04). Additionally, index and mobile testing had a higher positivity rate compared to HIV-ST (p < 0.001). Conclusion: The ZHCT project has successfully scaled up HIV self-testing which contributed significantly to HIV case finding. Countries should consider using the lessons to scale-up the intervention which will contribute in reaching under-served and undiagnosed populations. Frontiers Media S.A. 2021-03-23 /pmc/articles/PMC8021778/ /pubmed/33834013 http://dx.doi.org/10.3389/fpubh.2021.606376 Text en Copyright © 2021 Muchedzi, Mpofu, Mudzengerere, Bateganya, Mavimba, Satti, Dhliwayo, Zulu, Tapera, Samushonga, Nyagura, Ncube and Tafuma. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Public Health Muchedzi, Auxilia Mpofu, Mulamuli Mudzengerere, Fungai H. Bateganya, Moses Mavimba, Tarirai Satti, Hind Dhliwayo, Rumbidzai Zulu, Tinashe Tapera, Talent Samushonga, Tendai Nyagura, Tendai Ncube, Getrude Tafuma, Taurayi A. High HIV Positivity Rates Following Large-Scale HIV Self-Testing Implementation in Zimbabwe, 2018–2020 |
title | High HIV Positivity Rates Following Large-Scale HIV Self-Testing Implementation in Zimbabwe, 2018–2020 |
title_full | High HIV Positivity Rates Following Large-Scale HIV Self-Testing Implementation in Zimbabwe, 2018–2020 |
title_fullStr | High HIV Positivity Rates Following Large-Scale HIV Self-Testing Implementation in Zimbabwe, 2018–2020 |
title_full_unstemmed | High HIV Positivity Rates Following Large-Scale HIV Self-Testing Implementation in Zimbabwe, 2018–2020 |
title_short | High HIV Positivity Rates Following Large-Scale HIV Self-Testing Implementation in Zimbabwe, 2018–2020 |
title_sort | high hiv positivity rates following large-scale hiv self-testing implementation in zimbabwe, 2018–2020 |
topic | Public Health |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8021778/ https://www.ncbi.nlm.nih.gov/pubmed/33834013 http://dx.doi.org/10.3389/fpubh.2021.606376 |
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