Index testing, including partner notification services (PNS), is a key strategy to identify and support those most at risk of acquiring HIV: sexual contacts, needle-sharing partners, and biological children of newly diagnosed HIV+ individuals.[1] Its implementation is critical to controlling the HIV epidemic and meeting the UNAIDS target that 95% of people living with HIV will know their status. Evidence from Cameroon, Kenya, Malawi, and Mozambique has demonstrated PNS is feasible, safe, and highly effective.[2-6] Additional data suggest PNS improves HIV prevention uptake, linkage to treatment, and sustained engagement in HIV care.[7-9] In December 2016, the World Health Organization issued guidelines recommending that PNS “be offered as part of a comprehensive package of testing and care offered to persons with HIV.”[10] PEPFAR has since supported efforts to bring PNS to scale across supported countries.
I-TECH and the University of Washington have extensive experience in index testing research and programming including direct service delivery; quality improvement; training; policy and guideline development; and monitoring and evaluation. I-TECH promotes evidence-based index testing and counseling strategies focused on reaching recent sexual contacts and all biological children, placing them at the forefront of HIV case identification programs to reach epidemic control.
- Golden M, et al. Partner notification for sexually transmitted infections including HIV infection: an evidence-based assessment. Sexually transmitted diseases. 4th edn. McGraw-Hill; New York, NY: 2007.
- Brown LB, et al. HIV partner notification is effective and feasible in sub-Saharan Africa: opportunities for HIV treatment and prevention. J Acquir Immune Defic Syndr. 2011 Apr 15;56(5):437-42.
- Henley C, et al. Scale-up and case-finding effectiveness of an HIV partner services program in Cameroon: an innovative HIV prevention intervention for developing countries. Sex Transm Dis. 2013 Dec;40(12):909-14.
- Rosenberg NE, et al. Recruiting male partners for couple HIV testing and counselling in Malawi’s option B+ programme: an unblinded randomised controlled trial. Lancet HIV. 2015 Nov;2(11):e483-91.
- Myers RS, et al. Acceptability and Effectiveness of Assisted Human Immunodeficiency Virus Partner Services in Mozambique: Results From a Pilot Program in a Public, Urban Clinic. Sex Transm Dis. 2016 Nov;43(11):690-695.
- Cherutich P, et al. Assisted partner services for HIV in Kenya: a cluster randomised controlled trial. Lancet HIV. 2017 Feb;4(2):e74-e82.
- Myer L, et al. Family matters: Co-enrollment of family members into care is associated with improved outcomes for HIV-infected women initiating antiretroviral therapy. J Acquir Immune Defic Syndr. 2014 Dec 1;67 Suppl 4:S243-9.
- Vreeman RC, et al. Disclosure of HIV status to children in resource-limited settings: a systematic review. J Int AIDS Soc. 2013 May 27;16:18466.
- Walcott MM, et al. Facilitating HIV status disclosure for pregnant women and partners in rural Kenya: a qualitative study. BMC Public Health. 2013 Dec 2;13:1115.
- World Health Organization. Guidelines on HIV Self-Testing and Partner Notification. 2016.
Program Highlights
I-TECH provides technical assistance on the clinical care and treatment of HIV and related opportunistic infections on a continuum that ranges from direct patient service delivery, to training and mentoring health care workers, to the development of national policies and health systems infrastructure. In particular, together with ministries of health and other key stakeholders, I-TECH has developed numerous curricula and clinical mentoring programs to train health care workers to safely and effectively treat patients who have HIV and TB or other opportunistic infections at a level of care commensurate with national and international standards.
I-TECH has also assisted ministries of health to create national prevention and care and treatment guidelines for infectious diseases, which has lead to standardized care and treatment for HIV, including antiretroviral therapy (ART) dosing for adults and children.
Program Highlights
I-TECH’s extensive experience in HIV prevention, care and treatment service delivery, particularly in supporting ART scale up and innovation, make us particular well-suited to support Treat All implementation and differentiated models of service delivery to improve impact. I-TECH recognizes that different clients have different needs and that patient-centered approaches are likely to result in better clinical outcomes and in turn lead to better retention, adherence, and viral suppression. I-TECH has already worked in many countries across PEPFAR to build and support health systems and develop and implement policy at all levels from Health Ministry to local ART centers, and has designed and delivered a broad spectrum of activities to improve service delivery. I-TECH is engaged in supporting Treat All scale-up and piloting DSD models in several countries.
Program Highlights
Key populations (KP) bear disproportionate burdens of HIV infection. Globally, new infections among KPs and their sexual partners account for 36% of all new HIV infections.1 Achieving the UNAIDS “fast track” treatment targets will require a renewed and focused approach to identify most at-risk and vulnerable populations and respond to their specific needs.
Evidence suggests that KPs—notably men who have sex with men (MSM), people who inject drugs, sex workers, and transgender persons—are underserved and face violence, criminalization, ineffective policies that don’t protect their rights, and stigma and discrimination, including in health care settings. This reality prevents KPs from accessing needed HIV prevention and care services, leading to low service coverage, an important driver of ongoing HIV transmission in many resource limited settings. Young women and girls are also increasingly at risk of acquiring HIV. Acquisition of HIV is often associated with the incidence of unintended pregnancies, transactional sex, and gender-based violence.
1UNAIDS, Gap Report, 2016.
Program Highlights
UNAIDS estimates that there are 870,000 new HIV infections among women and girls each year.1 Globally, adolescent girls and young women often lack adequate health care services; access to programs that prevent and address violence; and access to HIV/STI education, testing, and treatment.
I-TECH has worked to increase access and improve health care programs and services for adolescent girls and young women through innovative in-service training in Tanzania, supporting the build of a gender-based violence database in Kenya, building clinician capacity in the Caribbean region, and starting the DREAMS program in Namibia.
1UNAIDS, 2017
Program Highlights
Demand creation is an evidence-based approach that tailors messaging and activities to specific geographic locations and communities for the most effective results. I-TECH works with the ministries of health in Mozambique, Namibia, and Botswana to scale up demand creation activities for HIV prevention, retention, and testing.
Program Highlights
I-TECH’s quality improvement approach emphasizes ongoing assessments of program aims and operations. Country projects apply continuous quality improvement (CQI) strategies targeting both programmatic and management activities. Small-scale, practical Plan-Do-Study-Act (PDSA) cycles are used to construct improvement goals, test proposed changes, and implement adjustments, leading to increased quality of operations, service delivery, and care.
Program Highlights
