Globally, HIV testing services (HTS) act as a critical entry point to HIV care, treatment and prevention services. HTS are a central component in PSI’s HIV programs worldwide. Delivered in 28 countries across Asia, Africa and Latin America, these services are offered at community-level and within franchised-healthcare facilitie
High- quality, wide accessibility
To achieve this, we deliver highly tailored HTS to reach populations most likely to be affected by HIV in a given setting. Service delivery models are designed to maximize uptake in these groups, including community-based outreach in specific areas such as bars or workplaces, door-to-door home-based testing, index client testing and HIV self-testing. Our evidence-based demand creation campaigns use culturally appropriate, targeted media and interpersonal communication to increase testing uptake in specific populations.
We strive to offer the highest quality of care in all HIV testing services. All providers received standardized training, in line with local Ministry of Health standards. Ongoing supportive supervision ensures that providers implement services in accordance with standard protocols to ensure clients receive the highest possible quality of care.
Quality service delivery also requires the constant and robust use of data. On a daily basis, we monitor data trends, refining our HTS strategies accordingly and remaining responsive to the epidemic as it changes. In some settings, use of GPS coordinates allows us to understand the geographic trends in case finding. In others, demographic analyses allow us to shift targeting strategies to maximize impact.
Onboarding new HIV clients
As the entry point to HIV care, treatment and prevention services, our HTS programs also work to ensure linkage to appropriate follow-up services. This is a critical point in the life of a person newly-diagnosed with HIV. We work to build systems that support clients as they come to terms with the news of their diagnosis and navigate the many barriers that may prevent their uptake of treatment.
In some settings, we administer antiretroviral care on-site, allowing individuals to start treatment on the same day as their diagnosis. In places where this is not feasible, we engage expert clients who work closely with new clients to help them link to care at a nearby facility. Phone-based follow-up by counselors is also used to encourage linkage and to offer an opportunity to discuss concerns and barriers to seeking care.
When we reach people who are HIV-negative, we use HTS to build access to critical prevention services that can help these individuals remain negative. This includes linkage to voluntary medical male circumcision (VMMC), pre-exposure prophylaxis (PrEP) or appropriate repeat testing. We provide appropriate counseling and referrals to these services.
In all of our efforts, we seek to bring care close to our clients, making it easier for them to navigate the impact of their results.
Marketing knowledge for new products
We also work to bring new innovations in HIV testing to market. HIV self-testing (HIVST) is a new testing approach in which an individual collects a blood or oral-fluid sample, performs the test and interprets the results on their own. HIV self-testing can be directly-assisted by a healthcare provider or completely unassisted. HIVST kits can be distributed at pharmacies, through community-based distribution, at healthcare facilities, or through a sexual partner or peer. In 2016, the World Health Organization issued normative guidance recommending the use of HIV self-testing.
PSI is engaged in significant efforts to evaluate and expand access to HIVST. PSI leads the UNTAID funded HIVST Self-Testing AfRica (STAR) Project in three high-burden African countries – Malawi, Zambia and Zimbabwe. The STAR Project is conducting the world’s largest evaluation of HIV self-testing to date, involving the distribution of nearly 750,000 HIV self-test kits and piloting HIV self-testing models among different populations. The project will generate vital information about how to distribute HIVST products effectively, ethically and efficiently with adequate post-test support services, as well as answer key questions about the feasibility, acceptability and impact of HIVST.
PSI is also working to make high-quality, appropriately-priced HIV self-testing (HIVST) more accessible by shaping the global HIVST market. In 2016, PSI analyzed the HIVST market to estimate its size, to highlight how the HIVST market is likely to evolve, and to identify key constraints to market development. Based on these findings, PSI has issued recommendations to strengthen the HIVST market. More in-depth analyses are currently underway in key target markets.
Making a Difference
PSI and its partners are conducting the largest evaluation of HIV self-testing in Africa to date, which will generate crucial information about how to deliver HIV self-testing. For more information check out: http://psiimpact.com/tag/star-project/