Returning HIV-1 viral load results to participant-selected health facilities in national Population-based HIV Impact Assessment (PHIA) household surveys in three sub-Saharan African Countries, 2015 to 2016.

Autor: Saito S; ICAP at Columbia University, New York, NY, USA.; Department of Epidemiology, Mailman School of Public Health at Columbia University, New York, NY, USA., Duong YT; ICAP at Columbia University, New York, NY, USA., Metz M; ICAP at Columbia University, New York, NY, USA., Lee K; ICAP at Columbia University, New York, NY, USA., Patel H; Centers for Disease Control and Prevention, Atlanta, GA, USA., Sleeman K; Centers for Disease Control and Prevention, Atlanta, GA, USA., Manjengwa J; ICAP at Columbia University, New York, NY, USA., Ogollah FM; ICAP at Columbia University, New York, NY, USA., Kasongo W; Tropical Diseases Research Center, Ndola, Zambia., Mitchell R; Westat, Rockville, MD, USA., Mugurungi O; Zimbabwe Ministry of Health and Child Care, Harare, Zimbabwe., Chimbwandira F; Malawi Ministry of Health, Lilongwe, Malawi., Moyo C; Zambia Ministry of Health, Lusaka, Zambia., Maliwa V; ICAP at Columbia University, New York, NY, USA., Mtengo H; ICAP at Columbia University, New York, NY, USA., Nkumbula T; ICAP at Columbia University, New York, NY, USA., Ndongmo CB; Centers for Disease Control and Prevention, Atlanta, GA, USA., Vere NS; Centers for Disease Control and Prevention, Atlanta, GA, USA., Chipungu G; Centers for Disease Control and Prevention, Atlanta, GA, USA., Parekh BS; Centers for Disease Control and Prevention, Atlanta, GA, USA., Justman J; ICAP at Columbia University, New York, NY, USA.; Department of Epidemiology, Mailman School of Public Health at Columbia University, New York, NY, USA., Voetsch AC; Centers for Disease Control and Prevention, Atlanta, GA, USA.
Jazyk: angličtina
Zdroj: Journal of the International AIDS Society [J Int AIDS Soc] 2017 Nov; Vol. 20 Suppl 7.
DOI: 10.1002/jia2.25004
Abstrakt: Introduction: Logistical complexities of returning laboratory test results to participants have precluded most population-based HIV surveys conducted in sub-Saharan Africa from doing so. For HIV positive participants, this presents a missed opportunity for engagement into clinical care and improvement in health outcomes. The Population-based HIV Impact Assessment (PHIA) surveys, which measure HIV incidence and the prevalence of viral load (VL) suppression in selected African countries, are returning VL results to health facilities specified by each HIV positive participant within eight weeks of collection. We describe the performance of the specimen and data management systems used to return VL results to PHIA participants in Zimbabwe, Malawi and Zambia.
Methods: Consenting participants underwent home-based counseling and HIV rapid testing as per national testing guidelines; all confirmed HIV positive participants had VL measured at a central laboratory on either the Roche CAP/CTM or Abbott m2000 platform. On a bi-weekly basis, a dedicated data management team produced logs linking the VL test result with the participants' contact information and preferred health facility; project staff sent test results confidentially via project drivers, national courier systems, or electronically through an adapted short message service (SMS). Participants who provided cell phone numbers received SMS or phone call alerts regarding availability of VL results.
Results and Discussion: From 29,634 households across the three countries, 78,090 total participants 0 to 64 years in Zimbabwe and Malawi and 0 to 59 years in Zambia underwent blood draw and HIV testing. Of the 8391 total HIV positive participants identified, 8313 (99%) had VL tests performed and 8245 (99%) of these were returned to the selected health facilities. Of the 5979 VL results returned in Zimbabwe and Zambia, 85% were returned within the eight-week goal with a median turnaround time of 48 days (IQR: 33 to 61). In Malawi, where exact return dates were unavailable all 2266 returnable results reached the health facilities by 11 weeks.
Conclusions: The first three PHIA surveys returned the vast majority of VL results to each HIV positive participant's preferred health facility within the eight-week target. Even in the absence of national VL monitoring systems, a system to return VL results from a population-based survey is feasible, but it requires developing laboratory and data management systems and dedicated staff. These are likely important requirements to strengthen return of results systems in routine clinical care.
(© 2017 The Authors. Journal of the International AIDS Society published by John Wiley & sons Ltd on behalf of the International AIDS Society.)
Databáze: MEDLINE
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