Barriers To Optimal Index Testing for Improved HIV Positivity Yield in Lusaka Urban District of Zambia-A Research Protocol

Abstract

As the proportions of people living with HIV who do not know their HIV infection status decrease, reaching the last mile of those who are asymptomatic and not in contact with the health care system becomes a critical challenge. This project will use an explanatory sequential mixed-methods study design. It will be conducted in three high-volume health facilities in Matero sub-district 3 of Lusaka district in Zambia over a period of one year. The specific objectives are: to understand the perceived facilitators and barriers to HIV partner testing from the perspective of the health-care provider; to propose interventions necessary for improved HIV case finding; and to reach high risk but hard to reach populations in HIV programs such as middle-aged men and adolescent girls and young women (AGYW). The permission to conduct this study will be obtained from the Lusaka provincial health office before its commencement. Ethical clearance will be sought and obtained from the ERES Converge research ethical committee. The authority to conduct research will be sought from the National Health Research Authority. The expected main findings following the address of the identified challenges are: increased number of recipients of care indexed, increased index contact elicitation ration from 1:1 to at least 1:2, improved rate of contacts tested on time, improved HIV case finding through index testing, and overall, increased HIV index testing positivity rate from below 25% (baseline) to above 40% (at the end of the project).