Alex Vandy Saffa Bayoh
Conference 2023 Presentation
Reaching epidemic control through Index case testing and partner notification services in Sierra Leone
Authors and Affiliations
Alex Vandy Saffa Bayoh1, Alrine Cole2, Elsa Carew 1,3
1. Department of Pharmacy, College Of Medicine and Allied Health Sciences, University Of Sierra Leone
2. University of Makeni, Sierra Leone
3. Department of Medicine, College of medicine and Allied Health Sciences, University of Sierra Leone
In Sierra Leone, a country of 8.2 million people, about 76,000 are estimated to be living with HIV (UNAIDS), with only 62% knowing their status and 46% on treatment. National HIV prevalence has increased from 1.5 in 2013 to 1.7 in 2019 among adults aged 15-49 with prevalence among adolescent girls and young women two times higher as compared to their male counterparts. Modified and context -specific index case testing (ICT) and partner notification services is found to be the magic approach toward closing the gap in achieving HIV epidemic control. National progress towards reaching the 95.95.95 goal is at 62% and 61% respectively with no valid data available for the 3rd 95. There is a need for an innovative, high impact, cost effective and culturally appropriate intervention to close the gap towards epidemic control.
Clients who are newly diagnosed with HIV (index clients) are asked to voluntarily participate in Index case Testing services by providing the names and demographic information of their sexual partners, biological children and needle sharing partners. The information is captured in the Index form and register and contacts are reached and offered HTS services through the index client’s preferred method of referral for each contact.
Data collected across 30 health facilities in Sierra Leone shows a yield of about 20-25%, with sexual contacts contributing about 70% of the total yield. ICT approach also shows efficiency with lower number of HIV test kits utilization and even lower incidences intimate partner violence as a consequence of community stigma and discrimination.
In a low resource setting with limited health budget coupled with poverty, stigma and discrimination, Cost effective approaches such as high yield index case testing and partner notification services are the best solutions towards achieving epidemic control.