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dc.contributor.authorStafford, K.A.
dc.contributor.authorBlanco, N.C.
dc.contributor.authorLavoie, M.-C.
dc.contributor.authorClaassen, C.W.
dc.date.accessioned2020-07-07T19:59:42Z
dc.date.available2020-07-07T19:59:42Z
dc.date.issued2020
dc.identifier.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85086867348&doi=10.1002%2fjia2.25520&partnerID=40&md5=5865bff4e1525b34c05ea0c02bb49fc4
dc.identifier.urihttp://hdl.handle.net/10713/13234
dc.description.abstractIntroduction Current 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. Methods CIRKUITS 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. Results Over 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%. Conclusions Index 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.en_US
dc.description.sponsorshipThe CIRKUITS project was funded by the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) through the U.S. Centers for Disease Control and Prevention (CDC), Division of Global HIV and Tuberculosis (DGHT), and in collaboration with the Ministry of Health of Zambia.en_US
dc.description.urihttps://doi.org/10.1002/jia2.25520en_US
dc.language.isoen_USen_US
dc.publisherJohn Wiley and Sons Inc.en_US
dc.relation.ispartofJournal of the International AIDS Society
dc.subjectdifferentiated careen_US
dc.subjectfinding menen_US
dc.subjectHIV care continuumen_US
dc.subjectHIV testingen_US
dc.subjectindex testing servicesen_US
dc.subjectlinkage to careen_US
dc.subjectsub-Saharan Africaen_US
dc.titleIndex and targeted community-based testing to optimize HIV case finding and ART linkage among men in Zambiaen_US
dc.typeArticleen_US
dc.identifier.doi10.1002/jia2.25520
dc.identifier.pmid32589360


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