The Challenge of a Changing HIV Epidemic

January 30th, 2018 | Viewpoint


We have come a long way in our response to the HIV epidemic since its beginning. Many critical steps have been made. In the last seven years, new HIV infection rates have dropped almost 30 percent worldwide. During that time, the number of people with access to life-saving antiretroviral therapy (ART) has increased almost threefold.

But it’s still not enough.

The need now isn’t a brand new method of controlling the epidemic, but rather a new way of implementing tried-and-true interventions.

“Something we’ve learned from the HIV epidemic is the importance of asking how we can design services to reach the people not traditionally targeted for HIV services,” said Jackie Sallet, Project Director for the AIDSFree Project.

AIDSFree Reaches the Hard to Reach

One strategy AIDSFree uses to target previously underserved populations is assisted partner notification (APN).

APN is the practice of testing people in the networks of a newly diagnosed patient, also known as the index patient. Public health officials attempt to find family members, sexual partners, and needle-sharing partners of the index patient, those that would be most at risk of acquiring HIV.

“We’re able to reach people who would otherwise not have come in for an HIV test,” Sallet said, “the ordinary people that wouldn’t normally get routine tests until after they felt sick.”

Contacting at-risk individuals allows us to pinpoint people who may be unaware they are at risk of HIV. Finding more cases of HIV creates new opportunities for initiating ART and preventing further transmission of the virus.

Putting it into Practice

In Tanzania, AIDSFree uses APN to test at-risk persons connected to prison and police populations. These groups are often overlooked, even though they are at an increased risk of exposure to HIV. When AIDSFree personnel discover someone within the prison who is HIV-positive, they are able to reach out and suggest testing for that person’s partners.

AIDSFree has seen tremendous results with our testing approaches in Tanzania. New HIV diagnoses within police and prison populations increased 35 percent by the end of 2017 compared to the start of the year. AIDSFree surpassed its annual target of new HIV diagnoses in Tanzania, diagnosing 30 percent more cases than anticipated.

Working Together to Control the Epidemic

A common thread among all AIDSFree partners is the willingness and ability to adapt to the changing epidemic. As a consortium of eight partners, led by JSI Research and Training Institute, Inc., AIDSFree follows patients through the entire continuum of care, from diagnosis and treatment to interventions to help avoid the spread of the infection.

We urge you to do your part to stay aware of developments in the global HIV response. Follow AIDSFree as we continue to enhance HIV prevention, testing, and treatment practices. Discuss the latest HIV testing services and APN news with fellow professionals in our HTS Community of Practice. Keep an eye out for a summary of successful APN policies and practices from around the world that will be published by AIDSFree this spring.

Written by Robert Kueffer

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