Developmental Delay in HIV-Exposed Infants in Harare Zimbabwe
Zimbabwe HIV Self-testing presentation
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Transcript of Zimbabwe HIV Self-testing presentation
HIV Self-Testing to address the testing gap in Zimbabwe
Dr Owen Mugurungi Director AIDS and TB program
Ministry of Health and Child Care Zimbabwe
Status and Future for HIVST Meeting BMGF
Seattle , 27th of February 2015
Background
• Population: 12, 9m • 1, 39 m PLHIV including
170,717 children • HIV Prevalence: 15%, 15-49
yrs. – Female 18%– Male 12%
• General decline in HIV incidence from 1.42 in 2011, 1,07 in 2013 and 0.9 in 2016
• # PLHIV requiring ART in 2014– 1,207,175 (CD4 <500)– 101,106 children
HIV Prevalence by sex, age group 15-49
3Staveteig et al, DHS Comparative Reports, 2013
13% - 76%8% - 69%
In Zimbabwe, only 57% of adult women and 34% of adult men have ever had an HIV test and received results, according to the ZDHS 2010/11
Too few take a test and receive their result
HIV testing uptake
40% 36%57% 66%
0%
20%
40%
60%
80%
100%
120%
Early InfantDiagnosis
Males 15‐49yrs
Females 15‐49 yrs
PLHIV
Don’t Know StatusKnow HIV status
ZDHS 2010/11
Zimbabwe cascade of the UNAIDS 90-90-90 Targets
PLHIV
73%81%90%100%
1,400,000
1,260,000
1,134,0001,020,600
Identified
as Positive
HIV Testing Models
• 1.7 Million HIV tested annually
• PITC provided in 1445 (out of 1625) health institutions
• CITC provided through PSI’s 16 New Start centres & 25 mobile outreach contributing about 23% to the annual national HIV testing outputs
7
Home-Based
• Community through the Campaigns
• Index cases• Door to door• Self Testing
Campaigns plus (+) integration
• HTC + malaria, safe water, non-communicable diseases
Outreach (e.g. mobile)
• General populations
• Key populations
Institutions i.e. workplaces &
Schools• Reach out to
places with concentrated and easy to reach populations
Moving testing: Out of the facility & into the community
Community-Based HTC
HIV Self-Testing Rationale • HIV Self‐testing to complement current HTC strategies (PITC and
CITC) to reach treatment goal • Specific questions/concerns around HIV testing and self‐testing:
• How to promote testing among key populations currently underrepresented in HIV testing and repeat testing
• How to encourage regular repeat testing• How to ensure that people who self –test access treatment and care
services or are linked to HIV prevention, such as Male Circumcision • Evidence to support use of self testing and explore how it could most
usefully be implemented• Potential Social Harms • Cost‐effectiveness • Regulated access to self test kits • Policy support for HIV self‐testing
HIV Self‐Testing Introduction
• OraQuick Advance has been validated for use with oral fluids in Zimbabwe
• HIV Self‐Testing included in the new recently launched HIV Testing and Counselling Guidelines
• HIV Self‐Testing Steering Committee • HIV Self‐Testing pilot study collaboration with PSI/CeSSHAR/RTI – Acceptability – Feasibility – Accuracy – Linkage into care, treatment and prevention
Study Timelines
• Anticipate completion of supervised testing in February
• Observational study to start early March
• Linkage to care data will be available in June
• Results to feed into UNITAID HIV STAR PROJECT planned to start in June